Monday, April 30, 2012

Why I am hopeful of a cure of breast cancer


2 years ago, I had a mammogram that was fine.   So i was comfortable enough to get pregnant in my 30s.   midway through pregnancy, an aggressive IDC is found.   My experience illustrate the inherent limitation of mammograms and screening and awareness. Throwing billions of well intentioned donations won't fix these limitations.   The only way to cure breast cancer is to cure the stage IV patients.
    
Government research budgets are being cut these days.   Yet I am hopeful for the cure for metastatic breast cancer.   Here are why:
1. Examples of highly effective and highly targetted drugs like xykori for small minority of ALK positive lung cancer patients, like gleevac and Herceptin.
2. TDM-1 is recycling an old highly toxic chemotherapy drug and attach it to Herceptin for better delivery and targetting of cancer cells. There are many cytotoxins that kills cancer cells, but majority are eliminated during phase I because of unacceptable toxicity. Imagine a future, where every subtype of cancer patients can use any toxins effectively delivered to cancer cell without systemic toxicity.
3. At the same time, cost of genomic analysis are dropping. When genomes can be effeciently sequenced at <$10000 (it is now!), there's no excuse not to collect the tumor samples and run sequence and collect information to better target. Old clinical trials for all drugs can potentially be re-evaluated for information on which subset of people responds better to certain therapies.   Not just the drugs that has 50% clinical response rate, but also the ones with 25%, 10% even 5% response rate.   Each may work 100% for a very small population, and they can be made available to this population. That's why it's important that patients donate their samples and clinical records to make sure good data is available in future.
4.  2 words: Stem cells.   Imagine a future where every liver/lung/brain metsters can grow their own organ from purified stem cells and retransplant.
5.   research in metastasis and immune system, in high throughput genomic sequencing and other fundamental research.  Even stage IV patients will benefit because if their current tumor is stopped from further metastasis, then the current tumors can be surgically removed and their chance for life will be significantly improved.   What is lost in government funding needs to be replaced by private funding.    And people need to be careful about what they fund but must not stop the funding.

I don't want to read more costly studies like "a needle in the ocean is an environmental factor in breast cancer occurence", I don't want to see more awareness/screening/education campaigns that costs billions of dollars, or pay $3000 for a commercial BRCA1/BRCA2 test that gives me minimal information.

If every patient participate in 1 noninterventional research study and share 1 patient record and participate in 1 well targetted interventional clinical trials and donate 1 spare tumor sample, I have no doubt there will be a 95% cure for Metastatic Breast Caner and other Metastatic Cancers in 5-10 years.     When 95+% of the metastatic patients, including liver/brain/lung metsters and triple negative patients can look forward to living a normal life span, then we can save all the money spent on awareness, education, mammograms and go home and live without fear.

5 comments:

  1. Your story mirrors mine. I was also diagnosed at 36, but I was misdiagnosed during the pregnancy with breast cysts, cloggeg ducts, and I believed them. It wasnt until a year after when I was pregnant again that I screamed for a biopsy and they found the2.5 cm er, pr luminal b aggressive tumor:(

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    1. Please keep me posted of your situation. Do you have a blog? we are cancer twins!

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  2. Thanks for sharing your story. The similarity is uncanny! We are cancer twins.

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  3. No ,I dont have a blog. I will send u my google email address.
    Scarlett

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  4. Look into the news about the development of a bcl3 inhibitor in the UK. Very interesting and promising. I am srh242 in breastcancer.org
    Scarlett

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