When confronted with the diagnosis of cancer, persons are generally overcome with a deep sense of despair. Furthermore, when one is told, “the cancer has spread”, there is often significant compromise in one’s ability to think logically, ask the right questions, seek out the best treatment options, and make informed and measured decisions in keeping with the cancer’s specifics and the patient’s unique circumstances.

Up to one in two people will be diagnosed with cancer during their lifetime. Cancer is the second leading cause of death worldwide. Because of the ubiquitous nature of cancer, I have decided to dedicate this space over the coming weeks to some breakthroughs for a spectrum of cancers. This week is dedicated to female breast cancer.

One out of every eight women will develop BrCa during their lifetime. The majority of cases occur in women over the age of 45, and approximately 5% of cases occur in women under the age of 40. It is the number one cause of cancer deaths in women. Unfortunately, the mortality rate in Black women is 40%, primarily because of the higher prevalence of the more malignant triple-negative subtype. This subtype has a relatively high tendency to relapse and metastasize (spread). BrCa has been linked to hair dye, hair straighteners, a sedentary lifestyle, alcohol usage, being overweight, hormone replacement therapy, red meat consumption, eating processed foods, and genetics. It is critical that the subtype of BrCa is specifically identified in all cases so that customized and personalized treatments can be administered when treating the patient’s BrCa.

Below are some recent advances in breast cancer research which will translate into significant improvements in its prevention, detection, management, and prognosis in the coming years.

Pembrolizumab an injectable immunotherapy, when combined with chemotherapy has been shown to increase the patient’s survival time by up to 40% in advanced triple-negative BrCa.

Scientists at Mount Sinai School of Medicine have developed a therapy that successfully targets and eliminates the stem cells for triple-negative BrCa. This compound 108600, is also effective in destroying stage 4 and chemotherapy-resistant cancer cells. While not currently routinely used to treat breast cancer, this exciting new treatment is likely to be available in the proximate future for treating a subtype of BrCa that disproportionately affects Black and premenopausal women.

A Memorial Sloan Kettering Cancer Center study showed that trastuzumab deruxtecan halted tumour growth in the majority of HER2-low breast cancer patients.

A novel therapy, differentiation therapy, transformed BrCa cells so that they were no longer resistant to radiotherapy or chemotherapy.

ERX-41 is a synthetic oral compound that has shown significant promise in preclinical trials when used to treat triple-negative BrCa and other solid cancers. Human trials will be conducted in 2023.

Researchers at Queens University Belfast have started work on an mRNA vaccine against the highly aggressive triple-negative BrCa.

Liquid cytology which aims to detect BrCa at a very early stage via a blood sample took a big leap forward in 2022.

3D ABUS uses an advanced ultrasound system to aid in the early detection of BrCa, especially in women with dense breasts. 3D ABUS is intended to complement mammography.

Recently diagnosed breast cancer (BrCa) patients should attend their doctor with a close family member or friend, and below are some questions that need to be asked:

• Is the BrCa triple-negative? If not, what type is it?
• How far has the cancer spread? What is the stage of the BrCa?
• What was the size of the BrCa?
• Is there a need for additional tests?
• Are all the tests that are needed available locally?
• Are the best treatment options available locally? If not, what’s not?
• Would radiotherapy be needed? If yes, where can such be accessed?
• Can copies of all the reports be provided?
• Does the biopsy specimen need to be sent (overseas) for additional tests?
• Is there any additional type of treatment that can be beneficial even if it means having to travel or pay to bring it into the country?
• Are other doctors going to be involved in my treatment?
• What are the possible side effects of the proposed treatments?
• Is a second opinion locally or overseas recommended?

Prostate cancer will be covered next Friday.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale. For appointments: clinic@familycaresvg.com, 1(784)570-9300, (Office), 1(784)455-0376 (WhatsApp)

Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper, or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.