Breast Cancer – Fighting For a Cure
CANCER
New Hampshire Union Leader
Alyssa Marcus
Boston University Washington News Service
April 26, 2007
WASHINGTON, April 26 – A breast cancer diagnosis a few decades ago was a very different experience than it is today. Times have changed, and so has this disease that used to not leave much choice for the women involved, and was often a death sentence as well.
“The reality is that every year the drugs get better and chemo gets easier,” said Katie Paine of Durham, whose cancer has been in remission for more than three years.
But obstacles remain for breast cancer treatments, which is why breast cancer survivors and their allies deployed in late April to Capitol Hill to lobby Congress.
Rebecca Gray, the former president of the Vermont-New Hampshire affiliate board of “Susan G. Komen for the Cure,” a breast cancer foundation that is celebrating its 25th year, joined other representatives in taking their message to members of Congress.
Gray, a breast cancer survivor of 10 years, said there are four specific issues that the foundation is lobbying for. The first is to have Congress fully fund the National Breast and Cervical Cancer Early Detection Program, an allocation of $225 million for the next fiscal year. This program, established in 1991, provides low-income and uninsured women with access to services for early detection. Currently, the funding for this program is $204 million.
The foundation also is requesting that Congress spend $5.8 billion for the National Cancer Institute for 2008, or at least a minimum of $5.1 billion, which would be an increase of approximately six percent from the last fiscal year.
The third issue is Patient Navigator Services, a program that helps patients who may have barriers such as language or being uninsured to “navigate” their way through the system of getting breast cancer care, including hospitals, insurance and support organizations. The legislation for this, which authorized $25 million over five years, was passed in 2005. But so far, no funds have been appropriated for the services.
Finally the group is lobbying Congress to amend a 2000 to make more women eligible for care.
Gray said that in Vermont and New Hampshire, the women who fall through the cracks are low-income women. “In lower-income areas of New Hampshire, like the Claremont area, the death rate is much higher than in other areas of New Hampshire,” she said.
For the women who are lucky enough to receive treatment, there are many ways to treat breast cancer, and the treatment a woman receives depends on many variables.
Jacqui Bryan of Rye, whose cancer has been in remission for almost four years, said that one of the best advances in breast cancer treatments is discovering the different “personalities” of tumors.
“What they do is they look at the personality of the tumor and they determine the treatment based on the personality of the tumor,” she said.
Because of this focus on tumor “personality,” Paine and Bryan got different treatments because their diagnoses, although both breast cancer, were not the same.
Until the 1950s, breast cancer treatment consisted of mastectomy, the removal of the entire breast. The lumpectomy, an alternative method that removes the cancer from the breast, was developed and by the late 1980s it—along with radiation—was the standard treatment, according to Dr. Katherine Alley, medical director of the Suburban Breast Center in Maryland
Chemotherapy has also been used since the 1960s. There have been other advances since then, including a number of drugs likeTamoxifen that have been developed over the last 20 years, Alley said.
“In the past five to seven years, aromatase inhibitors have also been a big advancement,” Alley said. “Also, the newer drug Herceptin has now been around for five to seven years.”
A large part of cancer funding goes towards clinical trials. Paine participated in one as part of her treatment. She took the drug Xeloda, which was being tested as a substitute for Taxol, a common chemotherapy drug. The doctors administering the trial kept track of the results, and so far she said, the only difference between her and other women whose cancer is in remission is that she sees her doctor every six months, rather than once a year.
In terms of the alternate drug being the better one, Paine is not sure. “You don’t know until it doesn’t come back for five years,” she says. “But it was easier because it was a shorter period of time, and frankly, what they were trying to see too was what the side effects were, and I did have some side effects… and that tells them something.”
Although Bryan did not participate in a clinical trial as part of her treatment, she did receive the latest in breast cancer treatments, which is a chemotherapy regimen called Dose Dense. The difference between this regimen and the normal one is that with Dose Dense the patient goes in for chemotherapy sessions every two weeks instead of every three. It was relatively new when Bryan was being treated, but it’s now much more common. Shannon Morin of Milford also did Dose Dense only six months ago.
Of course, these advances in treatment have not come without a cost – literally: According to the National Cancer Institute’s Web site, cancer prevention and control would get $572 million in the proposed 2008 budget, which would be an increase of approximately 10 percent from 2007.
Alan Eastman, professor of toxicology and pharmacology at Dartmouth, said there is not enough money for cancer research. “Only ten percent of requests get funded,” he said. “The money has dried up, gone towards other resources. There are too many good ideas going to waste at the moment because there isn’t enough money.”
Paine, Bryan and Morin, three women who have gone through treatment for this disease, agree on two things. One is the fact that doing these tests on women of a variety of ages is a major factor in helping to find new treatments and, eventually, a cure.
“We don’t have much research for people in their 20s and 30s,” Morin said. “Right now, when I talk to doctors, I’m kind of in a gray area because they don’t know much about this age range.” Morin was 27 years old when her cancer was diagnosed in August 2006.
The other is the importance of being proactive. “It can strike at any age,” Bryan said. “It’s not a menopausal woman’s problem anymore. It can strike young, so be aware.”
And early detection is key, Alley said. “The most important thing about curing breast cancer is early diagnosis.”
###
