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Detection, treatment of breast cancer has come a long way

Research buoys cancer detection, treatment

By Ben Sutherly, Staff Writer Updated 8:49 PM Friday, October 16, 2009

October is Breast Cancer Awareness Month. This article is part of our month-long focus on breast cancer. To learn more or find ways to help, go to our Pink Edition Page.

DAYTON — Clinical trials have been key to improving methods for detecting and treating breast cancer, and Dayton has been in the thick of many of them.

“The only way to make progress in cancer care is through clinical trials,” said Stuart Merl, associate principal investigator of the Dayton Clinical Oncology Program. The nonprofit research consortium, one of several across the country, serves not only the Miami Valley, but communities as far away as Findlay and Indianapolis.

Currently, the program has 25 studies in which breast cancer patients may take part, he said, more than for any other disease.

Some past clinical trials with heavy local participation have been significant. In the 1990s, for example, 190 women from the area took part in two nationwide trials involving tamoxifen, an antiestrogen pill now widely used to reduce women’s risk of a recurrence of breast cancer.

Treatments administered to patients after tumor removal can be improved upon, partly explaining the large number of clinical trials for the disease, Merl said.

Also, many drugs exist for the treatment of breast cancer. The potential for combining them in new ways provides fertile ground for additional clinical trials, he said.

Here’s a look at some recent and expected advances in the detection and treatment of breast cancer, and in helping survivors cope with the disease’s side effects.

Treatment

Within three years, therapies tailored to a patient’s specific needs will likely be far more common, accounting for perhaps the most significant near-term advance in treating breast cancer, said Lynne Ayres, senior director of cancer research at the American Cancer Society’s Ohio division.

“Ten to 20 years ago, breast cancer was breast cancer, and everyone got the same treatment,” said Dr. Carol Sawmiller, director for breast cancer services for Kettering Health Network. “It’s becoming standard to really treat each woman’s cancer individually.”

Similarly, the software used in planning radiation treatments continues to evolve and improve, said Dr. Rebecca Paessun, radiation oncologist with Dayton Physicians LLC.

In 2005, a study that Paessun helped design began. It is comparing whole breast irradiation with accelerated partial breast irradiation (APBI).

Standard whole breast irradiation is usually delivered daily, Monday through Friday, for three to seven weeks. APBI, however, is delivered twice a day for five days, for a total of 10 treatments. It’s viewed as a potential plus for women in terms of convenience.

Image-guided radiation therapy is another relatively new technological advance in treating the disease. It may help reduce radiation exposure to adjacent organs, particularly the heart and lungs, though it’s expensive, Paessun said.

Studies are under way to determine conclusively whether maintaining a healthy weight and eating a low-fat diet can be effective not only in warding off cancer, but in preventing its recurrence in survivors.

Increasingly, Ayres said, the message of the future may be, “If you don’t want to get a recurrence of cancer, you need to get the weight off.”

Detection

Since November 2007, Greene Memorial Hospital in Xenia has offered patients breast-specific Gamma imaging. Like magnetic resonance imaging (MRI), breast-specific Gamma imaging focuses on the metabolic activity of breast tissue, potentially honing in on an area of concern undetected by a mammogram or ultrasound.

Another priority: finding effective ways to diagnose breast cancer without putting women through invasive biopsies, said Dr. Paula Termuhlen, medical director for the high-risk breast cancer center at Miami Valley Hospital South and associate professor of surgery with Wright State Surgical Oncology.

Experts are also honing their early detection focus as they learn more about which women are most at risk for developing the disease, Termuhlen said.

Side effects

Advances are letting more women be candidates for oncoplastic techniques, or a combination of cancer and plastic surgery to preserve the breast, Sawmiller said.

Some research is even focusing on breast-cancer survivors and the side effects of their treatment.

“Now that we have so many women surviving breast cancer, they’re being studied so we better understand what those side effects are so we can better manager them,” said Termuhlen.

Pneumatic compression garments and even liposuction, for example, may help treat a condition called lymphedema, a swelling in the arm or breast after treatment, Termuhlen said.

Joining the research

Breast cancer patients wishing to participate in a clinical trial may ask their cancer doctor, contact DCOP at (937) 395-8678, or go to www.med.wright.edu/dcop

In January, DCOP will relocate from 3525 Southern Blvd., Room 230, in Kettering, to 3123 Research Blvd.

Contact this reporter at (937) 225-7457 or bsutherly@DaytonDailyNews.com.

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Detection, treatment of breast cancer has come a long way

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