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Photo from Dr. Susan Love Research FoundationDr. Susan Love was the first person I turned to when I was kicked in the gut with my breast cancer diagnosis. Her book, Dr. Susan Love's Breast Book, helped me make important treatment decisions (to keep nodes, or not to keep nodes?) before, during (is six months of chemo enough?), and even after my treatment (should I remove my "good" breast proactively?).
Thanks to her Dr. Susan Love Research Foundation, there's a good chance I might see the end of breast cancer in my lifetime. To that end, Love/Avon Army of Women was created to "enlist" research participants (I just recruited myself!).
I asked Dr. Love to share her health tips and breast cancer insights. I asked, she answered.
Q: What is the current number one health concern for women? (Does this change periodically, and if so, why?)
A: This varies with age.
In young women, accidents are the biggest killers, while in women in their 70s, it's heart disease. Lung cancer has a higher death rate but breast cancer is the most common.
The goal has to be to live a pretty healthy lifestyle. Note I didn't say healthy because that is a goal never of us can totally achieve, but to live pretty well means regular exercise, reasonable diet, maintaining a healthy weight, not smoking, avoiding unnecessary radiation i.e., medical. With those you'll have done what you can to reduce the risk of most chronic diseases. Add wearing seat belts, helmets when indicated, and not texting or drinking while driving and you'll decrease accidents! It's impossible to do all these all the time.
As we say in my recent book Live a Little, when you have young kids, you do weight lifting normally just carrying them around. Running after them gets your heart rate up. But when you hit 50, it's more important that you make sure that physical activity is still part of your life. And we need to remember that we can't prevent all problems since we're not totally in control. Life is terminal! So it's important not to stress out too much trying to be healthy and remember to enjoy each day (remember chocolate is a vegetable since it comes from a bean!).
Q: Has breast cancer screening advanced in recent years, and if so, how?
A: The problem with screening is that it is NOT prevention but rather just finds cancers that already are there. We are better at "finding things" but NOT at knowing which ones are significant and need treatment and which are not. We know that 30 percent of women have microscopic cancer cells on their breasts on autopsy but most of the time they are dormant and harmless.
The goal is not to find those and over treat them, but rather to figure out which ones have the potential to kill you. That is where we have failed. We are really good at finding things with mammography, MRI, and even ultrasound, but not so good at knowing which ones matter.
Q: What are some of the recent advances in breast cancer treatment, and what does this means for women being treated (less side effects, less time to administer, etc.)?
A: The big advance came from the realization that not all breast cancers are the same (see above). We can now parse out at least six different kinds of breast cancer each with a different prognosis and sensitivity to treatments. This means we can figure out which hormone positive cancers needs chemotherapy as well as or instead of hormones and which ones do well with hormones and would have no benefit from chemotherapy (Oncotype Dx test). We know which tumors are well treated by Herceptin and which do the best with chemotherapy (triple negatives).
So, instead of one size fits all and more is always better, we now know that we need to match the tumor to the treatment so as to improve outcomes and decrease unnecessary side effects.
Q: What are your tips for reducing the risk(s) of breast cancer?
A: The best way to reduce the risk is maintain a healthy weight, exercise regularly, avoid unnecessary radiation, drink alcohol in moderation, and avoid or limit use of hormone replacement therapy.
Q: In the next 5-10 years, what do you think will happen in the breast cancer treatment arena?
A: While I think treatment will become even more personalized ie matched to the DNA of the tumor and your own pharmacogenetics (how you metabolize drugs) and your age, I hope that we will have found the cause and can just prevent the disease altogether.
Q: Anything else you'd care to add?
A: Within my professional career we have gone from treating an abnormal Pap smear with a hysterectomy to having a vaccine for HPV and being able to prevent cancer of the cervix almost completely.
Why can't we do that for cancer of the breast? My goal is to find the answer.
The first step is to move some of the research away from lab animals and petri dishes to women. Rats don't naturally get breast cancer unless we give it to them, and the findings from rats don't always translate to women. To do this, we need women willing to participate in the research, whether it's finding a blood test or testing a new hypothesis regarding the cause.
This has led to the Love/Avon Army of Women, which seeks to recruit one million women who are willing to consider participating in research. Once a woman signs up she will receive emails from us telling her about studies that we have approved. If she fits the requirements and wants to join, she RSVPs, if not she passes it on to a friend or acquaintance who may be interested.
We have launched 27 studies over the last year and a half and many we recruit everyone they need within 24 to 48 hours! We need women with breast cancer as well as women who have not had breast cancer. Of the over 333,700 women who have already signed up, 80 percent are healthy women and 20 percent are survivors. It is important that all ethnicities are represented or the research won't represent all women. This is a way that everyone can become part of the solution so that our children will never know what it means to have breast cancer!