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Targeted treatments wage war on breast cancer
Elizabeth Harden recently saw a patient in her 80s whose breast cancer metastasized, or spread to her bones, seven years ago. The woman is doing well and has not required additional chemotherapy during that time. She's not cured but she's living a good quality life.
"Fifteen or 20 years ago, we could not have offered that," says Dr. Harden, a medical oncologist certified in blood and cancer diseases. She's been with Virginia Oncology Associates for 17 years.
The woman's story is just one example of the many improvements made in breast cancer treatment, as well as detection and options.
How has breast cancer treatment changed? The most striking change is the move toward "targeted therapy." Regular chemotherapy kills rapidly dividing cancer cells but also good cells, especially bone marrow. We've learned that breast cancers are not all the same and now we can treat the specific kinds.
What's new with breast cancer-prevention drugs? Tamoxifen, around for 30 years, is now joined by Evista. Both block the growth of estrogen-sensitive breast tumors. Evista was first developed for osteoporosis treatment in women who couldn't take estrogen replacement but studies found those olden women were not developing breast cancer as expected. Evista was recently approved as a breast cancer prevention drug in post-menopausal women whose family histories and other risk factors indicate they need it. Tamoxifen and Evista are both taken in pill form and there is no hair loss or nausea with either. They are in a class of estrogen-blocking drugs known as selective estrogen receptor modulators.
In addition, there's a class of Aromatase inhibitors, called "AIs," that interfere with the body's ability to produce estrogen, which many breast tumors feed on. These are used in postmenopausal women.
A "wonderful drug" is Herceptin, which is used intravenously for aggressive breast cancers with a certain genetic makeup; about 15 to 25 percent of all breast tumors fall into that category.
Lifestyle tips for women? Stay fit and maintain a healthy weight.
Career: Medical oncologist for 17 years with Virginia Oncology Associates, 1051 Loftis Blvd., Port Warwick III in Newport News; www.virginiacancer.com or 873-9400.
Education: Medical degree from Duke University.
Family: Husband Richard Hoefer, physician and medical director of Sentara CarePlex Hospital's cancer program. His mother, Dorothy, donated money for the new Dorothy G. Hoefer Comprehensive Breast Center located at Sentara Port Warwick health campus in Newport News. Dorothy, 94, lives in New York; her sister died of ovarian and breast cancer and her step-daughter died of breast cancer in her 30s.
Online: Read more about cancer research and treatments through the National Cancer Institute at www.cancer.gov