Beating The Odds
Finely tuned diagnoses and targeted drugs are creating optimism about surviving breast cancer
The crowd applauded wildly and wouldn't be quieted. The overflow audience in the Orlando hall was clearly grateful for what it had just heard. One person described it as "mind boggling," another as "jaw dropping," and several said they were on the verge of tears. "It was a Rolling Stones concert in terms of crowd response," says George Sledge, who was onstage. "Truth to tell, I had a hard time keeping my composure at the end."
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But this was no rock concert. Not even close: It was the annual meeting of the American Society of Clinical Oncology, and Sledge, chair of the society's cancer education committee, was leading the discussion at a special session tacked on to the program at the last minute. The topic: a handful of studies looking at a new use of Herceptin, a breast cancer drug previously used to buy time for women whose cancer had spread elsewhere in the body. It was now being studied for use in the early stages of a particularly aggressive form of breast cancer that affects about 50,000 women a year, fully a quarter of women diagnosed with the disease. The Orlando session was the premiere for the kind of hard data that can turn skeptical oncologists into enthusiastic fans.
The researchers onstage got the Mick Jagger treatment for good reason. Herceptin helped a group of women with a specific type of cancer who previously had dim hopes. Science was able to single out these women, but it could offer little help beyond standard treatment. The new research showed that adding the drug to chemotherapy cut the recurrence of cancer by more than half. Put another way, that means that after four years, 15 percent of the women treated with chemo and Herceptin had a recurrence, compared with 33 percent of women treated with chemo alone. "This means major improvements in survival," says Robert Morgan, an oncologist at City of Hope Cancer Center in Duarte, Calif. The drug, he says, will immediately be used in the new way.
These women are not out of the woods yet. But the further good news for them is that the Herceptin findings come on the heels of other exciting developments in breast cancer treatment, including new and promising drugs and even news about therapeutic behavior changes, including diet. Add that to a growing understanding of the basic biology of breast cancer and incremental progress in treatment that has been made over the past few years, and the prospects for decreasing the mortality rate further are excellent. "This is a time for huge optimism," says Claudine Isaacs, an oncologist at the Lombardi Comprehensive Cancer Center at Georgetown University.
Challenges. Yet while there have been huge strides in treating breast cancer--the 10-year survival rate is now about 75 percent and will no doubt climb with the new treatments--challenges remain. A major one is pinpointing women with particular variations of the disease and matching them to the appropriate treatment. As drugs are given to women in earlier stages of their disease, the potential for harmful side effects must be even more carefully considered. And the array of new treatment options means more potential for confusion--and a greater need for women to be more assertive about getting the treatment they need.
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