PULLMAN, Wash. – I have an elderly aunt who was diagnosed with breast cancer many years ago. She was treated and remained cancer-free for years. But I also had a next-door neighbor who got the same diagnosis. She was treated, but succumbed to the disease not too long after.
My experience is not unique. Those of us who have been around the block a few times know people who have survived breast cancer and people who have died from it. Why the differences in results from person to person?
Part of the reason is that breast cancer is really several different diseases. There are four major types of the disease, with variations in those four categories. The four major types have the challenging names of basal-like, luminal A, luminal B and HER2-enriched.
Recently researchers announced a step forward in studying the different types of breast cancer, a step toward coming up with better treatments down the road.
Matthew Meyerson is one of the authors of a major paper published in the journal Nature. He is a researcher with the Dana Farber Cancer Institute in Boston. He talked to National Public Radio about a project he and many other researchers completed studying 825 breast cancer patients.
“We basically studied the genomes of breast cancers from each of these women in comparison to the genomes of the rest of their bodies,” Meyerson said to NPR.
As more knowledge about cancers accumulates, treatments can evolve in a positive direction. For example, certain genetic mutations may be behind basal-like breast cancer and ovarian cancer, especially in certain women. For them, it may be that future treatments could use ovarian cancer drugs for breast cancer treatment.
In the language of these matters, patients and researchers alike hope for a “silver bullet” that could be used in treatment, a medication or therapy plan that would make all the difference in survival rates. But Meyerson cautions that recent research, while promising, is a long way from anything like a silver bullet.
“I think in the end, to treat cancer, we’re going to be developing a lot of specific silver bullets, but we’ll need to use them in combination,” he said.
The lead author on the published study also used the metaphor of silver bullets. He said the disease is complicated, but progress is being made.
“The bad news is that (breast cancer) is complicated. And we have to figure out which bullet is to be used, where and when,” said Charles Perou of the University of North Carolina, speaking with NPR.
Unfortunately, it may be years before treatment is changed. That’s often the way with science: good work on the research frontier may come years before practical applications are developed for real-world difference in things like medical treatment. That’s the case in part because research must run down many avenues simultaneously, some of which will yield fruitful results and some of which simply won’t.
“(Doing) genomic screening, that’s not the end goal,” said Fran Visco of the National Breast Cancer Coalition. “That is simply a tool, a step on the way to figuring out how to save lives.”
Visco is brutally honest about where we stand with respect to breast cancer treatment and the recent research.
“We have to be careful what we celebrate. And we have to be careful what we consider to be a success. We are nowhere near success,” Visco said to NPR.
Starting with an optimistic frame of mine, Perou said he thinks the new research might translate into treatment differences in two to five years. The most likely scenario is that treatment would first change for luminal breast cancer, the most common type. That’s the case because it has comparatively few mutations.
According to the American Cancer Society, about 40,000 women die each year from breast cancer. That makes the malignancy second only to lung cancer in terms of deadly effects. Let’s hope the treatments for breast cancer improve at a record-breaking pace.