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.

Kathy Rich's Red Devil Book

I just finished Kathy Rich's Red Devil book.    It's got some tips for stage IV patients.   I hope it will be reissued at least in electronic form.  In the meanwhile, I'ill pass it on with 4 unaddressed stamped envelopes.

Some notes that I suspect might have made a difference in Ms Rich's incredibly inspirational story of survival (20 years with stage IV breast cancer):
1.   she exercised 45 minutes/day for 5 days/week on stair master.   Some of her oncologists advised her against it due to her extensive bone mets and risk of bone fracture.   She ignored them all for the endophin exercise gave her.    At one point, she went from paralysis to stairmaster in 2 weeks.   Robobabe, yeah.
2.   she is allergic to certain medications and brackish pond water.   Her immune system might have helped her more than we know.
3.   she's an international traveller on her job.    Probably took chloroquinone to prevent malaria.  there's 2 clinical trials that are testing chloroquine:
http://clinicaltrials.gov/ct2/results?flds=Xf&flds=a&flds=b&flds=c&term=chloroquine+breast+cancer&show_flds=Y
If anyone wants to try this, please join the clinical trial.   One of them has a low dose vs standard dose.   chloroquine has very good safety profile.
4.   At one time, she had rapidly rising tumor markers, collapsed vertebrae, was put on cytadren an anti-hormone therapy that is no longer used somehow, an unspecified infection.   Then miraculously she recovered and tumor markers dropped precipitously.   Either cytadren or the infection or both or neither contributed to the miracle.  and cytadren continued to work for 2+ years.
5.   Ms Rich seems to think stress has a lot to do with her cancer.   I'll let you read the book and decide.
6.  Ms Rich survived a stem cell transplant at Duke (standard treatment during that time, chronologically it was hazy, she must have had it around late 1990s, about 5 years after her stage IV diagnosis), and was NED for 3 years afterwards.  Recurrence was in adrenals (before her mets were bone only).   The book ends at this point, Ms Rich  subsequently went to India around 2001, lived for a year and wrote another book.   I haven't read that book yet and don't know whether it dealt with more cancer experience.
7.  Ms Rich is not oligometastatic by many definitions.   She started out with 8 distant bone mets with some large.   But according to her onco, her cancer responded to every treatment they throw on it.   Including chemo, megace, cytadren, possibly tamoxifen too.   She seems to have dropped tamoxifen due to its psychiatric side effect.

Unfortunately, Ms Rich was not here to see the new paper which categorized breast cancers into 10 subcategories.   It's possible that she had the newly discovered subcategory with errors in immune genes and surprisingly good prognosis.    We will never know.    But maybe, somewhere in Sloan Kettering, some scientists have permission to access Ms Rich's tumor sample, and derive some understanding of this phenomenon and one day there will be a cure.

http://scienceblog.cancerresearchuk.org/2012/04/18/increasing-the-resolution-on-breast-cancer-the-metabric-study/

Then Kathy will rest in peace.   Thanks

What can a patient do to help find the cure for cancer?

Childhood blood cancer (a rare disease) used to be more deadly than adult cancer, but now it's 90%+ survival rate. The reason childhood cancer research can make rapid progress is through recruiting every young patients into randomized clinical trials, which help cut the costs and shortened the time frame of drug development.

So, here's how every cancer patient (breast cancer, colon cancer, lung cancer, pancreatic cancer) can help: get genetic tests (like foundation medicine) and get on clinical trials! Look for clinical trials so all your treatments and results can potentially make better treatment in future. Sometimes you will be randomized to the control arm, but it's ok, you are getting the minimum standard treatment.

Every early stage BC patient should consider neojuvant iSPY-2 clinical trial before surgery, and every late stage or metastatic BC patients should consider a randomized clinical trial. Patients make a difference.

What is a cure for breast cancer?

I'm sure doctors have a definition for the word "cure".

Personally, I'd know breast cancer have a cure, if the cure is able to give 95+% metastatic patients a normal life-expectancy, including the liver/brain/lung met folks. By this standard, last 100 years of medicine has made enormous stride in finding "cure"s for a long list of once-deadly diseases:

Bacterial infection (99%), TB(95%), malaria(99%), HIV(treatable, not curable. 90% treatable. but any one remember when HIV is automatic death sentence?), diabetes (95+% nondeadly).

Yes some of them may come back to haunt us later, but fully a generation of patients have benefitted from the cure and enjoying more or less a normal life expectancy.

Compare that with metastatic BC (50-70% dead within 5 years, the survivors have low life expectancy).

If some team figured out a therapeutic vaccine/therapy that will "cure" stage IV BC so that 95+% of stage IV BC patients (including triple negative, liver involvement, brain mets) can have a normal life expectancy, I'd personally pay him $1000 out of my pocket + $1000 from my kids' college fund. I'd give more if I can afford more and everyone should too (remember that cancer cost us a lot more).

I'll write to X-prize and innocentive and ask them whether they will accept funding.