Sunday, September 22, 2019

Breast cancer split into 11 separate diseases

'Molecular wiring' of tumors might forecast survival or relapse, new study shows

Can the so-called "internal wiring" of breast cancer predict whether you will survive or face a relapse?

The answer is a definite maybe.

As reported recently by the BBC News website, a new study published in the journal Nature indicates that the malady is actually 11 separate diseases with each having "a different risk of coming back [and] each with a different cause and needing different treatment." 

The article by health and science correspondent James Gallagher says that scientists at Stanford Universities and the University of Cambridge "looked in incredible detail at nearly 2,000 women's breast cancers" and analyzed the genetic mutations inside the tumors so they could "create a new way of classifying them."

Doctors, the piece notes, "currently classify breast cancers based on whether they respond to the hormone estrogen or targeting therapies like Herceptin."
Professor Carlos Caldas
Gallagher's story quotes Professor Carlos Caldas of the Department of Oncology at Cambridge Institute to the effect that the findings — which focus on the "molecular wiring" of the tumors — are "a very significant step to more precision-type medicine.

The study also "showed that triple negative breast cancers — one of the hardest to treat — were not all one class of cancer, but two."

The first group, according to the story, is "one where if women have not relapsed by five years they are probably cured" but a second subgroup is one in which women "are still at significant risk of later relapse."

Four subgroups, the article continued, "were both driven by estrogen and had a 'marked increased' risk of recurrence" — situations where patients "may benefit from a longer course of hormone therapy drugs like tamoxifen."

More information on research regarding the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Sunday, September 8, 2019

U.S. eyes label warning for Allergen devices

FDA pressure results in breast implants that cause rare cancer of the immune system being recalled

Allergen is recalling its textured breast implants worldwide that have been linked to anaplastic large-cell lymphoma, a rare cancer of the immune system.

The company has responded to belated pressure from the Federal Drug Administration.

According to a recent story by Denise Grady in The New York Times, however, the FDA reports that women who have the implants but no symptoms don't need to remove them.

Yet the article does note "the recall means that doctors and hospitals should not implant any more of the devices and should return any on their shelves to Allergen."

The disease is not breast cancer but developed in tissues around the implant. "In most cases," Grady's story says, "removing the implant and the scar tissue around it cures the cancer, but if it is not detected early it can spread and kill the patient."

The condition, it continues, "has occurred with implants placed for cosmetic breast enlargement and with those used for reconstruction after mastectomy for breast cancer."

Thirty-three deaths and 573 cases have been reported from implants, Grady's piece reports, with a dozen deaths and 481 of them attributed to Allergen Biocell, according to the FDA, which dragged its heels after first recognizing the link to breast implants in 2011.

The Times story, which notes that the devices were banned months ago in Europe, contends that the "Biocell textured implants carry a risk that is about six times that of other textured implants sold in the United States."
Dr. Binita Ashar
It also reports that Dr. Binita Ashar, director of the FDA's Office of Surgical and Infection Control Devices, said at a news briefing…about the recall" that "hundreds of thousands of women in the United States have Biocell implants." 

The article also quotes Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, as saying that "the data regarding deaths was particularly informative of our decisions."

Main symptoms of the disease "are usually swelling and fluid accumulation around the implant," Brady writes.

FDA officials reportedly are considering "adding a black-box warning [to the labeling of the breast implants] to draw attention to the risks, and requiring doctors and patients considering the surgery to go over as checklist to help women understand the benefits and risks of the devices."

More information about implants can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.