For women facing a breast cancer diagnosis, the question no longer has to be, “How long do I have?” but rather, “How are we going to cure this?”
“We deal with this every day,” said Dr. Jorge Diaz, hematologist/oncologist for Clearview Cancer Institute. “We have a lot to help, regardless of their stage. We can cure them. Many times we tell them, ‘We know we can cure you, the question is, how are we going to do it?’
“Sometimes they feel hopeless, they feel like they don’t have anything when they hear that they have metastatic disease or stage IV. Many patients hear that and think they have six months or less to live. I try to explain to them that’s not true, particularly for the patients with breast cancer, that’s absolutely not true. We have a lot to offer, not only treatment wise, but support wise.”
Over the past 10 years a lot has changed in regard to the treatment of breast cancer, according to Diaz, changes that have especially ramped up over the past two years, as targeted therapies and genomics have played an increasing role.
Take, for instance, patients with HER2-positive cancer. While chemotherapy drug Herceptin is often used, the Food and Drug Administration has approved the use of T-DM1 for some patients.
“It’s like a smart missile,” Diaz said. “It’s an antibody, just like Herceptin, that is linked to a payload that delivers chemotherapy just where it needs to go. We’re improving on the amount of drug that goes in there, decreasing the toxicity to the patient.”
Thanks to advances in genomics, some patients may find they don’t even need chemotherapy, because a diagnosis is no longer generalized as simply “breast cancer,” with a one size fits all approach to treatment.
“We’ve gone beyond that – the genomic profile, the mutations that a particular tumor has, tell us a lot about its biology,” Diaz said. “Genomic tests give us recurrence scores, and that helps us determine what patients will benefit from early stage breast cancer, and which ones don’t need it.
“For a patient with a 2 centimeter tumor in the breast with no lymph node involvement, many years ago we used to say everybody would get chemotherapy. Now we send that tumor for genomic tests and we determine will they really benefit from chemotherapy or maybe they don’t need it. The biology of the tumor helps us understand more; it tells us a lot. We’re trying to do less where we can, and for the patients who really need help, we have a wider array of things to offer.”
The best part for patients in the Tennessee Valley is they don’t have to travel far for treatments thanks to CCI’s nine locations across North Alabama. Diaz noted that oftentimes a patient will seek a second opinion, only to find everything they need is offered at CCI.
“What we have here is state-of-the-art,” Diaz said. “Everything that is out there, specifically for breast cancer patients, we have available here.”