Thursday, March 31, 2011

Prostate v Breast : A Cancer Decision

Medicare has announced today that it will cover the $93,000 cost for men who suffer from advanced stage, incurable prostate cancer. The new drug, Provenge, is said to extend the lives of these patients by four months.

WASHINGTON – Medicare officials said Wednesday that the program will pay the $93,000 cost of prostate cancer drug Provenge, an innovative therapy that typically gives men suffering from an incurable stage of the disease an extra four months to live.
The Centers for Medicare and Medicaid said the biotech drug made by Dendreon Corp. is a "reasonable and necessary" medicine. The decision ensures that millions of men would be able to afford the drug through the government-backed health care coverage.

Women with advanced stage breast cancer are being denied Avastin, a lifesaving drug, by Medicare and many other insurance carriers because the FDA has declared  it is ineffective in treating late-stage breast cancer and only offers a few extra months of survival which does not outweigh the cost and risk of the drug.
Avastin delayed the worsening of the cancer by only one to three months, according to the FDA decision rescinding its approval for breast cancer.

The Verdict

Prostate cancer drug prolongs a man's life for four months: covered. Breast cancer drug prolongs a woman's life for three months: denied.

Wednesday, March 30, 2011

Confessions of a Content Farm Animal

A girl's gotta do what a girl's gotta do, you know?

Anyone who has been a reader of this blog or the forums of No Surrender, knows that money is tight. It is for everyone, not just non-profits. But take a small non-profit and put it up against one of the big guns and the donation dollars can be doled out just so much. We may be small, but our work is tremendous. That is something that makes it all worth while. However, to keep things up and running and helping women from all over the world, it takes money. So, a couple of months ago I became a Content Farm Animal.

Here I am, a published author with a wonderful book that has rave reviews and is changing the lives of breast cancer survivors, stuck in a crowded pen on a Content Farm. It sure goes against the glamorous image of a writer. People think that once you get a book published you turn into millionaire. Not quite. You get the book published, you go on speaking engagements, book signings, etc., all for free. No one covers the transportation costs or the outfits you must wear on television. You learn that you cannot wear the same thing twice on TV, and it has to be a certain color, fabric, etc. You also learn that there is no hair and makeup at the studios, and you had better cover that yourself if you don't want to appear on screen looking like What Ever Happened To Baby Jane. It costs money. Your own money. At every speaking engagement, however, copies of the book are sold. I sign them for the women who buy the books from my publisher, who then keeps the money from the book sales.

This glamorous lifestyle and the rising costs of running the Foundation are what led me to the Content Farm.

When I wrote for magazines, before print media went belly up, I earned money for my articles. Good money. Maybe that is why print media has gone the way of eight track tapes. There is simply no more money. Moo-ove over old media, the Content Farm is here.

What the heck is a Content Farm? They are huge websites who "hire" writers to write articles within a very specific parameter that you must adhere to. The topics are built on search engine key words. They comb Google or Bing for questions the average web user poses. The following are actual titles you can choose from:

"Projects Using Mountain Dew Bottles"
"How to Find a Surveyor's Boundary Pin"
"How to Use Solderless Crimp Terminals"
"Can You Get Dog Urine Stains off Ceramide?'

The Content Farm Animals, also known as freelance writers who previously worked for print media and are now competing to write about dog urine, race to "claim" their assignment. If you are lucky, you get it before someone else snatches it up. Depending on the topic and how much research required and the sources that must be cited, it can take anywhere from two to five hours to write an "approved" article. There are Content Farm Hands who handle the Animals and they are very, very precise when it comes to the proper documentation of Mountain Dew Bottles. After approval, your article appears on the humongous website and you are paid. The fee? If you calculate the time it takes to research, write, document, edit and submit: $2.35/ hour.

Published writers, with advanced degrees, are fighting over articles that pay them no more than $15 a piece.

This is the New Depression. Times are tough out there. We are in at least three wars. Gasoline is $4 a gallon. Health insurance, for those of us with pre-existing conditions, is astronomical. And we live under the constant threat that if we are late with  one payment we lose it.  As if that wasn't enough, when you have rent to pay, websites to run with the rising costs of servers, bandwidth fees, file uploading charges, and the escalating costs for maintaining your lifesaving programs, a Solderless Crimp Terminal starts to look pretty darn tempting.

Monday, March 28, 2011

At What Price Prevention?

The UK Independent printed an article today based on a study from The Lancet. It proposes that women with dense breasts be prescribed endocrine therapy to prevent breast cancer from occurring.

Women with dense breasts are at higher risk of developing breast cancer. However, not all women develop hormone responsive cancer, so taking a drug such as Tamoxifen or Arimidex to prevent it, would not protect them.

Ask any woman who is on an aromatase inhibitor, like Arimidex or Femara, or on a drug like Tamoxifen, and they will most likely share with you a list of side effects that they have to live with in order to prevent their cancer from recurring. What's more, to take a aromatase inhibitor, a woman must be post menopausal. Does this mean we put young women into premature menopause so they can take these drugs to maybe reduce their risk of getting breast cancer?

There are risks associated with these drugs including blood clots, uterine cancer, bone loss, body aches, fatigue, weight gain and depression.  Spend the money making baseline breast MRIs affordable for young women, Before the age of Forty, to detect tumors while still tiny in dense breasts. But don't destroy the quality of life for a healthy woman on the chance she will get hormone responsive cancer.

From the UK Independent

Breast cancer could be curbed by preventive drug treatment

By Jeremy Laurance, Health Editor
Monday, 28 March 2011
The soaring rate of breast cancer in Britain could be curbed if drugs to prevent the disease were offered to women in the same way that statins to lower cholesterol are offered to people at risk of heart disease, a panel of experts has concluded.

One in 10 women in the highest risk band would benefit, they said. Trials of newer drugs currently under way could eventually see preventive treatment offered to as many as half of all post-menopausal women.

The 12 international experts met in Switzerland last year to review the latest evidence and have published their conclusions in a consensus statement in Lancet Oncology today.

They draw a parallel with statins for the prevention of heart disease which have been in widespread use for more than a decade and are taken by millions. But the use of drugs to prevent cancer is in its infancy and is still unfamiliar.

"The idea of preventing cancer with drugs seems quite alien," said Professor Jack Cuzick, the chairman of the expert panel and Cancer Research UK epidemiologist at Queen Mary, University of London. "But if someone came to a clinic with high cholesterol and was told 'Come back in a year and we will check you again' you would think that was mad. Yet that is what we do with cancer."

The equivalent of cholesterol levels in cancer is the density of the breast tissue, as seen on a mammogram. Women with dense breasts have a four times greater chance of developing cancer than those with the least dense breasts.

One in 10 women has dense breasts, defined as those where more than 75 per cent of the mammogram shows up as opaque white fibrous tissue, and should be offered drug treatment, the experts say.
Breast density offers a simple measure of risk for women in the same way that blood cholesterol levels provide a measure of heart disease risk.

Once started on preventive drugs, a reduction in breast density can be used to measure their effectiveness in the same way as a fall in cholesterol indicates a response to statins.

Breast cancer is rising rapidly with almost 48,000 new cases a year, an 80 per cent increase in 30 years. The rise is being driven by lifestyle changes that alter the levels of female hormones including later childbirth, smaller families, shorter breast feeding, growing obesity, increased alcohol intake and lower exercise.

Until now, prevention efforts have focused on encouraging women to exercise more, eat less and cut down on alcohol. But unlike heart disease, preventive drug therapy has not been emphasised.
The main drug recommended is tamoxifen which shows a 40 per cent reduction in risk when taken for five years but has side effects including blood clots and a small extra risk of endometrial (womb) cancer. But a trial of a newer class of drugs – aromatase inhibitors – is under way and may show an even bigger reduction in breast cancer risk.

"We are hopeful we will see on the order of a 70 per cent reduction. It is generally better tolerated. You don't get the blood clots or the endometrial cancer. But it does cause bone thinning in some women so that has to be monitored. It is only suitable for post-menopausal women but it might be suitable for half of them," Professor Cuzick said.

How easy is it to get the drugs?
Women hoping to obtain the drugs face a difficulty. The main drug recommended – tamoxifen – is only licensed in Europe as a treatment for breast cancer, not as a preventative. It is "off patent" and its original manufacturer has not applied to extend its licence to include prevention, which is holding back its use. It can only be prescribed "off label", where the doctor carries the risk.

Professor Jack Cuzick, chairman of the expert panel and Cancer Research UK epidemiologist at Queen Mary, University of London, said: "This is an enormous problem. Tamoxifen is not licensed for prevention, but all the experts believe it should be. Only the manufacturer can apply and, because it has gone off-patent, it does not want to bear the cost. There is no mechanism for getting it licensed. It is a crazy situation."

Tamoxifen has been shown in trials to reduce the risk of breast cancer by 40 per cent when taken for five years. But it has side effects, including an increased risk of blood clots, and a small increase in endometrial cancer of the womb. Raloxifene is also recommended – it has fewer side effects but less benefit. Tamoxifen was licensed for prevention in the US before the patent ran out.

Saturday, March 26, 2011

Will Your Cancer Spread? Answer Found in Genes

WEDNESDAY, March 23 (HealthDay News) -- Scientists may have developed a new way of predicting when breast cancer will spread.

Two varieties of what scientists call "epigenetic signatures" seem to distinguish more aggressive cancers from less aggressive ones, according to a new study.

Epigenetic alterations do not involve changes to the sequencing of the genes themselves. Instead, they involve alterations in the outer wrapping that holds genes within the chromosome. This chromosomal casing helps determine whether the genes will activate and at what intensity.
Environmental factors, including diet, stress, illness or environmental pollutants can all influence epigenetics, experts note.

The findings could not only lead someday to a new diagnostic screening tool to parse out more aggressive cancers that might benefit from more aggressive treatment, but could also "open the door for new physiological targets" for therapies, explained Dr. Timothy A. Chan, senior author of a paper appearing March 23 in the journal Science Translational Medicine.

It's also not out of the question that modifiable environmental factors might be identified that contribute to the cancers, Chan said.

How to tell if a particular tumor will spread (metastasize), and then finding ways to prevent that are major goals of the researchers. Patients usually die from a cancer that has metastasized, not from localized tumors.

This international consortium of researchers collected a variety of different types of breast cancers -- some were hormone receptor-positive, some negative, some had spread and some had not -- then analyzed their methylation profiles.

Methylation refers to the epigenetic "marks" left on the genome.

"To our surprise, we noted that there appear to be two main epigenomic subgroups," said Chan, who is a lab head and attending physician at Memorial Sloan-Kettering Cancer Center in New York City.
This was a surprise because scientists have identified myriad different types of breast cancers based on their genetics and other characteristics.

In this case, one group showed high methylation and one showed low.

The high-methylation group "tended to be pretty stable at the genomic level and were composed primarily of hormone-positive cancers," Chan said. "The [low-methylation] group includes all the hormone-negative group and about half of hormone-positive cancers."

And women with high-methylation tumors did much better than the other group, independent of their hormone-receptor status.

The team is now working on a test to distinguish the two epigenetic types and are investigating what drives these changes, which have also been observed in colon cancer and the deadly brain cancer glioblastoma.

"What we're probably looking at is some fundamental process that becomes dysregulated and helps drive the cancers," Chan said.

"This [study] allows us to further subset breast cancers into those that are likely to metastasize and those that aren't likely to metastasize, and that's helpful," noted one expert, Dr. Patrick Borgen, chairman of the department of surgery at Maimonides Medical Center in New York City.

But, Borgen cautioned, "the technology that [does this categorization] is far from the grasp of day-to-day clinicians. [The study is] an important foundation for further research."

Thursday, March 24, 2011

One Hundred Years Ago: Remembering Triangle

Originally posted on this blog last year.  2011 is the 100th anniversary of this terrible tragedy.

On March 25, 1911, a fire broke out in the Triangle Shirtwaist Factory in New York City. The doors were locked and the young immigrant girls and women who worked the sewing machines could not escape the flames. Many jumped to their deaths. This was a terrible tragedy in New York  history. It began the movement for safer working conditions for workers everywhere. Because of what happened at Triangle, exit signs became mandatory over doors;  doors had to open out and not in - and not be locked;  sprinkler systems became part of building code, and fire drills had to be performed on a regular basis.

The following is the story about the fire as it appeared in the New York Times, the day after the fire, on March 26th, 1911

New York Times, March 26, 1911, p. 1.

141 Men and Girls Die in Waist Factory Fire; Trapped High Up in Washington Place Building; Street Strewn with Bodies; Piles of Dead Inside

Three stories of a ten-floor building at the corner of Greene Street and Washington Place were burned yesterday, and while the fire was going on 141 young men and women at least 125 of them mere girls were burned to death or killed by jumping to the pavement below.

The building was fireproof. It shows now hardly any signs of the disaster that overtook it. The walls are as good as ever so are the floors, nothing is the worse for the fire except the furniture and 141 of the 600 men and girls that were employed in its upper three stories.

Most of the victims were suffocated or burned to death within the building, but some who fought their way to the windows and leaped met death as surely, but perhaps more quickly, on the pavements below.

All Over in Half an Hour.
Nothing like it has been seen in New York since the burning of the General Slocum. The fire was practically all over in half an hour. It was confined to three floors the eighth, ninth, and tenth of the building. But it was the most murderous fire that New York had seen in many years.

The victims who are now lying at the Morgue waiting for some one to identify them by a tooth or the remains of a burned shoe were mostly girls from 16 to 23 years of age. They were employed at making shirtwaist by the Triangle Waist Company, the principal owners of which are Isaac Harris and Max Blanck. Most of them could barely speak English. Many of them came from Brooklyn. Almost all were the main support of their hard-working families.

There is just one fire escape in the building. That one is an interior fire escape. In Greene Street, where the terrified unfortunates crowded before they began to make their mad leaps to death, the whole big front of the building is guiltless of one. Nor is there a fire escape in the back.

The building was fireproof and the owners had put their trust in that. In fact, after the flames had done their worst last night, the building hardly showed a sign. Only the stock within it and the girl employees were burned.

A heap of corpses lay on the sidewalk for more than an hour. The firemen were too busy dealing with the fire to pay any attention to people whom they supposed beyond their aid. When the excitement had subsided to such an extent that some of the firemen and policemen could pay attention to this mass of the supposedly dead they found about half way down in the pack a girl who was still breathing. She died two minutes after she was found.

The Triangle Waist Company was the only sufferer by the disaster. There are other concerns in the building, but it was Saturday and the other companies had let their people go home. Messrs. Harris and Blanck, however, were busy and ?? their girls and some stayed.

Leaped Out of the Flames.
At 4:40 o'clock, nearly five hours after the employes in the rest of the building had gone home, the fire broke out. The one little fire escape in the interior was resorted to by any of the doomed victims. Some of them escaped by running down the stairs, but in a moment or two this avenue was cut off by flame. The girls rushed to the windows and looked down at Greene Street, 100 feet below them. Then one poor, little creature jumped. There was a plate glass protection over part of the sidewalk, but she crashed through it, wrecking it and breaking her body into a thousand pieces.

Then they all began to drop. The crowd yelled "Don't jump!" but it was jump or be burned the proof of which is found in the fact that fifty burned bodies were taken from the ninth floor alone.

They jumped, the crashed through broken glass, they crushed themselves to death on the sidewalk. Of those who stayed behind it is better to say nothing except what a veteran policeman said as he gazed at a headless and charred trunk on the Greene Street sidewalk hours after the worst cases had been taken out:

"I saw the Slocum disaster, but it was nothing to this."

"Is it a man or a woman?" asked the reporter.

"It's human, that's all you can tell," answered the policeman.

It was just a mass of ashes, with blood congealed on what had probably been the neck.

Messrs. Harris and Blanck were in the building, but the escaped. They carried with the Mr. Blanck's children and a governess, and they fled over the roofs. Their employes did not know the way, because they had been in the habit of using the two freight elevators, and one of these elevators was not in service when the fire broke out.

Found Alive After the Fire.
The first living victims, Hyman Meshel of 322 East Fifteenth Street, was taken from the ruins four hours after the fire was discovered. He was found paralyzed with fear and whimpering like a wounded animal in the basement, immersed in water to his neck, crouched on the top of a cable drum and with his head just below the floor of the elevator.

Meantime the remains of the dead it is hardly possible to call them bodies, because that would suggest something human, and there was nothing human about most of these were being taken in a steady stream to the Morgue for identification. First Avenue was lined with the usual curious east side crowd. Twenty-sixth Street was impassable. But in the Morgue they received the charred remnants with no more emotion than they ever display over anything.

Back in Greene Street there was another crowd. At midnight it had not decreased in the least. The police were holding it back to the fire lines, and discussing the tragedy in a tone which those seasoned witnesses of death seldom use. 

"It's the worst thing I ever saw," said one old policeman.

Chief Croker said it was an outrage. He spoke bitterly of the way in which the Manufacturers' Association had called a meeting in Wall Street to take measures against his proposal for enforcing better methods of protection for employes in cases of fire.

No Chance to Save Victims.
Four alarms were rung in fifteen minutes. The first five girls who jumped did go before the first engine could respond. That fact may not convey much of a picture to the mind of an unimaginative man, but anybody who has ever seen a fire can get from it some idea of the terrific rapidity with which the flames spread.

It may convey some idea too, to say that thirty bodies clogged the elevator shaft. These dead were all girls. They had made their rush their blindly when they discovered that there was no chance to get out by the fire escape. Then they found that the elevator was as hopeless as anything else, and they fell there in their tracks and died.

The Triangle Waist Company employed about 600 women and less than 100 men. One of the saddest features of the thing is the fact that they had almost finished for the day. In five minutes more, if the fire had started then, probably not a life would have been lost.

Last night District Attorney Whitman started an investigation not of this disaster alone but of the whole condition which makes it possible for a firetrap of such a kind to exist. Mr. Whitman's intention is to find out if the present laws cover such cases, and if they do not to frame laws that will.

Girls Jump To Sure Death.
Fire Nets Prove Useless Firemen Helpless to Save Life.
The fire which was first discovered at 4:40 o'clock on the eighth floor of the ten-story building at the corner of Washington Place and Greene Street, leaped through the three upper stories occupied by the Triangle Waist Company with a sudden rush that left the Fire Department helpless.

How the fire started no one knows. On the three upper floors of the building were 600 employes of the waist company, 500 of whom were girls. The victims mostly Italians, Russians, Hungarians, and Germans were girls and men who had been employed by the firm of Harris & Blanck, owners of the Triangle Waist Company, after the strike in which the Jewish girls, formerly employed, had been become unionized and had demanded better working conditions. The building had experienced four recent fires and had been reported by the Fire Department to the Building Department as unsafe in account of the insufficiency of its exits.

The building itself was of the most modern construction and classed as fireproof. What burned so quickly and disastrously for the victims were shirtwaists, hanging on lines above tiers of workers, sewing machines placed so closely together that there was hardly aisle room for the girls between them, and shirtwaist trimmings and cuttings which littered the floors above the eighth and ninth stories.

Girls had begun leaping from the eighth story windows before firemen arrived. The firemen had trouble bringing their apparatus into position because of the bodies which strewed the pavement and sidewalks. While more bodies crashed down among them, they worked with desperation to run their ladders into position and to spread firenets.

One fireman running ahead of a hose wagon, which halted to avoid running over a body spread a firenet, and two more seized hold of it. A girl's body, coming end over end, struck on the side of it, and there was hope that she would be the first one of the score who had jumped to be saved.

Thousands of people who had crushed in from Broadway and Washington Square and were screaming with horror at what they saw watched closely the work with the firenet. Three other girls who had leaped for it a moment after the first one, struck it on top of her, and all four rolled out and lay still upon the pavement.

Five girls who stood together at a window close the Greene Street corner held their place while a fire ladder was worked toward them, but which stopped at its full length two stories lower down. They leaped together, clinging to each other, with fire streaming back from their hair and dresses. They struck a glass sidewalk cover and it to the basement. There was no time to aid them. With water pouring in upon them from a dozen hose nozzles the bodies lay for two hours where they struck, as did the many others who leaped to their deaths.

One girl, who waved a handkerchief at the crowd, leaped from a window adjoining the New York University Building on the westward. Her dress caught on a wire, and the crowd watched her hang there till her dress burned free and she came toppling down.

Many jumped whom the firemen believe they could have saved. A girl who saw the glass roof of a sidewalk cover at the first-story level of the New York University Building leaped for it, and her body crashed through to the sidewalk.

On Greene Street, running along the eastern face of the building more people leaped to the pavement than on Washington Place to the south. Fire nets proved just as useless to catch them and the ladders to reach them. None waited for the firemen to attempt to reach them with the scaling ladders.

All Would Soon Have Been Out. 
Strewn about as the firemen worked, the bodies indicated clearly the preponderance of women workers. Here and there was a man, but almost always they were women. One wore furs and a muss, and had a purse hanging from her arm. Nearly all were dressed for the street. The fire had flashed through their workroom just as they were expecting the signal to leave the building. In ten minutes more all would have been out, as many had stopped work in advance of the signal and had started to put on their wraps.

What happened inside there were few who could tell with any definiteness. All that those escaped seemed to remember was that there was a flash of flames, leaping first among the girls in the southeast corner of the eighth floor and then suddenly over the entire room, spreading through the linens and cottons with which the girls were working. The girls on the ninth floor caught sight of the flames through the window up the stairway, and up the elevator shaft.

On the tenth floor they got them a moment later, but most of those on that floor escaped by rushing to the roof and then on to the roof of the New York University Building, with the assistance of 100 university students who had been dismissed from a tenth story classroom.

There were in the building, according to the estimate of Fire Chief Croker, about 600 girls and 100 men.

Wednesday, March 23, 2011

Triple Negative Management: A Lifelong Committment

I am a triple negative breast cancer survivor. In September, it will be ten years since I first even heard that there was such a type of cancer. Back then, they simply called it "The bad one." Upon further investigation I found out that we have a "poor prognosis." I don't think so. And neither did my doctors. So we made a plan of attack for surviving triple negative breast cancer:

1. Hit it with everything we could as far as chemo and radiation

2. Change my diet drastically to reduce my fat intake to under 30 grams a day

3. Exercise

4. Flax seeds, whole grains, asparagus.

And most important?

I alternated mammograms with breast MRIs every six months. I had scans to catch any tiny cell that might be thinking about dividing and taking up more real estate in my body. They watched me like a hawk. It is, by far, the most important thing a TN patient needs to do.

Early detection of distant metastasis is as important as early detection for primary cancer.

Thank God I had insurance that covered me for this. Why? Because if you are triple negative, unable to afford insurance and depend upon Medicaid or Medicare, once chemo is over, so is your coverage. What does that mean? After your treatments are completed, because you are triple negative and cannot benefit from any long term medication,  like hormone responsive cancer patients do, they declare you "done." That includes NO follow-up care with doctors,  NO surveillance,  NO scans and  NO CARE for the most aggressive type of breast cancer out there.

Kay M.  has been waging a one woman war in Indiana to get coverage. She has been denied. She has been told there is no more treatment so no more care. She has gone through the Indiana State government and all the way up to the White House. Every door has been closed on her. A second member of the No Surrender family from Indiana is also losing her coverage for her triple negative disease once her chemotherapy is ended.

Are you aware of the laws in your state? Are you on Medicare or Medicaid and Triple Negative and getting covered for follow-up care? Please let us know if you are. If you are like Kay, please help us change this "rule" banning coverage for Triple Negative patients post treatment.

WE NEED ACTION:  Coverage for Follow-Up Surveillance for Triple Negative Breast Cancer Patients  is the only way to protect these women. If you know of a way to help, please contact us.

Tuesday, March 22, 2011

Don't Stop Tamoxifen Early, Study Says

Five years of Tamoxifen reduces cancer: study

A study conducted by the researchers based at the Cancer Research UK and UCL Cancer Trials Centre for Tamoxifen, demonstrated that the cancer was less likely to come back in women who took the drug for five years, compared to two years.

The results of the trial, with 3,500 patients, suggested that the cancer came back in around 40% of the patients who took the medicine for five years, as compared to those who has taken Tamoxifen for two years.

According to the scientists, taking Tamoxifen for five years gives the best chance of survival from breast cancer.

Cancer Research UK Clinical Research director Kate Law said this large Cancer Research UK-funded study is the first to look at the long-term performance of Tamoxifen - considered to be one of the most important drugs in the history of breast cancer treatment.

"Our research is behind many important drugs, including Tamoxifen, that have contributed to more than three quarters of women with breast cancer now surviving their disease for ten years or more," Law said.

Drug Combo Improves Triple Negative Breast Cancer Survival

Drug combinations may improve triple negative breast cancer treatment

HOUSTON -- (March 21, 2011) -- Researchers led by Baylor College of Medicine have found a new way to tackle a difficult-to-treat form of breast cancer – a discovery that is being translated into human studies with currently approved FDA drugs.

The new strategy begins with their discovery that a gene called PTPN12 plays a pivotal role in triple negative breast cancer, an aggressive form of the disease that accounts for approximately 20 percent of new cases of the disease and is resistant to common drugs such as Tamoxifen and Herceptin®. Until now, the genes that drive the growth of triple negative breast cancer have been a mystery, making it difficult for scientists to devise new therapies for this disease.

In a report in a recent issue of the journal Cell, Dr. Thomas F. Westbrook of BCM and colleagues describe their new understanding of the forces that drive this aggressive disease and, more important, how to use a combination of drugs to block those forces.

PTPN12 prevents breast cancer

"This study gives us promising new insight into how to treat patients with triple negative breast cancer and possibly other cancers," said Westbrook, assistant professor of biochemistry and molecular biology and molecular and human genetics at BCM and senior author of the report.

In this study, Westbrook and his collaborator, Dr. Stephen J. Elledge of Harvard Medical School, screened literally tens of thousands of genes for their role in human breast cancer. They found that the gene PTPN12 prevents or suppresses breast cancer. Next, together with researchers at the BCM Lester & Sue Smith Breast Center, Westbrook showed that most triple negative breast cancers have lost that protective gene.

Most important, the researchers found that the loss of PTPN12 unleashes a specific combination of cancer-promoting enzymes called tyrosine kinases. These enzymes work in concert to cause aggressive growth and spread of triple negative breast cancer. Blocking just one kinase is not enough, said Westbrook. Specific combinations of kinases have to be blocked to stop the growth of the breast cancer.

Combining kinase inhibitors

Because drugs that block some of these kinases are already FDA-approved for patients, this study provides an exciting strategy for combining specific kinase inhibitors to combat triple negative breast cancer as well as other forms of cancer.

This double-barreled discovery gives researchers a new foothold from which to fight triple negative breast cancer.

"This discovery is an important advance for patients, because we may now be able to rationally combine drugs that inhibit these kinases to treat patients with triple negative breast cancer (and other cancers) that were previously thought intractable to such therapies," said Westbrook, also a member of the NCI-designated Dan L. Duncan Cancer Center.

Combos block spread

Westbrook and colleagues showed that inhibiting specific combinations of these kinases effectively blocks the growth and spread of triple negative breast cancer in animals. Because drugs that block some of these kinases are already approved for patients, this study provides an exciting strategy for combining specific kinase inhibitors to combat triple negative breast cancer as well as other forms of cancer.

Many researchers and physicians believe it will be important to combine drugs for cancer treatment," said Westbrook.

"But the strategy of which medicines to combine is difficult to predict. Here, we are providing a new rationale to combine a specific set of medicines to treat this debilitating disease, and we are now pursuing clinical trials to test this new idea."

May play role in other cancers

In addition to triple negative breast cancer, PTPN12 may play a role in other difficult-to-treat malignancies such as lung cancer. In fact, there may be a whole class of genes that behave like PTPN12 to inhibit kinases and cancer formation.

"By discovering these new genes and how they work, we think we can develop new therapies for many types of cancer," said Westbrook.

Others who took part in this study include Tingting Sun, Kristen L. Meerbrey, Jessica D. Kessler, Maria Botero, Jian Huang, Ronald J. Bernardi, Earlene Schmitt, Mitchell Rao, Chad J. Creighton, Susan G. Hilsenbeck, Chad A. Shaw, Donna Muzny, Richard A. Gibbs, David A.Wheeler, C. Kent Osborne, Rachel Schiff and Ilenia Migliaccio,, all of BCM; Nicola Aceto and Mohamed Bentires-Alj of the Friedrich Miescher Institute for Biomedical Research in Basel, Switzerland; Natalya Pavlova, Guang Hu, Mamie Li, Noah Dephoure, Steven Gygi, and Chunshui Zhou, all of Harvard Medical School, and Don Nguyen of Yale University School of Medicine.

Funding for this work came from The V Foundation and the Mary Kay Ash Foundation for Cancer Research, the Susan G. Komen for the Cure Foundation, the Special Program of Research Excellence of the National Cancer Institute, the U.S. Army and the Howard Hughes Medical Institute.

Monday, March 21, 2011

Radiation RECALL Notice

From the New York Times
March 21, 2011

Riddled With Metal by Mistake in a Study

Women participating in a study of patients with breast cancer have been inadvertently left with hundreds of tiny particles of the heavy metal tungsten in their breast tissue and chest muscles. The particles came from a device used during surgery. The device has since been recalled.

It is not known if the metal is dangerous to health because relatively little research has been done on its long-term effects in the body. But it shows up on mammograms, and may make them difficult to read, an especially troubling effect for women who have already had breast cancer and worry about recurrences. (The particles resemble calcium deposits, which can indicate cancer.)

About 30 women have been affected, according to the manufacturer of the device that caused the problem, the Axxent FlexiShield Mini. The women are in a quandary. At least one, fearing that the tungsten could cause cancer or another illness, is trying to decide whether to get rid of the particles by having her breast and its underlying tissue removed in a radical and disfiguring operation.

Twenty-seven of the cases occurred at Hoag Memorial Hospital Presbyterian in Newport Beach, Calif. Eleven of those women have had mammograms, and all 11 showed tungsten. Hospital officials declined interviews, but issued a statement acknowledging that the problem had occurred.

Two other women were treated in a study at Karmanos-Crittenton Cancer Center in Rochester Hills, Mich. A hospital spokeswoman said that both patients had been informed of the recall and the potential problem but had not returned to the hospital.

The episode casts doubt on the safeguards for people who participate in medical research and on the Food and Drug Administration’s ability to protect the public from flawed medical devices.

The Axxent FlexiShield Mini had been cleared by the agency in June 2009 in an abbreviated process used for devices that are considered equivalent to products already on the market. That process, known as 510(k), takes less time than the procedure used to approve a new device, and it generally does not require tests on humans. The FlexiShield Mini equipment was recalled last month. Neither its manufacturer nor the F.D.A. could explain what went wrong with the device.

Karen Riley, a spokeswoman for the agency, said it was just beginning its review of the device and the recall. So far, she said, F.D.A. toxicologists had found no evidence that the tungsten was toxic or that patients were harmed.

Ms. Riley said the 510(k) process was used to avoid “reinventing the wheel” for products that were essentially the same as others that had already passed muster with the agency.

The women who were exposed to the tungsten were taking part in a study of a radiation technique that some doctors predicted would be a big advance in the treatment of breast cancer. Unlike the usual five to seven weeks of daily radiation sessions, the newer method delivers the entire course of treatment in one dose while the woman is still in the operating room after undergoing a lumpectomy for breast cancer.

But in the study, a device that was temporarily placed in the women’s incisions during the radiation treatment was apparently flawed, and riddled their breasts with tungsten. The Axxent Flexishield Mini, a $100 disk made of tungsten and silicone, was used to shield healthy tissue from the radiation.

The first patient to take part in the study at Hoag said the events had shattered her faith in the vigilance of the drug agency, the hospital and her surgeon, who she said enthusiastically talked her into participating, emphasizing how convenient it would be to finish radiation treatment before she even woke from surgery.

“I do work, so it was appealing,” said the woman, a 57-year-old psychologist with a busy practice who did not want her name used for privacy reasons.

The purpose of the study was not to test the new radiation treatment itself, but rather to determine whether imaging studies could correctly predict which women would be candidates for it. The device’s manufacturer did not pay for the study.

It never occurred to the first patient that the equipment might be faulty, she said, because she knew that it had been approved by the F.D.A. She also trusted the doctor and hospital to ensure that the study was safe.

“I had this illusion, like most people do, that the F.D.A. wouldn’t allow this to happen,” she said. “I definitely feel like a lab rat now.”

The manufacturer, Xoft, which was bought in December by iCad, intended the shield to be used with its portable radiation device, the Axxent Electronic Brachytherapy System.

The president of iCad, Ken Ferry, said his company bought Xoft because the idea of giving radiation treatment during surgery seemed so promising. A study published last summer showed good results from a different radiation machine using the same technique. Mr. Ferry said he thought the procedure might eventually be used to treat half of the 270,000 women a year in the United States who develop breast cancer.

“We think the growth of the procedure will be dramatic over the next three years,” Mr. Ferry said. “That’s what really drove us to acquire the company.”

But iCad also acquired the tungsten problem, which became apparent only a week or two after the deal was closed.

“Dumb luck, if you want to use that word, is what it feels like to iCad that we ran into it,” Mr. Ferry said. But, he added, “it doesn’t diminish our enthusiasm.”

The psychologist is suing Hoag and the manufacturer.

She first learned that something was wrong in December, when she had a routine follow-up mammogram six months after her lumpectomy and radiation.

The image showed hundreds of tiny spots scattered inside her breast and along the muscle at the back of her chest wall. Doctors did not know what the spots were, but her radiologist said some resembled the calcifications that can indicate cancer. “I was terrified,” she said. “It looked like it was snowing inside my breast.”

A biopsy found the tungsten.

“I went to my oncologist,” she said. “He just was beside himself. He just said: ‘You’ve got to get this out of you. It’s toxic. You can’t have this in your system.’ ”

He urged her to have a mastectomy and recommended a surgeon, who told her that to remove the tungsten, he would have to remove her entire breast and some of the chest muscles.

“I would have a dent in my side,” she said. “He said he didn’t really want to move ahead until there was more information because it would be so disfiguring. That made me physically ill. I’d kind of gotten myself used to the idea of having a mastectomy, but not being disfigured.”

ICad has offered to pay for toxicology consultations for the exposed women, along with blood and urine tests to measure tungsten. The company has also said it will consider paying for mastectomies, and it commissioned a report to examine the scientific data on tungsten. The report said its toxicity appeared low, but that long-term studies were lacking.

Dr. Steven Markowitz, a physician at Queens College in New York who specializes in occupational and environmental medicine, said there was not much information about the effects of pure tungsten like that used in the shields. Most research, he said, involves workplace exposure to tungsten compounds.
“Given this unorthodox route of exposure, it’s hard to say a whole lot about likely consequences,” Dr. Markowitz said.

The first patient in the Hoag study said she had consulted a toxicologist, who told her little was known about the long-term health effects of tungsten but said that she (the toxicologist) would probably not leave it in her own body. The patient said that she was leaning toward having the surgery. But, she added, “I would love to hear there’s evidence that there’s nothing to worry about.”

Sunday, March 20, 2011

So You've Been Diagnosed with Breast Cancer...

So you've just been told you have breast cancer... or you are in the thick of treatment... or you are just emerging from the battlefield wondering what is next....

Fight Your Cancer the  No Surrender Way
Have you visited our main website and support forum? I suggest you do. Why? Because we tell you how to live a healthy life now that you are a survivor. Such as, what supplements to add to help keep your cancer from coming back. What you should eat if you are Triple Negative and how much you should exercise. We show you how to fight this cancer in a clear and concise way- no pale pastels, baby. Real life, big time, big girl fighting.

Here are some quick links for you:

Living Healthy
Life Style

Real Survivors- Real Help - NO SURRENDER

Monday, March 14, 2011

Rideau Survivorship Foundation

Many of us in the United States are lucky to have access to medical care close to home. In certain areas of Canada, however, a person who is suffering from a chronic illness oftentimes may have to travel great distances to get the care they need. A dear friend of mine decided to change that in her area, here is her story. If you live nearby her Center, you are in luck! ( The RSF generously donates 5% of their proceeds to the NSBCF and we are doing whatever we can to help them through our website and support forum.)

"My name is Cheryl Gulseth and I created The Rideau Survivorship Foundation. Being a 5 year survivor of breast cancer I know how hard it is to get through this journey. Travelling to the major centres for treatment  is overwhelming to say the least. I myself have to pass up valuable support services that are available in Ottawa simply because I don't have the time to make additional trips into the city now that I am back to work. Together with my directors  Angie Stoddard and Barbara Ann Cregan, we are here to make sure that everyone in our community has access to the support they need right here at home. The journey doesn’t end when treatment does. The centre will be there for survivors and their families as long as there is a need.
One of the huge challenges identified is finding post-treatment care. There are a lot of rehabilitation programs available but when it comes to cancer it is almost non-existant in our community.We (Rideau Survivorship Foundation) are hoping to bring much needed support services to people living with cancer and other chronic illnesses into the heart of the Rideau. Our aim is to have a centre to offer support to cancer patients and caregivers after diagnosis and particularly after treatment.
The Centre is  located in the loft above Vickie's Specialty Shop
14 Main Street West in Smiths Falls

Through fundraising activities we are happy to say that we will be able to open our resource centre on March 12th. It will be located upstairs at 14 Main Street West. Grant acquisitions will enable us to add to our centre and services in order to assist the people in need of support services. We want these people to get what they need locally and not have to travel all the way to Ottawa, Kingston, Carleton Place, Kemptville or Brockville. Chronic illnesses such as cancer can be overwhelming enough without having to travel long distances to obtain support. Patients from this  area that are receiving treatment in Ottawa or Kingston (for example) could be referred here so that they can receive  any additional support that they need right here in their own community.
The Rideau Survivorship Foundation is opening  its doors right here in Smiths Falls and offer the following services to the people of this community….
Library available to do research as well as online access to link with support forums, groups and information

Look Good Feel Good Program sessions arranged on demand

Registered massage therapist nearby the centre specializing in lymphatic drainage for post surgery issues

Meeting room for information sessions and group meetings

Exercise classes will be scheduled as required 

Assistance in finding financial support

Wig boutique across the street with private courteous service

Mastectomy products, swimwear and clothing in house

Peer support, by survivor for survivor (by appointment if outside of centre hours)
The centre will be a one-stop location to help people travel along the road that they never wanted to take. Knowledge is power and where there is knowledge there is hope. Early screening is key in prevention, and self-advocacy is key in successful treatment and recovery. With early detection, and armed with good information we  WILL one day find the cure."

Friday, March 11, 2011

More Proof of the Need for our Before Forty Initiative

We have asked for support in spreading awareness of our Before Forty Initiative for  a long time now. Time and again we have offered evidence based documentation backing up our cause. The following is another addition to this.

Please consider helping us save the lives of young, African American women.

Study Finds Racial Disparity in Breast Cancer Outcomes

Black women had higher death rates, no matter what kind of breast cancer they developed

FRIDAY, Jan. 14 (HealthDay News) -- In an ongoing effort to shed light on the reason for racial disparities in breast cancer prognosis, researchers in North Carolina report new findings from their research on black women and breast cancer.

Previous research has shown that breast cancer in younger black women in the United States is more likely to be the more aggressive basal-like (triple-negative) subtype, which may help explain why black women are more likely to die from breast cancer than other women.

In this new study, researchers analyzed tissue from 518 black women and 631 white women with invasive breast cancer who were enrolled in the Carolina Breast Cancer Study.

"Our data show that basal-like breast cancer is an equally aggressive disease in African-American women and white women," study co-author Charles M. Perou, a professor of genetics and pathology at the University of North Carolina at Chapel Hill School of Medicine, said in a university news release.
"In addition, African-American women had worse outcomes no matter what kind of breast cancer they developed, suggesting that other factors such as disparities in access to care and treatment, for example for the more common subtypes of breast cancer like luminal A breast cancer, also contribute to the higher breast cancer mortality observed in African-American women," Perou said.

The data suggest that it may not be possible to "identify a truly good prognosis subtype [of breast cancer] in African-American women and we need to find out why," study co-author Dr. Lisa Carey said in the news release.

The study was published in a recent issue of the journal Clinical Cancer Research.


Our thoughts and prayers are with the people of Japan.

Sunday, March 6, 2011

Borne Back Ceaselessly Into the Past

the first mansion was Bel Caro, beyond that is Daisy's house, owned by Bayard Swope the famous publisher
"And so it happened that on a warm windy evening I drove over to East Egg to see two old friends whom I scarcely knew at all. Their house was even more elaborate than I expected, a cheerful red-and-white Georgian Colonial mansion, overlooking the bay. The lawn started at the beach and ran toward the front door for a quarter of a mile, jumping over sun-dials and brick walks and burning gardens — finally when it reached the house drifting up the side in bright vines as though from the momentum of its run. The front was broken by a line of French windows, glowing now with reflected gold and wide open to the warm windy afternoon, and Tom Buchanan in riding clothes was standing with his legs apart on the front porch."

 Was it seventh grade or eight grade? I cannot remember exactly, but I do remember coming home from school and taking the book assigned to us for homework to the beach that spread out before our home. To the left, the beach curved, and there were the remains of what was once a Normandy Style mansion, razed decades before, but the sea wall, carriage house, and garages were still there. Directly across the Sound, was Execution Rocks, the infamous lighthouse where the British Army tortured American prisoners during the American Revolution. A glance to the right led to "Land's End" a beautiful, white mansion that sat on a bluff which jutted out overlooking Long Island Sound.

I turned the pages of the book and things seemed familiar. Very familiar. It wasn't long before I realized Fitzgerald was writing about exactly where I sat, in East Egg, overlooking the "great, wet barnyard" of Long Island Sound.

Many years have passed. The book has always been my favorite of all. I worked on it in college and reread it at the beginning of each summer, two weeks before the longest day of the year. Our house is gone now. A classic colonial torn down to make way for a cement box that could easily pass for a drive-through restaurant. Our family is scattered now. The dreams we had when we lived in our waterfront home have been altered. Things change. We are told to expect that. But the sun-filled memories and laughter across the lawn, the cozy Christmas eve's and the Fourth of July parties on the beach, they still live on in our hearts.

"Turning me around by one arm, he moved a broad flat hand along the front vista, including in its sweep a sunken Italian garden, a half acre of deep, pungent roses, and a snub-nosed motor-boat that bumped the tide offshore. We walked through a high hallway into a bright rosy-colored space, fragilely bound into the house by French windows at either end. The windows were ajar and gleaming white against the fresh grass outside that seemed to grow a little way into the house. A breeze blew through the room, blew curtains in at one end and out the other like pale flags, twisting them up toward the frosted wedding-cake of the ceiling, and then rippled over the wine-colored rug, making a shadow on it as wind does on the sea."

And now, the last remaining house from The Great Gatsby, will be torn down. As prominent as any character in the book, the houses held as much meaning as Tom and Daisy, Gatsby and Nick and yes, even Myrtle. We can't seem to preserve anything anymore. We must make way for the new and plastic. Sands Point is just a shadow of its former self. The frenzy for McMansions has changed its face forever, for the worse. If it were up to me, and it is clearly not, I would preserve the past. I am, unabashedly and unapologetically, a romantic, just like Gatsby.

I've had a lot of loss in my life. Why should the razing of an old mansion bother me? It's part of my childhood, my joyful past, of days gone by and the loss of that young girl who sat on that beach and could faintly hear the echoing of the orchestra playing from Gatsby's lawn....

"The one on my right was a colossal affair by any standard — it was a factual imitation of some Hotel de Ville in Normandy, with a tower on one side, spanking new under a thin beard of raw ivy, and a marble swimming pool, and more than forty acres of lawn and garden. it was Gatsby’s mansion."
Gatsby's house, the walls, guest house, garage and gates are still there

If you want to see Daisy's house before it is reduced to rubble, take Port Washington Boulevard north, all the way into the Village of Sands Point. Turn onto Hoffstot Lane and take it to the end. There used to be gates at the entrance of the road that said "Bel Caro" for the mansion that was next to Daisy's. It, too, was destroyed to make way for less.  If you want to see what it left of Gatsby's house, don't turn, but continue straight ahead. You will see Normandy-style walls and gardens, a garage, a carriage house and a wrought iron gate. Close your eyes and think of Scott visiting on a warm, summer day, remembering his romance with Zelda and turning it into one of the greatest novels of all time.

"...and so we beat against the current...borne back ceaselessly into the past...."