Breakthrough research but...

Its all over the news this morning that a new study was published in Nature Magazine yesterday. You can read it here in its full technical jargon. You can also read about it here in its 'translated for normal people' version. It does represent some great research where they have broken down breast cancer into four types:

• Triple negative seems to be a basal type which makes it more related to ovarian cancer so this is saying should it be treated like ovarian cancer? An interesting thought for a very aggressive and difficult to treat disease.
• The most common type of breast cancer ER+/PR+/Her2- is divided into two groups based on the luminal status (whatever they are). One group does well with chemotherapy, one does not, but both do well with hormonal therapy (Tamoxifen/Femara etc). So this means some women would no longer get chemo as in the past.
• The last group is the Her2+ group which has recently been treated with Herceptin that has turned one of the worst cancers in to one of the easier to treat.

This is all wonderful and good but it was based on a study of the tumors in 825 women... which is a really small number. And as the article in the New York Times on this cautions:

"For now, despite the tantalizing possibilities, patients will have to wait for clinical trials to see whether drugs that block the genetic aberrations can stop the cancers. And it could be a vast undertaking to get all the drug testing done. Because there are so many different ways a breast cancer cell can go awry, there may have to be dozens of drug studies, each focusing on a different genetic change."

So as always, more studies (and patient patients) are needed.

Clinical trials and long term after effects

So yesterday, after my deeply profound post on the long term affect effects of chemo, I went to a conference for people living with cancer. I sat through a couple of sessions on the state of cancer care and its future which were very interesting.

They were talking about new treatments coming out - for example additional treatments other than Herceptin for those who are Her2 positive. There were also some discussions on radiation treatment advances and how the new 3D and IMRT machines allow for more precise delivery of radiation - hence sparing nearby body parts which do not need to be scorched.

There was some conversation of things that are in clinical trials should be available soon or are even in the first round of human trials. So I started thinking about why are there no clinical trials for us longer term people? There was a clinical trial I wanted to participate in - for the recurrence vaccine. While I am not a fan of needles, I would be happy to get a series of shots if it could reduce my chance of recurrence. Then I found out it was only for people who were less than two years out from treatment so I was not eligible.

I understand that they want to have precise groups of volunteers in clinical trials which meet a specific set of criteria so they are comparing apples to apples with fewest possible interferences. These become very small groups. But it seems once you are through treatment, there are no trials available. And that seems wrong.

We are still people coping with a cancer diagnosis and once we get through treatment, we are excluded from research. No one seems to care about the long term effects. Too may potential variables which could interfere with a trial have entered our lives so no one wants to do any research with us. But we still count.