With cancer,one size doesn't fit all
Jeannie Armstrong, National Post · Mar. 24, 2011

Question: Why are treatments and outcomes for breast cancer so different for each patient?

Answer: Breast cancer is not one kind of cancer. Research has identified multiple subtypes of breast cancer. Each subtype has a different genetic signature and requires individualized treatment.

No two breast cancer patients have an identical disease, says Dr. Tak Mak, director of The Campbell Family Institute for Breast Cancer Research at Toronto's Princess Margaret Hospital.

"There are perhaps six,seven or eight different subtypes of breast cancers. No longer can we treat breast cancers as if they are one type. One-size-fitsall is no longer possible," Mak says.

His research focuses on identifying new genetic targets for breast cancer. "The human body contains 22,000 genes.Cancer can mutate in as many as 18,000 of them,making the disease very complex," Mak says.

Understanding the genetic signature of each breast cancer subtype is the first step in developing targeted drug therapies.

Herceptin, a targeted drug developed by UCLA's Dr.Dennis Slamon,has boosted survival rates for HER2 positive breast cancer patients.

"Now we have found a genetic link between basal or triple negative breast cancer and ovarian cancer," says Mak. This discovery could lead to anew drug capable of treating both devastating diseases.

The sobering reality is that anew drug takes about 20 years and $1.5 billion to develop.

"With cancer affecting one out of two men and one out of three women, we have no choice but to push on, looking for new leads,new ideas.The battle will go on."

FAMILY TIES

Breast cancer hit Terry Becker's family with a vengeance.The Vancouver resident,her mother,two aunts and sister were all diagnosed with breast cancer within fiveyears.

The cancer subtype and treatment varied with each woman. "We're all cancer-free. We're all survivors," says Becker.

At first,Becker could not even talk about her disease,let alone ask questions. "It was like a monster living under the bed.I was afraid to look."

Surgery brought her out of denial. She became an internet expert, devouring information from the B.C. Cancer Agency and the Canadian Breast Cancer Foundation.

Becker now urges friends and colleagues to be "breast aware" and be screened regularly. She reaches out to other breast cancer patients, funding a breast cancer walking club at Vancouver's Ridge Meadows Hospital.

RESEARCH MATTERS

MJ DeCoteau was 22 when her mother passed away from breast cancer.While researching her own risk factors,she discovered alack of programs for younger women.

In 2001, DeCoteau established Rethink Breast Cancer, an organization dedicated to women in their 20s, 30s and 40s.

"Our goal is to pioneer cutting edge breast cancer research, support and education that really speak to young women," says DeCoteau.

"We are funding the next generation of brilliant young breast cancer researchers who are showing creativity and productivity very early in their careers."

Since its founding 20 years ago, the Breast Cancer Society of Canada (BCSC) has raised over $10 million for breast cancer research.

BCSC funds transitional research, promoting interaction between scientists and physicians. "Researchers work hand-in-hand with the diagnostic and treatment physicians, so they can adjust the research to meet the current needs of the patient," says BCSC Director Marsha Davidson.

"Research is making the difference. The chance of surviving this disease is close to 90 percent, especially if caught early."

JEANNIE ARMSTRONG

editorial@mediaplanet.com

FACTS

• Since the the mid-1990s, breast cancer death rates have declined in all age categories, and in all ages combined.
• Basal breast cancer is often referred to as "triple negative" because it lacks estrogen and progesterone receptors and has normal amounts of HER2 protein. Triple negative represents 10 and 20 per cent of breast cancers, most often striking young, premenopausal women and black women.
• When young women get breast cancer, it often spreads more aggressively, leading to tougher treatments and lower survivor rates. The good news is,when caught in its earliest stages, the five-year survival rate for women ages 20 to 39 is almost 90 percent.

Courtesy of Breast Cancer Society of Canada,

The Princess Margaret Hospital Foundation,

Rethink Breast Cancer