Puzzle Pieces

I just caught the opening of the Seattle Seahawks/Chicago Bears playoff football game. I’ve lived near or in both cities, but I’m only one of those fair-weather fans. Out here, we’re all stunned that the Hawks have gotten as far as they have this year. But after I saw the Bud Light ad, with the guys partying in the oil change shop, I figured I’d be better off writing.

This is a column of updates and more pieces to add to the triple-negative breast cancer puzzle.

First, the personal updates:

I had my last 3-month check-up back in November and everything seems to be fine. That abdominal pain I was having turned out to be – besides another trip on the worry train – just a bladder infection. The naturopath has again tweaked the supplements (add vitamin B, drop the CoQ10). At my appointment with him, we discussed our preferences for martini recipes. He prefers gin with a twist AND an olive. Rumor has it that he’s also been known to eat a Pop Tart on occasion. It’s good to know he’s human.

The chemotherapy port was removed before Christmas, and it’s nice not to have that lump on my chest anymore, even if I had to give up a day of skiing to recover properly. The sacrifice let me finish grading essays for my classes, and I am back to teaching again as of this week. We celebrated my daughter’s 14th birthday, Christmas, and New Year’s, and I managed to trigger a mistrial during jury duty in November, all because of some M&Ms. (More on that story later on my other blog, Firefly.)

Here are the news updates from the Breast Cancer Symposium in San Antonio in December:

  • PARP inhibitors still seem promising in treating patients with metastatic triple-negative disease, and there’s more and more evidence that hormone replacement therapy is tied to the development of breast cancer.
  • Obesity negatively affects survival for those with hormone positive tumors, but not for hormone-negative. (Guess I can start gaining weight now.)
  • In the past 10 years, cases of triple-negative disease have almost doubled in women in Brazil while cases of hormone-positive cancer have decreased, though no one knows why.
  • The FDA has pulled the plug on the use of Avastin – a chemotherapy drug – for breast cancer patients, but Avastin shows greater promise in those with triple negative disease. Avastin is also used in patients with other types of cancer.

 

And now the puzzle pieces.

A recent article in the New England Journal of Medicine charted the overlap between triple-negative, basal and BRCA-1 breast cancers. The authors found that triple-negative tumors can also be basal, but aren’t always. They are also often associated with the genetic defect of BRCA-1, but not always. BRCA-1 (often pronounced Brack-ah 1) is the more serious of the two types of genetic defects found in breast cancer (the other being BRCA-2), and can be implicated in ovarian cancer as well. This article got me wondering whether to look into genetic testing for my situation.

As I mentioned many posts ago, I don’t have much of a family history of breast cancer. (Despite what the media lead you to believe, it’s only about 15% of women who do have that family history.)  It appeared only in my maternal grandmother – somewhere back around 1970, long after she went into menopause.  Like most women at that time, she had a total mastectomy and doctors didn’t know anything about hormone receptivity.  She did not have chemotherapy or radiation and lived another dozen years till her death at the age of 85. This illness has not shown up in any of my close relatives. Given that I come from a Catholic family, there’s a lot of relatives (8 aunts/uncles and about 35 first cousins). The recent research shows, though, that it’s not just a pattern of breast cancer that gives away the genetic problem, but a pattern of prostate cancer too.

A misconception is that breast cancer passes through the mother’s side of a family, but this article from Parade magazine shows that the genetic defect often passes through the male line, showing up as either breast cancer (1970 new cases a year) or prostate cancer. A friend of mine followed her instincts when she received her diagnosis at the age of 41. The docs told her there didn’t seem to be a genetic component, but once she investigated she discovered that her paternal grandfather had died of prostate cancer in his 50s. Not only did the gene pass through the male line to her, but it skipped a generation too.

As screening methods evolve – not just for cancer but any serious health issue — it becomes increasingly important to have as full a picture of your family history as possible. There are a number of online tools you can use to chart that history, like this one from the Surgeon General of the U.S.

And finally, there’s the puzzle of light:

An interview in January’s issue of The Sun magazine spotlights Andrew Weil, M.D. Those of you familiar with his work know that he embraces alternative methods of healing and is based at the University of Arizona. In the interview, he comments on the influence of light on cancer: “One detrimental influence on our sleep is our ability to light up the night, which is a significant change in our environment over the past hundred years. There’s a body of literature suggesting that exposure to light at night, even briefly, greatly increases cancer risk, especially risk of breast cancer in women. Women who are blind from birth have very low rates of breast cancer. Women who work night shifts have high rates of breast cancer.” He recommends that, if you need light during the night, use a red Christmas tree bulb, since light at the red end of the spectrum is safest.

If you’re one of those who hasn’t yet put away the Christmas lights, here’s your excuse.

 

 

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3 Responses to “Puzzle Pieces”

  1. Sue Rickels Says:

    Thanks for the concise, but understandable update on the latest research on triple negative b.c. I enjoy that kind of thing. Also, my thought when they pulled Avastin from the mkt. is this is the beginning of rationing. I think drugs that have serious side effects, are expensive, should be left on the mkt. with black box warnings and lots of layman articles in the news as well as on t.v.

    The minority of folks who have not responded to other treatments for a disorder should make the decision with their doctor (s), possibly a second opinion, as to the risks they are prepared to take with full knowlege of them.

    It’s still amazing how many people die of liver failure each year in the U.S. from acetophetamine (Tylenol) because of ignorance. It is the most widely used form of suicide in the UK.

    So, what’s the deal? The bottom line of lobbyist money, I suppose.

    And where are the media pundits when they do the high drama of drugs being removed and the platitudes on exercise and diet?

    I’m very cynical.

    Good Post!

    Sue

    • Julie Yamamoto Says:

      Thanks for your note soon. Just to clarify, Avastin hasn’t been pulled from the market. It’s still a very effective drug for many types of cancer (including triple negative breast). It’s just that the FDA has decided it doesn’t merit continued use in breast cancer patients in general. The triple negative category is still so new that the best treatment hasn’t necessarily been distinguished from other types of breast cancer. Docs should still be able to use it for patients if they think it’s necessary. But of course the insurance companies will have something to say about that!

  2. Nicole Lascurain Says:

    Hi Julie,

    First off, I came across your site and wanted to say thanks for providing a great cancer resource to the community.

    I thought you might find this useful infographic interesting, as it shows the detailed effects of chemotherapy in an interactive format: http://www.healthline.com/health/cancer/effects-on-body

    Naturally, I’d be delighted if you share this embeddable graphic on https://thepopsiclereport.wordpress.com/2011/01/16/puzzle-pieces/ , and/or share it on social. Either way, keep up the great work Julie!

    All the best,

    Nicole Lascurain | Assistant Marketing Manager
    p: 415-281-3100 | e: nicole.lascurain@healthline.com

    Healthline
    660 Third Street, San Francisco, CA 94107
    http://www.healthline.com | @Healthline


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