Body of Knowledge Full-Frontal Assault
An attack on BREAST CANCER has brought about greatly improved treatments—but are we on course to stop it entirely?
by SAMANTHA DUNN /illustration by DAN WINTERS
Twenty-six years ago, in the wake of Tamoxifen—the first major drug used to treat breast cancer—October was deemed National Breast Cancer Awareness Month. But I’m probably like millions of women who don’t need a special month to make me think of the disease. Let’s just say I learned this anatomy connection the hard way: If your hand feels a lump in your breast, your knees will go weak.
The year was 1994, and I was in my twenties. Back then, as today, the Centers for Disease Control and Prevention listed breast cancer as the most common form of cancer in American women, along with skin cancer, and the second leading cause of cancer-related deaths in women. If you got the diagnosis, on your treatment menu was a mastectomy or lumpectomy, some radiation...and a few Hail Marys.
Statistically speaking, as a twentysomething white woman, the odds were on my side that it wasn’t malignant. According to the U.S. National Cancer Institute, 1.9 percent of women aged 20–34 will be diagnosed with breast cancer, and mortality rates for that age group are .9 percent. Still, when the doctor told me it was merely an easily removable cyst, I felt lucky. When it’s your breast and your life, statistics offer small comfort.
Today I’m in my mid forties, and once again a lump has been found, this time through a routine mammogram. The American Cancer Society heads the long list of institutions that recommend the yearly test for women 40 and over, despite last year’s much ballyhooed report of the U.S. Preventive Services Task Force that advised delaying mammograms until 50, because false positives are more common in women 40–49, and reducing routine mammograms to every two years.
Once again, the tumor in my breast turned out to be benign, a fibroid my doctor says is better left where it is for now. But this time around, I’m slightly less lucky—first because the formation of these fibroids signals my increased risk for developing breast cancer and, second, because the older you get, the more your risk goes up.
Unlike when I was younger, the disease now has a real face for me: Breast cancer looks like the brown-eyed woman I was chatting with at a concert, who had a double mastectomy at 38; like my beautiful British friend Kate, who is in her second round of chemo at 51; like Melissa Etheridge, Christina Applegate, Edie Falco, Suzanne Somers and two of the original Charlie’s Angels, Kate Jackson and Jaclyn Smith. I can’t help wondering when my luck will run out and the face of breast cancer will include the one staring back at me in the mirror.
If in the future I’m among the faces of breast cancer, the good news is that the vast majority of women who are diagnosed with the disease today don’t die from it. The bad news is it’s still a gamble, because no one can predict which ones will die. (Mortality statistics are a convoluted mass of percentages on which even the experts are fuzzy).
“The hope for women has dramatically improved in the last decade. Improvement data keeps moving at almost light speed compared with other cancers,” says Dennis J. Slamon, director of UCLA’s Clinical/Translational Research and the Revlon/UCLA Women’s Cancer Research Program at UCLA’s Jonsson Comprehensive Cancer Center.
“It’s a bold statement,” says Slamon, “but I think it’s true—breast-cancer research has led the field of oncology.”
Slamon is a pioneer in this field, much laureled for heading the team that turned the tide for one in four women—between 40,000 and 45,000 each year—with breast cancer who test positive for Human Epidermal Growth Factor Receptor 2, otherwise known as HER-2, a gene that produces too much of a growth-promoting protein.
A HER-2 diagnosis had been, before Slamon came along, the genetic lottery ticket no one wanted. Death was the likely prognosis within two to three years. Now, Herceptin, developed in conjunction with work being done in Slamon’s lab, targets the genetic mutation that causes the protein to go wild and blocks the cancer’s power supply.
As a result, those women with a HER-2 form of cancer have gone from some of the worst prognoses to the best. “Too many women a year still die,” says Slamon, but he and his research team believe the numbers of those who do will continue to go down. And to that end, Los Angeles itself has been a major-league player in changing the odds.
Researchers nationally and through the world—at the Cleveland Clinic, the Mayo Clinic and Sloan-Kettering in New York, among many others—have substantially advanced the understanding of both the nature of the disease and treatments for it. But L.A. is unique for having powerful research institutions like UCLA, USC/Norris Comprehensive Cancer Center and NCI’s City of Hope and for being the very public stage of the world’s entertainment nexus. The combination provides a megaphone for world-renowned voices such as Susan Love, MD, MBA, clinical professor of surgery at UCLA’s David Geffen School of Medicine, president of the Dr. Susan Love Research Foundation and author of the seminal work for any woman facing the disease, Dr. Susan Love’s Breast Book.
Competition for funding can be fierce here, but Love says L.A.—and California as a whole—is “more open to new ideas and approaches. The expansive landscape does lead one to big ideas.”
No one knows that better than Slamon. In the late ’80s and early ’90s, he found nothing but dead ends for funding, and colleagues doubted his theories about HER-2. “We owe a huge debt to the greater Los Angeles community for the success we’ve had in combating breast cancer and other cancers,” he says.
Lilly Tartikoff Karatz—then wife of the late Brandon Tartikoff, former head of NBC, who was suffering a form of Hodgkin’s disease—came to know Slamon’s work when he helped in her husband’s treatment. Impressed, she brought her entertainment connections to bear, raising millions far quicker than any government grant could. It led to the creation of the Revlon/UCLA Women’s Cancer Research Program with Revlon CEO Ronald Perelman and brought public awareness to unprecedented levels.
“A lot of money comes into the laboratory and moves back into the community very quickly,” says Slamon, who doesn’t much resemble Harry Connick Jr., the actor who portrayed him in a 2008 Lifetime Original Movie, Living Proof, which dramatized his efforts to develop Herceptin.
What has been learned in the study of HER-2 and the development of Herceptin has widened the understanding of cancer as a whole. Cancer is not one thing. There are different types of tumors and different causes for them. “It’s a bold statement, but I think it’s true—breast-cancer research has led the field of oncology,” says Slamon.
Slamon believes we’ll see a day when breast cancer will be, if not cured, only chronic. And because of earlier detection and advances in radiation and chemotherapy, plus targeted treatments like Herceptin, endocrine therapy and gene therapy, it won’t cast a lethal shadow. “There are people alive today who barely remember there was such a thing as polio,” he notes. “We can’t wait for the day when we won’t need a Breast Cancer Awareness Month.”
“Competition for funding can be fierce here, but Susan Love says L.A. is ‘more open to new approaches. The expansive landscape does lead one to big ideas.’ ”
Joanne Mortimer—director of the Women’s Cancers Program and vice chair of medical oncology and therapeutics research at City of Hope, one of 44 National Cancer Institute centers around the country—agrees the landscape for breast cancer is different now than it was a generation ago. Understanding has evolved; researchers are now aware of at least seven types of tumors, with another 10 possible subtypes.
“The more we understand, the more we know that treatment is not a one-size-fits-all proposition,” Mortimer says. “Personalized medicine is somewhat of a kitsch phrase, but the fact is, how my body responds to a disease and treatment is different from how your body responds. We’re working for the time when treatments will be better tailored to the specific types of the disease and the people who have them.”
Mortimer says women’s fear of breast cancer outsizes the actual numbers of those who succumb to it. While the Centers for Disease Control and Prevention lists heart disease as the number one killer of women 65 and older and lung cancer as women’s most lethal cancer, she notes a recent survey found 30 percent of women think they will die from breast cancer.
Truth is, roughly 200,000 are diagnosed with this cancer every year, and estimates are that about 40,000 actually die from it. In a population of 307 million, that doesn’t seem high in the abstract, but when you think of it in terms of a population the size of Culver City filled with moms and daughters and sisters, the number feels more pressing.
Breasts are the symbol of our femininity. “Everyone knows of a young woman who was taken by the disease or a mom who died and had to leave her children,” Mortimer says. “Those stories rip your heart out.”
Despite the advances yielded by the more than $4 billion spent on breast-cancer research, there are still gaping holes. For one, says Mortimer, “We still can’t kill the cancer cells that kill the patient—women with metastatic cancer don’t get cured.”
Susan Love is among the most vocal calling for a shift in the way research is focused. Because 80 percent of breast cancers originate in the ducts, the Dr. Susan Love Research Foundation concentrates its efforts there.
“We still have no idea what causes the disease or how to prevent it,” says Love, who has become a major women’s health advocate by not being shy. “For a variety of reasons, all the emphasis in research has been on treatment, which, while it has saved many lives, has caused significant side effects in many women.
“It is time to put as much effort as we have into treatment toward prevention and finding the cause. A good example is cancer of the cervix. Thirty years ago, we were doing total hysterectomies, with a resulting loss of fertility, to treat abnormal Pap smears. Now we have a vaccine. In breast cancer, we are still removing normal body parts (breasts and ovaries) to prevent the disease, because we don’t know what else to do! We need to go beyond risk factors, which explain only about 30 percent, to finding the cause. Could it be a virus? Wouldn’t surprise me.”
Love notes that another big paradigm shift is the new understanding from basic research showing that cancer requires not just a mutated cell “but also an environment that is egging it on.”
As she explains, “Around 30 percent of women are walking around with dormant cancer cells that are causing them no harm. If, however, the local tissue or systemic environment changes—think obesity, hormones, stress—they can become activated. This new thinking of what’s called cell stromal interaction starts to explain how things like exercise might prevent disease and recurrence.”
Meanwhile, some days I swear I can feel that fibroid getting bigger, and I start to wonder...and worry. The exploding possibilities with new treatments, the investigations into the cause of the disease—how does this all translate to my everyday life? It seems today’s woman needs to become her own health advocate to sort through all the options. Will another quarter century go by before we know the answers that will make this type of cancer an artifact?
“I do think we will have the cause and how to prevent it figured out before 25 years,” Love says. “There is no reason we can’t be the generation that stops this disease once and for all.”
Categories: Feature Story / Health+Wellness
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What is worrisome to me is that local MDs treat the disease differently than an MD at a research hospital.
Do your self a favor, get more than one opinion and one should be from a research MD.
Posted by: southoc | 10/14/2010 at 07:04 AM
Readers should know they can help at home. Check out IBM's "World Community Grid" and Stanford University's "Folding at Home" on the internet. Both let your home computer contribute to important medical research.
Posted by: karina | 10/19/2010 at 07:43 AM
Ms. Dunn: Congress and the NCI and the NIH are not the savior for cancer victims but the problem. They have had almost 40 years now to solve this problem. They have squandered over $100 billion public and private dollars, up to a trillion by some estimates, but cannot even tell you what cancer is, let alone how to cure and prevent it in the human body. The $100 billion figure came from a fairly recent NYTimes article.
All approved orthodox cancer treatments are life threatening, so if a patient dies while under treatment, they could have died either from the cancer or the treatment or both; most die from the treatment but are falsely reported as having died from the cancer to protect doctors from legal liability. Most of the time an autopsy, let alone a true and objective one, is not performed to prove how the patient died. It is usually speculated they died from cancer when most of the time it is from treatment or effects of failed treatments approved by the cancer generals of the war on cancer over the years.
Most people do not want to read the books and articles which document the above statements. They would rather put their heads in the sand and pretend that our government is our savior when it is, in fact, the villain. The drug companies have corrupted the government agencies. Much is known about cancer and has been known for a very long time but most of it has been obstructed and denied by the cancer generals who have been corrupted by MONEY of pharmaceutical companies who have been looking in the wrong direction for answers; namely a genetics solution to cancer.
It has been known since 1923, based on scientific facts and experiments in the laboratory, for animals, that cancer is caused by respiratory impairment or oxygen deficiency over a long period of time or the wrong energy supply to living cells. This was discovered and proved by a genius level medical doctor and scientist in Germany Otto Warburg, M.D., Ph.D. It has been checked by numerous others around the world. It has been proved for human cancers by about the 1950’s-1960’s. We basically know how to prevent most cancers and this information has been known for decades but denied by the cancer generals of the United States. The problem is that once cancer develops in the body for some time it is irreversible, and so simply the addition of oxygen will not cure it. It must be killed or excised or destroyed without destroying the host. If you kill the host you kill the cancer and that is about the crude level the cancer generals are at and have been at for decades. There is no money for pharmaceutical companies in preventing cancer is there? They want a patented pill to do the job that they can sell, through doctors, to unwitting patients. But they have not been able to find one that works because they have denied science and not followed the scientific method and have obstructed and lied about the basic work of Otto Warburg, M.D.,Ph. D. in Germany.
All cancer cells metabolize by a process called anerobic glycolysis. All normal cells metabolize by the respiration of oxygen. This is how they obtain their energy most of the time with a few exceptions. But cancer cells switch to operating on sugar mostly in the absence of oxygen. This has been given a disease name cachexia, a wasting disease which produces lactic acid inside the body which must be recycled at the expense of the fat and muscle and other tissues of the host. All cancer patients exhibit this to a greater or lesser degree and this is the experimental proof, for all to see, of the basic scientific discovery of Otto Warburg, M.D., Ph.D., in cancer many decades ago for animals, and then humans. Otto Warburg published over 500 scientific papers and books on cancer and other subjects he worked on; most scientists and medical doctors today have violated the scientific method by not reading his works and obstructing and lying about them because they have been brainwashed by the failed cancer generals that genetics is the cancer answer, when genetics theories and speculations have not only failed now for decades, they have killed many patients and caused untold suffering of patients.
The answer to cancer is not some miracle cure, but prevention. But prevention is not dangerous and expensive mammograms or drugs like Tamoxifen which themselves can cause cancer. Prevention is following some relatively simple rules of life, avoiding things like radiation from microwave ovens or television sets, avoiding certain chemicals like food preservatives and others which are known to cause cancer, and doing those things necessary to aid the immune system of the body in fighting off cancer before it becomes a raging firestorm that cannot be controlled. One can also supply the body with essential fatty acids, a component of all cell linings, to aid in oxygen transfer before cells have become irreversibly malignant. There is no miracle cure and likely never will be. That is the lesson the the past nearly 100 years of cancer research if you take the time to read about it, and not be brainwashed by the criminals running the failed war on cancer.
Another point is that it has been known since 1969 that Vitamin C at high doses kills cancer cells by forming hydrogen peroxide in them. Humans do not manufacture Vitamin C. Most animals do. A goat makes about 13 grams of Vitamin C per day. This is why humans must take Vitamin C supplements or eat foods containing Vitamin C regularly to maintain enough Vitamin C in the system to control cancer because Vitamin C is not produced in humans, but moves out of the body quickly. This is a simple solution but he cancer generals have criminally denied and obstructed it. All our government approves is 60 milligrams of Vitamin C to prevent scurvy.
Not only are the government agencies not the cancer answer, they are the criminal problem and all the cancer generals should be fired and” prosecuted for medical quackery, fraud, scientific misconduct and crimes against humanity. Here are a few references: Each references contains numerous others sometimes hundreds. Reading and thinking are difficult; but allowing oneself to become brainwashed is the easy way out which most people choose.
“The Hidden Story of Cancer” by Brian Peskin, E.E.. with ‘Amid Habib, M.D., Pinnacle Press, Houston, 2006-2010.
“The Cancer Industry” by Ralph W. Moss, Ph.D., Equinox Press, N.Y., 1996, first published as “The Cancer Syndrome”, 1980, and also 1989.
“Cancer and Vitamin C Therapy for Patients” by Reagan Houston, M.S., P.E., Townsend Letter for Doctors and Patients, Aug./Sept., pp. 92-96, 2007.
“The Truth About Hydrazine Sulfate-Dr. Gold Speaks” by Joseph Gold, M.D., www.hydrazinesulfate.org.
“Cancer-Its Cause, Prevention, and Cure” by John P. Dobbins, Sc.D., Cytobiologische Revue, No. 3, pp. 123-134, 1985.
Here is what the only person in the world who has won two solo Nobel Prizes chemistry (1954) and peace (1962) said about the war on cancer in 1989 on the book jacket of the above book by Ralph W. Moss, Ph.D.:
“The revelations in this book about the ways in which the American people have been betrayed by the cancer establishment, the medical profession, and the government are shocking. Everyone should know that the ‘war on cancer’ is largely a fraud, and that the National Cancer Institute and the American Cancer Society are derelict in their duties to the people who support them.”
Linus Pauling, Ph.D. The ignorant non representatives in Congress are also responsible for this dismal patent medicalfailure of our time. Cancer treatment is the biggest medical scam in the world today thanks to the dismal failure of Congress to take action and discipline the criminals running the cancer agencies. Ms. Dunn, how long would you continue to pay someone who failed for 40+ years?
Winfield J. Abbe, Ph.D., Physics
150 Raintree Ct.
Athens, GA 30607
wjabbe@aol.com
Posted by: Winfield J. Abbe | 10/19/2010 at 06:59 PM
Breast and prostate cancer are caused by dairy products. Read the China Study by Campbell for scientific fact rather than opinion.
The life you save could be your own.
Read why you have not heard this before.
Posted by: Reliable information | 10/25/2010 at 12:00 AM
And what about prostate cancer? The death rate from prostate cancer is just a tad less than from breast cancer, but the funds for prostate cancer research are pitiful. Why is that? Why no prostate cancer awareness month, no blue ribbons? Sexism much?
Posted by: RTC | 11/02/2010 at 06:32 AM
For breast and prostate cancer all are advised to consult the China Study book by Campbell.
The two are tied in that the way to help prevent the two are deleting the use of dairy products.
My PSA went from 1 to 2. I elimiated dairy and returned to one.
Please read the book your self which compiles the results of a lifetime of clinical research available at amazon.
May God Bless You.
Posted by: William Franklin | 11/03/2010 at 11:47 PM
Thank you very much for the post. This is a pretty good post. Keep posting such interesting topics. Cheers.
Posted by: skin cancer treatments Los Angeles | 12/18/2010 at 09:53 PM
Go Organic & get the Hormones out of your food. Get off beef & dairy, they are the worst offenders in injecting hormones into cattle & milk cows to make them bigger and produce more milk. This really increases their profits at your expense.
Posted by: Rusty | 01/21/2011 at 11:59 AM
check out the iodine protocol at breastcancerchoices.org. increase your iodine levels and breast fibroids decrease.
Posted by: tirz | 01/29/2011 at 10:06 AM
"And what about prostate cancer? The death rate from prostate cancer is just a tad less than from breast cancer, but the funds for prostate cancer research are pitiful. Why is that? Why no prostate cancer awareness month, no blue ribbons? Sexism much?"
-- RTC
I agree with RTC, why this discrimination?? Why is prostate cancer not seen as much of a threat??
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