The Pink Page

Breast Cancer Treatments Go Meta

By Matthew M. F. Miller
CTW Features

Metastasis via the blood stream is the most common cause of death in breast cancer patients, but a new medical finding could soon make it testable and, ultimately, more easily preventable.

In a new study by New York-Presbyterian Hospital/Weill Cornell Medical Center, funded by the National Cancer Institute, researchers identified a new breast cancer metastasis marker called Tumor Microenvironment of Metastasis (TMEM). The density of the TMEM-marker was more than double in patients that developed systemic metastases compared with the patients with only localized breast cancer.

“Currently, anyone with a breast cancer diagnosis fears the worst, that the cancer will spread and threaten their lives,” says senior author Dr. Joan G. Jones, professor of clinical pathology and laboratory medicine at Weill Cornell Medical College. “A tissue test for metastatic risk could alleviate those worries, and prevent toxic and costly measures like radiation and chemotherapy.”

According to the National Cancer Institute, 40 percent of breast cancer patients suffer a relapse and develop metastatic disease, and more than 40,000 women die from it each year.

“If patients can be better classified as either low risk or high risk for metastasis, therapies can be custom tailored to patients, preventing over-treatment or under-treatment of the disease,” says Dr. Brian D. Robinson, resident in Anatomic Pathology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and co-author of the study.

The discovery could directly impact survival rates by giving doctors the ability to assess each individual’s likelihood to develop metastasis based on more accurate information.

"Traditionally, the likelihood of breast cancer metastasis is estimated based on tumor size, tumor differentiation – how similar or dissimilar the tumor is compared to normal breast tissue – and whether it has spread to the lymph nodes,” Jones says. “While these are useful measures, TMEM density directly reflects the blood-borne mechanism of metastasis, and therefore may prove to be more specific and directly relevant.”

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Quality Over Quantity

By Matthew M. F. Miller

CTW FEATURES

Coping with a cancer diagnosis isn’t easy for anyone, but a new study finds that as a woman’s quality of life increases over time, coming to terms with breast cancer requires fewer coping mechanisms.

“It is generally assumed that coping strategies impact quality of life, with more active coping strategies generally associated with better quality of life,” says Suzanne C. Danhauer, Ph.D., assistant professor at Wake Forest University Baptist Medical Center, Winston-Salem, N.C., and lead investigator of these analyses. “This research examined coping strategies over time and the reciprocal relationship between coping strategies and quality of life among younger women with breast cancer to see if the opposite might be true – that quality of life determines the use of coping strategies.”

The study focused on 267 women with breast cancer, with a mean age of 43 years, who completed surveys within six months of diagnosis and follow-up surveys six weeks and six months later. Researchers discovered that the coping strategies in younger women changed over time. Seeking social support, spirituality, wishful thinking and making changes decreased over time and detachment increased, all leading to positive cognitive restructuring (reinterpreting something stressful as positive or helpful), which was the most frequently used coping strategy. Keeping feelings to oneself was the least used coping strategy and its use remained consistently low over time.

Those reporting a poorer quality of life were more likely to use multiple coping strategies at subsequent time points. This finding suggests that people adapt their coping strategies in response to problems with which they are dealing. As quality of life increased, fewer coping mechanisms were needed.

“We emphasize, however, that this finding is suggestive and not definitive,” Danhauer says. “The relationship between coping strategies and quality of life is complicated and future studies should examine this reciprocal relationship.”

© CTW Features

Matthew M. F. Miller, author of “Maybe Baby: An Infertile Love Story” (HCI, 2008), is a syndicated fatherhood blogger

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