Ten Years of Hormone Therapy Reduces Breast Cancer Recurrence

My Oncologist, Dr. Daniel Hayes, M.D. is the President of American Society of Clinical Oncology (ASCO) comprising 40,000 oncology professionals who care for people diagnosed with and living with cancer.  It is quite an amazing honor for him and his patients!  ASCO (and every cancer patient around the world) is so fortunate to have him as their President!   Because of my confidence and trust in Dr. Hayes, I have been paying close attention to press releases coming from ASCO about breast cancer care.

The following study was released in June, 2016 about Aromatase Inhibitors and increasing taking them for ER Positive Breast Cancers from 5 years to 10 years to help prevent recurrences. On my last oncology visit, Dr. Hayes warned me to be prepared to take an Aromatase Inhibitor drug for 10 years and also told my sister, Diann, to be prepared to do the same.

Please read the study and MAKE SURE to discuss this with your Oncologist.  If you are pre-menopausal and on Tamoxifen, also talk to your Oncologist about this!

“These data are important to the millions of women around the world with ER positive breast cancer, and suggest that longer durations of widely-available therapy reduce the risk of cancer recurrence, and prevent second cancers from arising,” said Harold J. Burstein, MD, FASCO, ASCO expert in breast cancer. “Ten years of any therapy is a long time. Fortunately, most women tolerate extended treatment reasonably well, with few side effects. Now, women can talk with their clinical team and make informed decisions to extend adjuvant endocrine therapy, or not.”

CHICAGO – A randomized phase III clinical trial, MA.17R found that postmenopausal women with early breast cancer benefit from extending aromatase inhibitor (AI) therapy with letrozole (Femara) from 5 to 10 years. Following five years of an AI and any duration of prior tamoxifen, women who received letrozole for five additional years had a 34% lower risk of recurrence than those who received placebo. The trial was led by the Canadian Cancer Trials Group with participation from the National Clinical Trials Network. These results will be discussed in ASCO’s Plenary Session, which features four abstracts deemed to have the greatest potential to impact patient care, out of the more than 5,000 abstracts featured at the ASCO Annual Meeting. “Women with early-stage hormone-receptor positive breast cancer face an indefinite risk of relapse,” said lead study author Paul Goss, MD, FRCP, PhD, director of Breast Cancer Research at Massachusetts General Hospital in Boston, Massachusetts and Professor of Medicine at Harvard Medical School.

“The study provides direction for many patients and their doctors, confirming that prolonging aromatase inhibitor therapy can further reduce the risk of breast cancer recurrences. Longer AI therapy also showed a substantial breast cancer preventative effect in the opposite, healthy breast.” Overall survival was not significantly different in MA.17R between the two groups but Dr. Goss notes that because of the slow chronic relapsing nature of hormone-receptor positive breast cancer, overall survival has proved difficult to demonstrate in clinical trials. Because of this, most endocrine therapies for breast cancer have gained regulatory approval based solely on improvement of disease-free survival. Patient overall quality of life was comparable between the two groups. Small differences in physical role functioning in favor of placebo was observed but these were not considered clinically significant. “A large proportion of women with early breast cancer are long-term survivors. As hormone therapy is given over a long period of time, measuring how women feel is very important,” said Julie Lemieux, MD, lead author of the analysis of patient-reported outcomes from MA.17R, and a researcher at the Centre hospitalier universitaire de Québec in Canada.

About the Study Data from two related abstracts from the MA.17R clinical trial will be presented at the Annual Meeting, with the first reporting on safety and efficacy outcomes (LBA1 – Plenary) and the second reporting patient quality of life outcomes (LBA506). The trial enrolled 1,918 postmenopausal women who had received five years of any one of three AI therapies either as initial treatment or after any duration of prior tamoxifen. Although patients were allowed to enroll up to two years after completing previous AI therapy, about 90% began receiving letrozole or placebo within six months of completing prior therapy. Patient-reported quality of life was measured using the standard SF-36 questionnaire, which covers various areas of physical health and mental health, and a menopause-specific questionnaire, MENQOL. Of the 1,918 study participants, 1,428 were eligible to complete initial quality of life assessments. These were repeated at 12, 24, 36, 48 and 60 months, with more than 85% of women completing the questionnaires at follow-up. Key Findings Impact on Risk of Recurrence and New Breast Cancer (LBA1 – Plenary):

Women in the extended letrozole group had a 34% lower risk of breast cancer recurrence. The annual incidence of contralateral breast cancer, was lower in the letrozole group than in the placebo group (0.21% vs. 0.49%), indicating a breast cancer prevention effect. At five years of follow-up, 95% of women receiving letrozole and 91% of those receiving placebo were breast cancer free. The five-year overall survival was 93% for women receiving placebo and 94% for those receiving letrozole (not statistically significant).

Quality of Life Findings (LBA506): Overall, there were no significant differences in either overall quality of life or menopause-specific quality of life between women who took letrozole for five years and those who received placebo. Small differences in physical role functioning were detected in favor of placebo but these were less than that considered clinically meaningful.

In 2012, there were more than six million women around the world who survived at least five years after breast cancer diagnosis;1 the vast majority of these women have estrogen receptor-positive breast cancer, and may wish to consider these findings. This study received funding from the Canadian Cancer Society Research Institute, the National Institutes of Health and Novartis. This study received funding from the Janssen Research & Development. View the full abstracts: LBA1 LBA506

For Your Readers: Guide to Breast Cancer Hormonal Therapy for Early-Stage Breast Cancer Side Effects 1 http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/breast-cancer-statistics Accessed May 27, 2016. View the disclosures for the 2016 ASCO Annual Meeting News Planning Team. ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING IS REQUESTED IN ALL COVERAGE. ###

About ASCO: Founded in 1964, the American Society of Clinical Oncology (ASCO) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation.

“In Celebration of” Honoree for Komen – why and how

Several people have asked me to share my Team Hello Courage page for the upcoming September 28th Race for the Cure in NW Ohio.   I would be DEEPLY honored if you would consider contributing any amount however small to Susan G. Komen Race for the Cure for my team, Hello Courage, for the race which I am the “In Celebration of” honoree.   Asking for money is one of the things I like to do least.

TEAM PAGE AND DONATE HERE:   http://nwohio.info-komen.org/site/TR/RacefortheCure/TOL_NorthwestOhioAffiliate?team_id=304769&pg=team&fr_id=4263

Here is why I am committed to this cause:

  • I am alive today because of God’s grace and research dollars generated by Komen.
  • My Oncologist, Dr. Daniel Hayes, is a National Komen Scholar along with 59 other of the best and brightest breast cancer experts from around the world.  Dr. Lori Pierce, one of my mom’s physicians for her recent breast cancer diagnosis, is also a National Komen Scholar.  Here is a list of breast experts who are Komen Scholars:  http://ww5.komen.org/ResearchGrants/ScientificAdvisoryCouncil.html
  • Dr. Hayes told me that almost every breakthrough in breast cancer research in the last 20 or more years has Komen stamped all over it.
  • The hospital where I received and continue to receive treatment, the University of Michigan, has been the recipient of millions of dollars from Komen.
  • The hospitals here in Toledo where I live received radiation have received funding to allow thousands of women who have no insurance or who are underinsured to receive mammograms.

When I got that phone call saying I was chosen from a field of very worthy candidates, terror hit me I must admit.  From watching past honorees on the megatron screen on race day, I wanted to say no, to turn it down, but I knew I could not.  I knew this would give me more of a platform to get my message out to women and men I would otherwise not be able to reach who would not read my Blog.  That message is:  do monthly breast exams, get your mammograms and don’t stop until you die, early detection does save lives (a lesson I learned when my mom was diagnosed Stage 1 at age 80) and fight like crazy if you are diagnosed because if I can do it, you can do it as well!!

Some women tell me that they are tired of pinkwashing and pink ribbons.  Sometimes I am too, especially in October when there are even pink eggs at the grocery store.  But as a Stage 3 Breast Cancer Survivor, I would rather live in a world with too many pink ribbons than live in the world my aunt by marriage lived in during the 1960s after an advanced breast cancer diagnosis.  She had absolutely no one to talk to,  she never even talked to my mom about it who was a close friend, people whispered about her, she endured a mutilating surgery, no treatment options were available then, and she raised 4 children while being totally alone with breast cancer–no computer support, no blogs, no breast doctors, NOTHING.  She lived against all odds and died of something else in her mid-70s.  I often “talk” with her now with tears in my eyes and tell her I am so sorry she had to endure such pain and agony alone.

Komen was surrounded by controversy several years ago about the Planned Parenthood situation.  People were angry no matter what side of the issue they were on.   Komen handled the whole controversy poorly.  I understand how that can happen as I’ve received several emails, some telephone calls, and several friends have confronted me to voice their opinions.  I wasn’t prepared for the onslaught.  Neither was Komen. 

What I found out was there are 117 Komen affiliates in the United States.  Each one is a separate 501C3 organization.  My local affiliate gives 75% of money received for  breast cancer health and treatment programs and 25% to national research.   My local affiliate and the majority of local affiliates around the country, do not fund Planned Parenthood for mammograms as Planned Parenthood in most all or all locations, has no mammography equipment.  My local affiliate funds hospitals to give mammograms to uninsured or underinsured women.  Here is a list of hospitals in the NW Ohio and SE Michigan area that are currently doing free mammography screening to those in need funded by Komen.  http://www.komennwohio.org/about-us/news/upcoming-mammogram-screening.html

National Komen, a separate entity, ONLY gives money to research.  They do not fund local programs or organizations.  National Komen has one objective – money for research to find a cure. 

I would be so appreciative if you would consider a contribution.  If Komen isn’t a charity you can support for whatever reason, please consider giving to another worthy breast charity.

Thanks so much!

Denise

 

 

 

 

 

My Mom Had Breast Cancer at age 80

Many of you have been writing to ask how my mom is doing.  Mom, a very active 80-year-old that can run circles around most 50 year olds, found a lump in her breast and was diagnosed with Breast Cancer.  Thankfully, she listened to me when I asked her if she was doing breast self-exams, did one, and found it.  The doctors were amazed she found the lump because it was rather small, and they had difficulty finding it.  She said that it wasn’t so much the lump but she noticed a difference in her breast tissue – it felt very hard. Thankfully, she knew her body!

Breast Cancer at age 80 with no family history of any kind of cancer was a shock to my mom and our entire family.   But overall, it has been good news for which we are all grateful.

  • Mom’s breast cancer was estrogen positive, progesterone positive, and Her2 Negative.
  • Her lump was 1.7 centimeters – Stage 1, Grade 2.
  • She had a Lumpectomy on June 26, 2014.  It took about 4 weeks for her to feel really good again and be without pain.
  • The Radiation Oncologist and Oncologist presented the facts to mom and me.  No one recommended chemo.  There was an 8% reduction in chance of recurrence if she did Radiation, but she decided against it.  All the doctors concurred that at her age that was the best decision.
  • She is awaiting results from the Dexi Bone Density Scan to see if she can start Arimidex.  I am hoping she can tolerate it because Arimidex cuts your risk of recurrence by up to 50%.

Breast cancer is still breast cancer at whatever age, whatever stage, and is extremely frightening and devastating.   The fear of recurrence is present no matter what, and it is something you have to learn to coexist with on a daily basis.

My mom’s post-lumpectomy breast looks no different from her before breast cancer breast.   It is not sunk in, has no deformity, and other than the 2.5 inch scar that is already starting to fade, that fact is quite amazing to me.   A surgeon’s experience plays into this greatly.  I am always preaching to women to make sure they go to a BREAST SURGEON that only does breast surgeries.  Dr. Jessica Bensenhaver, the surgeon who did my mom’s Lumpectomy, is at the University of Michigan.  I asked Dr. Bensenhaver how many breast surgeries she did in the past year.  Her response, “I have done over 300 this year and did over 300 the previous year.”    That is a lot of experience.  It is also extremely beneficial to have surgery at a cancer center that has the ability to test the tumor margins while the patient is in surgery.  This greatly lessens the chance of having to have yet another surgery to clear those margins!

Studies show that women who have had surgery by a breast surgeon have less rate of recurrence than those who had a general surgeon.  That is certainly something to consider and take seriously.

Thank you for your thoughts and prayers for my mom.  We are all grateful.  And make sure you tell the elderly women in your life not to stop getting those mammograms!

 

 

 

Choosing the right Oncologist for you, trusting your Oncologist, and other Oncologist observations

The most important thing I’ve learned thus far in Breast Cancer treatment is you must have the right Oncologist for you.  Sometimes the choice is made for you, and other times you do the choosing.  But whatever way you and your Oncologist end up being a cancer-curing team, make sure it is a good match for you.

How do you find the right Oncologist when you are so overwhelmed with all of the intricacies of a cancer diagnosis?

1)    Start asking other people especially any nurse or doctor friends you may have.   If this isn’t possible, assign someone you know who may be connected in this area to get information on area Oncologists.

2)   When you have your list narrowed down, research the Oncologist.  See where they went to undergraduate school, medical school, where they did their residency, and fellowship.   This is extremely important.

3)  If you live in a small town and your medical resources are limited, consider making an hour or more drive to find someone better qualified.  Even though this is very inconvenient, in the long run, it will definitely have its payoffs.

4)  On your first meeting with your Oncologist, have a list of questions ready for him/her.   If you are not comfortable with him/her for any reason, seek out the advice of another Oncologist.

5)  Make sure they have a positive attitude about the treatment of your cancer.  I have an acquaintance who was diagnosed with Stage IV Breast Cancer.  Oncologist #1 told her “Go home, get your things and children in order, and be prepared to go to Hospice”.  She and her mom weren’t buying that answer.  Oncologist #2 said, “Don’t worry, we will aggressively treat your Breast Cancer”.   She began dense dose chemo and within 2 months the metastases in her lung and liver were gone!  She is now 3 years No Evidence of Disease (NED).   What a difference an Oncologist makes!

6)  Along those same lines, if you have a Stage III or Stage IV diagnosis, you visit an Oncologist and are given a bleak outlook for your future, consider making a trip by plane or automobile to a major cancer center like MD Anderson in Houston which is the #1 Cancer Center in the USA.  Here is a list of the top cancer hospitals in the United States by US News & World Report:   http://health.usnews.com/best-hospitals/rankings/cancer          If you cannot continue treatment there, at least you will have a valued second opinion.   These centers will also recommend places for treatment closer to your home.  This visit can mean your life.   Personally, I know numerous people who are alive today because they made the trip to a major cancer center.

7)   To me, the staff at my Oncologist’s office is extremely important.  The Nurse Practitioners, the nurses, and office staff are also keys to your healing.  A well-trained office staff speaks highly about the care you will receive from your Oncologist.

8)  If you start with your Oncologist, don’t trust him/her, have bad feelings about them, look for another Oncologist.  THIS IS YOUR LIFE!  If your intuition is speaking to you that this Oncologist is not a good match for you, keep looking!

I am extremely fortunate to be treated by Dr. Daniel F. Hayes, Director of the Breast Oncology Program at University of Michigan Breast Cancer Care Center one of the top breast cancer centers in the country.  My confidence in him is 100%.  It makes a huge difference in how I feel about my cure rate.  He is  extremely credentialed.  Plus, an expert in the field of Her2Neu which is a marker in my breast cancer.  He has written countless published research about it.  What pride I have to call him my Oncologist.

Not only do I trust him, but he knows how to handle me emotionally.  When I told him I felt like giving up he said:  “Oh no you’re not.  I will not let you.”

When I told him I have no control over my life, he said with a laugh:  “That’s because I am controlling your life now.”

And when I asked him for an extra week off between chemo drugs he said:  “No negotiations.  But I can’t fault you for trying.”

Then he sat down, held my hand in a doctorly fashion, and told me I was doing far better than I realized, my blood counts were up, I have been strong and courageous, and that he was proud of me and my progress.  Then he made me laugh with a joke!   Here is an Oncologist who knew the right things to say, who cares about my whole person, and not just the cancer.

His responses were right for me.  They gave me more strength and courage to continue on this rugged road.   He instills confidence in my ability to heal and not have a recurrence.  That is priceless.  I want you to have that relationship and feeling of confidence in your Oncologist.  It is imperative!

University of Michigan Breast Care Clinic

I have only been a patient at the University of Michigan Breast Care Clinic in Ann Arbor, Michigan for three weeks.  But it has been an incredible, intense three weeks.  The care I have received thus far has been unlike anything I’ve experienced.  Their comprehensive approach really calms you as a patient and lets you know the experts are handling it.

For example, I received a call from my Nurse Practitioner today on her day off from her home to tell me the results of my bone scan and CT Scan.  There were some question marks on the tests, so I have to have an MRI next week.  Their entire approach is, “Don’t worry, if it is something, we can handle it. We will postpone surgery and start chemotherapy. We have chemo that can target it.  And they always tell you about another patient who is doing well after dealing with the same thing two years or five years or 20 years later.”   They bring comfort, support and encouragement always in the name of healing.

When you go to the University of Michigan Hospital, I decided it is like the Walt Disney World of Medicine.  It is like living in Tomorrow Land.  Have you been to Disney?  If so, you know the amazing, organized way they move thousands of people through their intricate system. University of Michigan Hospital does it with their patients.  And like Disney, the employees always have a smile on their face and are willing to help you.  If you stand in a corridor for 30 seconds and look the least confused as to where you are, a minimum of three employees will stop and ask if they can help you.  That means something to a patient.

The biggest thing I have received is the support.  Don’t worry, we can target that specific area, we have drugs that will help that, just relax and enjoy your life.  Let us handle the rest.  And so I am.

Check out my new ONLINE STORE:   cropped-cropped-cropped-logofb.jpg

UPDATE:   I have no been a patient there for over 4 months through surgery and chemo.  My opinion has only gotten better of University Of Michigan Breast Care Clinic and Hospital.  It is an amazing place!   One Chemo Nurse told me their philosophy is they never give up on a patient.

FURTHER UPDATE:  It is close to a year since my treatment began at University of Michigan.  I cannot say enough good things about my treatment there.