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Vol. 7, No. 4 · October 2003 · Editor: Martha L. Golar, Esq.
IN LIVING FULLY WITH BREAST CANCER” DATE: November 18, 2003 TIME: 6:30 P.M. PLACE: Skadden Arps Slate Meagher & Flom Four Times Square, 37th Floor (between 6th Avenue & Broadway) New York, NY GUEST SPEAKERS: Dr. Roberta Lee, MD, medical director of the Continuum Center for Health and Healing Dr. Martin H. Erlich, MD, CAc, MPH, internist and acupuncturist at Continuum. The Continuum Center for Health and Healing is an integrative medical center sponsored by Beth Israel Medical Center. · Current News Items · September Program -- "Beyond Mammography: Breast Imaging in 2003" · Courthouse Alert Kick-Off Event · JALBCA Participates in Komen Race for the Cure · Attorney General Health Helpline · Cornell University Program on Breast Cancer and Environment Risk Factors in New York State (BCERF) · Calendar of Events Current News items The news media has reported several items of interest concerning breast cancer which JALBCA members may find of interest. The news articles are summarized below, however JALBCA has not independently researched or investigated the accuracy of the reporting. Docetaxel and Taxotere trial -- Docetaxel, which is marketed under the brand name taxotere and manufactured by Aventis S.A., was studied in a clinical trial which compared its effectiveness to paclitaxel, marketed as taxol by Bristol-Myers Squibb Co. In the trial, women who took docetaxel survived for an average of 15.4 months, compared to 12.7 months for those taking paclitaxel. However, they experienced more side effects such as loss of strength, fever, mouth ulcers and low white blood cell count. The study included 449 women with advanced breast cancer who had previously undergone standard chemotherapy treatment. Paclitaxel is extracted from the bark of the Pacific yew tree. Docetaxel is made by a semi-synthetic process. Both compounds interfere with cell division but they are broken down and cleared by the body differently. Herceptin and Taxotere combination trial --It was reported that women with tumors testing positive for the HER2 gene who were given a combination of herceptin and taxotere had nearly double the life expectancy of those who were given only taxotere, the difference between 24 months as compared to 13 months. Herceptin is marketed by Roche Holding AGwith Genentech Inc. The results of the two trials described above were presented at the European Cancer Conference in Copenhagen during September 2003. Gene test to predict cancer survival -- The New England Journal of Medicine in September published findings of a cancer genetic test which was developed at the Netherlands Cancer Institute, with help from Rosetta Inpharmatics in Kirkland, Washington. The approach is still experimental but may point the way to predictive testing in the future. The researchers used a 1-by-3 inch gene microarray, or chip, to examine simultaneously which of 25,000 genes were expressed (i.e., switched on) in tumor samples from 295 women below age 53. The researchers discovered 70 genes which, when switched on or off in a certain pattern, predicted either that the cancer will spread and kill the patient or, alternatively, will not do so. The group consisted of a genetically defined high-risk group as well as a low-risk group. The high-risk patients were five times more likely to have their cancer spread. In addition to the genetic test allegedly being more accurate in predicting recurrences of cancer in women in the low-risk category, the test could also have an impact on treatment. This is because the test apparently suggested that many patients are misclassified into high- or low-risk categories using standard American methods and such classification, in turn, affects the aggressiveness of a patient’s treatment. Researchers are also working under the hypothesis that this type of study can be done successfully with other tumor types, with comparable results. Gene profiling test to prescribe the best therapy -- The Lancet medical journal reported the research of scientists at Baylor College of Medicine in Houston, Texas to conduct genetic profiles on samples of cancerous breast tumors in order to test their response to docetaxel. The study was headed by Dr. Jenny Chang and used tumor samples from 24 patients. The research team found 92 genes that seemed to indicate whether the tumor would be sensitive or resistant to docetaxel. The obvious benefit of a successful genetic profiling test would be that, by knowing how a tumor would respond before treatment commences, medical providers could avoid using drugs that would be ineffective and instead select therapies that would be most effective. September Program -- "Beyond Mammography: Breast Imaging in 2003"  JALBCA’s September program featured Annette Brown, M.D., a radiologist with Long Island College Hospital. She discussed the current methodologies employed for breast imaging, noting that mammograms remain the “gold standard”, notwithstanding new techniques such as ultrasound, digital mammography, magnetic resonance imaging (MRIs), positron emission tomography (PET scans) and stereotactic biopsy, each of which she discussed.Turning first to ultrasound, Dr. Brown noted it was not currently FDA approved nor recommended by the American College of Radiology as a screening tool for breast cancer. It is merely an adjunct to mammography. Its applications include investigating a suspected problem, e.g., to distinguish between a fluidfilled cyst and a solid mass. Radiation is avoided with ultrasound, but it is not reliable as a screening tool for the following reasons: it lacks spatial resolution (i.e., fine detail), cannot detect most calcium deposits on breast tumors, its effectiveness depends largely on the operator, it cannot document how much breast tissue has been imaged and it can result in false positive or false negative results. The technique, however, may be advisable for screening purposes in women who have had breast cancer and have dense breasts, for young women with a bad family history of breast cancer who have dense breasts, and for women over age 50 with dense breasts. The second technique, digital (computerized) mammography, uses x-rays but involves a digital receptor rather than a film cassette. The resulting images have better contrast than those obtained with regular screen film. Dr. Brown explained that both digital and regular mammography are presently considered “comparable” in detecting breast cancer, although a clinical trial funded by the NCI may provide more information in 2005, when results should become available. Benefits of digital mammography were described as including the following: improved contrast between dense and nondense tissue, faster image acquisition, shorter exam time than film screen mammography, easier image storage, and the ability to transmit the image over the phone line. On the other hand, digital mammography is more expensive than standard screen film mammography and there is no efficient method to compare digital mammography images against existing mammography films. Dr. Brown next explained the use, advantages and disadvantages of MRI, which have been approved since 1991 as a supplemental tool to mammograms, to help diagnose breast cancer. MRIs use powerful magnetic fields and a contrast material called gadolinium DTPA, which is injected into a vein in the arm before or during the procedure to improve the quality of the image. Breast malignancies will typically become brighter more quickly and more intensely than benign tissue with the use of this contrast material. The advantages of MRIs include the following: the physician can image breast implants and ruptures, it is highly sensitive to small abnormalities, it is effective for dense breasts, it allows evaluation of inverted nipples for evidence of cancer, it allows evaluation of the extent of the breast cancer, it can help determine what type of surgery is indicated (lumpectomy vs. mastectomy), it may enable the physician to detect recurrences and residual tumors after lumpectomy and it allows for location of the primary tumor in women whose cancer has spread to axillary lymph nodes. Among its limitations, though, are the facts that MRIs are expensive, take 30-60 minutes to perform, require a contrast agent, can be difficult for those who suffer claustrophobia if a closed MRI unit is used, and the tissue it identifies can be non-specific (i.e., cancerous or non-cancerous). Dr. Brown then introduced a type of nuclear medicine imaging, PET scans, which require low-level radioactive chemicals. These involve cross-sectional data, as do CT-scans. PET scans are helpful in checking for recurrences. Finally, Dr. Brown discussed the use of a stereotactic biopsy to pinpoint the location of an abnormality which cannot be felt on a physical exam. This is an alternative to an open surgical biopsy. She explained that it would involve taking approximately twelve core specimens but it is minimally invasive and is associated with less deformity, less morbidity and is also cheaper than surgery. Courthouse Alert Kick-Off Event  JALBCA kicked off its annual October Courthouse Alert with a well-attended, very successful reception in the courthouse of the Appellate Division, Second Department. The reception featured the jazz ensemble Safe Sex. The program began with brief formal presentations by JALBCA Co-Presidents Roy Reardon, Esq. and Acting Justice Shirley Kornreich and Honorary Event Chair Justice A. Gail Prudenti (Presiding Justice, Appellate Division, Second Department). The reception was coordinated by Civil Court Judge Ellen Spodek and JALBCA Secretary Susan Solomon, Esq. Justice William C. Thompson (ret.) served as master of ceremonies.  As part of its Courthouse Alert activities, JALBCA has arranged through the American-Italian Cancer Foundation to have a van provide free mammograms (the cost of which is subsidized by JALBCA) in Brooklyn at three separate locations – a “first” for Red Hook under this project – as follows:October 9 – Red Hook Community Courthouse, 88 Visitation Place November 8 – Brown Memorial Baptist Church, 484 Washington Avenue, Fort Greene December 15 – Brooklyn Supreme Court, 360 Adams Street Vans are also being arranged for in other counties in New York City. Appointments can be made by calling the American-Italian Cancer Foundation at 800.564.6868. JALBCA Participates in Komen Race for the Cure On Sunday, September 14th, JALBCA members participated once again in the Komen Race for the Cure. This year, 67 women and men joined the JALBCA team. Our distinctive black and pink t-shirts were prominent as our members ran and walked to the finish line. The weather held, and the event, which raises money for education, research and treatment of breast cancer, was successful and a great deal of fun. Much thanks goes to Lisa Volpe, who “creates” the JALBCA team each year, and to her co-captain Co-President Shirley Kornreich. Attorney General Health Helpline Members are reminded that the NYS Attorney General’s Health Care Bureau operates a Health Care Helpline for consumers. The Helpline assists New Yorkers with individual problems and investigates and takes law enforcement action to address systemic problems in the operation of the health care system. Inquiries can be made to 1-800-771-7755 option 3. By way of example, the Helpline has assisted to resolve a situation where an HMO failed to comply with New York’s Prompt Pay Law (which requires a health insurer to pay an undisputed claim within 45 days of receipt of a claim or bill for services rendered, including interest at the rate of 12% if the claim is paid after 45 days). Specifics on the Prompt Pay Law can be found in New York’s Insurance Law, Article 32, Section 3224-a. Cornell University Program on Breast Cancer and Environment Risk Factors in New York State (BCERF) BCERF, created eight years ago, has been involved with public education and public health protection legislation to provide science-based information on environmental risk factors for breast cancer. During Summer 2003, BCERF announced that it will join with the newly created Sprecher Institute for Comparative Cancer Research in Cornell’s College of Veterinary Medicine, and that this will enable them to continue their efforts and also provide an opportunity to “extend comparative medicine not only across different cancers but also different species." Those interested in learning more about BCERF, or in obtaining their Newsletter, can check their new website address at http://envirocancer.cornell.edu. BCERF has scheduled a regional cancer and environment forum for October 24, 2003. It will take place in Westchester County at Manhattanville College in Purchase. A fee of $10 will be charged to attendees. Calendar of Events MEMORIAL SLOAN-KETTERING POST-TREATMENT RESOURCE PROGRAM Call 212.717.3527 to register for the following program: Transitions: A Meeting for People Recently Finished with Autologous Stem Cell Transplant The aftermath of treatment may present challenges such as coping with feelings of isolation and fatigue. Peers and health care team members will address concerns.
SHARE (SELF-HELP FOR WOMEN WITH BREAST OR OVARIAN CANCER) 1501 Broadway, Suite 1720 NYC Call 212.719.0364 for further information. SHARE HOTLINE: Breast: 212.382.2111 Ovarian: 212.719.1204 Breast cancer support groups, ovarian cancer support groups, breast and ovarian combined groups, groups for family and friends affected by breast or ovarian cancer, wellness workshops; educational programs. Some upcoming programs: Cancer and the Role of Proteins
Lymphedema Q & A Session
Chemotherapy and Your Heart
JALBCA does not endorse the content or efficacy of any workshops or programs listed in the Calendar of Events; listings are for informational purposes only, so that our readership is aware of current offerings. |
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