Breast cancer

08 October 2010

Biologics and breast cancer

Carrie Brown was only 27 years old when her battle with breast cancer began. She was diagnosed in 2004 - and again in 2007. But she's beaten it with the help of biologic therapy.

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Every October, the medical profession and breast cancer survivors raise understanding of the dreaded disease during Breast Cancer Awareness month. For those who have been treated with biologics and have shared their stories to give hope to others, breast cancer has become a journey.

Biologics is the target-specific treatment that now offers hope for people with certain cancers. According to Dr Devan Moodley, an oncologist at Wits Donald Gordon Medical Centre in Johannesburg, the main advantage of biologic therapy lies in its ability to exert its effect only on the target.

“This is not always innocuous, though, as many targets may not only be on the tumour but also on other normal tissues, which may lead to side effects. It is not all a bed of roses, but it’s certainly nothing like conventional chemotherapy.”

 Real-life story

Durban resident Carrie Brown (now 34) was only 27 years old when her battle with breast cancer began. And she fought a long, hard fight. This is her story:

When I was first diagnosed, I searched the internet and read books on what to expect and how I could overcome the disease. I have since learnt that - just like there is no text book for life, there is no text book for cancer - no two people are the same and the journey is different for everyone.

 I’ve been down the breast cancer road twice now. My first diagnosis was in May 2004. I underwent a mastectomy, two sets of chemotherapy, radiotherapy and HER2 targeted IV therapy, because I had an aggressive form of breast cancer called HER2-positive.

We had beaten this beast and had no sign of recurrence. I regained my fertility and - miraculously after this intense treatment - I fell pregnant and had a little boy in November 2006. 

 My cancer experience, however, was far from over as I was diagnosed in February 2007 with a second primary cancer, completely unrelated to the first and with different receptors to the first - though still HER2-positive.

Carrie’s treatment plan

Treatment included two sets of chemotherapy and what I call my miracle drug - the targeted therapy - for a period of 12 months.

It was so refreshing to receive such an effective drug with minimal side effects; to know that I had this “safety blanket” and to be able to get on with my everyday life without feeling tired, ill and vulnerable to infection.

My advice to anyone going through a similar ordeal is to make sure they find out whether their breast cancer is HER2-positive or not. Knowing your HER2 status helps you and your doctor plan your treatment specifically for your type of breast cancer.

 An oncologist or surgeon can do a HER2 test to find out your status.

Life after breast cancer

My new life has been filled with various things - some were exciting, while others were incredibly draining. Nevertheless, I have had six precious years since diagnosis which is just awesome – and I plan to be here for many more years to come. 

The chemotherapy was challenging, but I have also watched my baby grow (he is turning 4 in November 2010) and saw the book I wrote, Losing my Balance, grow from notes on pieces of paper into a bound and printed book. 

I received incredible feedback from people who read it and it made me so glad to have been through the experience so that I could inform and uplift others. That truly makes it all worth it.

If someone had told me six years ago that I was about to experience cancer first hand, I would have laughed at them. Who, me? Never!  If someone had told me that cancer was going to be one of the most life changing journeys I would experience and that I would never want to look back, I would have said to them, “Are you crazy?” 

If someone had told me that I would write a book documenting my experience that would win a publishing prize, I would have never believed it. If someone had told me I would defy the odds, conceive and give birth to a perfectly healthy little boy following my cancer treatment, I would have told them they were dreaming. 

It all just goes to show how unpredictable life is and how every person is an individual. Stay strong and never stop believing. Life is an incredible journey – enjoy the ride!

What is HER2+ breast cancer?

HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2), which promotes the growth of cancer cells. In about one of every five breast cancers, the cancer cells make an excess of HER2 due to a gene mutation.

This gene mutation and the elevated levels of HER2 that it causes can occur in many types of cancer - not only breast cancer.

HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. Medical science is, however, making great strides in the treatment of this cancer and others, with drugs known as “biologics”.

What are biologics?

The essential difference between a biologic drug and other drugs is their size and complexity. Regular drugs (like antibiotics and painkillers) are small, simple molecules that can be manufactured in laboratories.

Biologics, however, are so large and complex that scientists cannot manufacture them: They are ‘farmed’ or grown from living organisms (such as yeast cells) which have been genetically modified to produce these complex substances.

These complex molecules are later “cleaned” to remove impurities, folded in a form that makes them work effectively and often modified with complex sugar molecules on their surfaces to make them more stable and efficient.

This is why they’re called biologics - because they are produced through complex biological processes. Think of it this way: If a normal drug was a bicycle, a biologic drug would be an F1 fighter jet both in size and complexity.

The success rate in breast cancer treated with biologics is “variable”, says Moodley, depending on which drug is used. However, with biologics proving to be quite remarkable in their function, SA’s Biologics Working Group (BWG) says that biologics often represent the latest biomedical research, and can therefore be the most effective means to treat a variety of illnesses when conventional treatment fails - and some offer solutions where previously no treatment was available.

Hope for biologics’ future

According to the BWG, biologics are not a first-line treatment in South Africa and strict guidelines govern their use. However, this should not detract from the hope they provide.

Kirti Narsai of the BWG says, “Clinical experience has shown that in the early treatment of HER-2 positive breast cancer, the death rate from the disease is halved when patients are treated with a well known biologic.”

Pink ribbons may one day be a thing of the past, as long as medical science keeps researching and developing treatments like biologics.

 Source: Biologics Working Group (011 805 5100).

 (Health24, October 2010)

Read more:
Breast self-examination
Types of cancer

 

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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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