Previously published in Examiner
We have made remarkable advances in the treatment of breast cancer over the years with the use of surgery, radiation, chemotherapy, drugs, and healthy diet. Screening measures have also improved; but still, medical doctors are not sufficiently able to predict the final diagnosis of any patient. You can say that this prediction is left to God, or if you are not religious, it is simply beyond the grasp of modern medicine.
According to a an article published by CTV News, Dr. Lorne Brandes states that even the patients who are in exactly the same stage of tumor growth and spreadability will have different outcomes in terms of cure and fatality rates. The truth is that these tumors do react differently to treatment.
Some breast cancer tumors have lots of hormone receptors and these tumors respond well to antiestrogen drugs such as tamoxifen or the newer class of aromatase inhibitors. These tumors occur because of the sex hormones estrogen and progesterone. On the other hand, other tumors do not have the receptors for estrogen and progesterone. These tumors are not as predictable as the estrogen/progesterone triggered ones. They do however, respond to chemotherapy treatment. Tumors known as HER2 account for about 20 percent of all breast tumors. They don’t have estrogen/progesterone receptors and they spread rather rapidly. Recently, doctors have been using the HER2-targeting drug Herceptin in combination with chemotherapy to eradicate these tumors with some degree of success.
There is another type of cancer tumor which does not have estrogen/progesterone receptors or HER2 receptors and they are called triple-negative. If they don’t come back after two to three years then they are cured; however, many of them do come back even with the treatment of radiation and chemotherapy.
Because of all these factors, choosing the right treatment is often an uphill battle for doctors; the type of tumor, the stage and grade of the tumor, makes proper diagnosis so difficult to begin with and the prognosis even more elusive.
A study published in Nature states, “We have been given a whole new road map of the biology of breast cancer; with it comes the ability to more accurately predict the behavior of individual tumors. This breakthrough was made by a consortium (known by the acronym METABRIC) of Canadian- and U.K-based. cancer researchers led by Drs. Samuel Aparicio of Vancouver’s British Columbia Cancer Centre and Carlos Caldas of the Cambridge Research Institute.”
According to the study which examines the different clusters of abnormal genes, the group found that Breast cancer is not one, but 10 different diseases! Each subtype exhibits unique genetic (and, therefore, biological) characteristics.