Expedition Inspirations continues to
Breast cancer symposium
By DANA DUGAN
Express Staff Writer
"Itís remarkable what
we get in this valley," a woman said as she departed a recent public forum
on breast cancer research. "Weíre lucky to live here." The woman, a
cancer survivor, had just spent two hours listening to some of the foremost
doctors and researchers on breast cancer in the country.
The forum was part of the
Expedition Inspirationsí Seventh Annual Laura Evans Memorial Breast Cancer
Titled "Breast Cancer
Metastases: Formation, Detection, Treatment," the symposium was held in Sun
Valley, Feb. 20 through Feb. 23.
The public forum included
featured speakers who made presentations on timely subjects and general breast
cancer research and developments. It concluded with a flurry of questions from
Featured speakers were Dr.
Julie Gralow, chair EIFBCR Medical Board, associate professor of medical
oncology at the University of Washington School of Medicine and Fred Hutchinson
Cancer Research Center in Seattle; Dr. William Gradishar of Northwestern
University Medical School and director of Breast Medical Oncology at the Robert
H. Lurie Comprehensive Cancer Center, Chicago; Dr. Marc Lippman, chair of the
Department of Internal Medicine Research and Developments at the University of
Michigan Health System in Ann Arbor.
Dr. Ron Dorn and Dr. Kathleen
Grant, two of Laura Evansí doctors who were on the groundbreaking climb on
Argentinaís Mount Acongagua in 1995, also participated on the panel. They are
both also on the Expedition Inspirations board.
Another board member, Dr.
Robert Vestal, from Boise was on the panel. Other speakers included Dr. Cliff
Hudis, chief of Breast Cancer Medical Service at Memorial Sloan Kettering in New
York; Dr. Donald Cleveland of the Ludwig Institute for Cancer Research, at the
University of California in San Diego; Dr. Chris Benz, of the Buck Institute in
Novato, Calif., and Dr. John Lung of Mountain States Tumor Institute, Boise.
Dr. Gralow began the talk by
discussing the risk factors involved with breast cancer. The No. 1 risk is being
female, she said. Although, men can and do get breast cancer. The No. 2 risk
factor is age, with the average age of a breast cancer patient being 62.
The third largest risk factor
is reproduction history. Several components factor into this issue. The history
of a womanís menstrual cycle, how many pregnancies a woman has had, whether
babies were breast-fed and at what ages the pregnancies occurred.
pregnancies," Gralow said, "the less the risk. Does this mean we
should go into schools and promote pregnancies? No. Thatís a whole other
problem. But pregnancy does protect us."
Part of the reason the
incidence of breast cancer has risen in the past 20 years is that women have put
off having babies. In many cases the later a woman bears a baby, the higher the
risk of breast cancer.
Life style is also a risk
factor. Factors such as stress, smoking, extreme weight gain, lack of exercise,
exposure to pollutants and toxins, alcohol intake, and diet play a role.
The fifth largest risk factor
is family and genetic history. Many people assume itís the most important
factor, but Gralow said 70 percent of cancer patients do not have a history of
cancer in their family.
Dr. Gradishar added that it
remains a pertinent issue if the "family history has multiple close family
membersómother, sistersówho have cancer."
Regarding prevention, Dr.
Lippman discussed, as he did last year, phytoestrogens, progesteron and clinical
trials. "I donít think it matters what kind of progesterone you use if
the risk goes up," he reiterated. "If youíre taking enough
phytoestrogen to reduce hot flashes, youíre more likely stimulating breast
cancer cell growth."
In addition he said,
"Oral contraceptives are wonderful anti-cancer" drugs for the average
women who has no risk factors.
Despite the necessity of
exercise, he said that a woman who over exercisesómarathoners in particularóruns
the risk of decreasing her menstrual cycles, thus putting her at risk.
Lippman had hopeful words as
well, though. Death from breast cancer will fall below 40,000 a year. The
chances of a patient dying are now down to one in five, which is a significant
improvement, he said. Much of this is because of better drugs coming on the
market after long trial periods. Breast cancer is not just one disease, he said.
"We have to match the drug to the disease.
"We can now look at
30,000 genes on a slide. We can see which gene is on or off. What is the pattern
and how is this cancer changing? What makes this a bad cell?"
Cancer cells have unlimited
growth and have the ability to spread, he said. Normal cells donít migrate to
other sites. And unlike normal cells, cancer cells donít know when to die.
"Whatís really cool,
is that we have figured out how to treat them by looking at them and
understanding what is making a cancer cell behave metastatically," Lippman
said. "But thatís the tip of the iceberg."
Cancer cells not only know
how to feed themselves, they can grow proteins, which keeps them from dying.
"Cancer is a metaphor
for what we feel we canít control. We have to get rid of the metaphor. Cancer
is running out of places to hide."
Many pencils were scribbling
across paper as Lippman talked. A valley health care provider in the audience
leaned over and whispered, "The study of cancer is the study of
The audience for the forum at
the River Run Lodge was filled with informed cancer survivors.
Dr. Cleveland said,
"Within all cells there exists a suicide pathway. However, some drugs,
including Taxol, are being looked at which may encourage cancer cells to commit
suicide." This finding is so important that the 2002 Nobel Prize for
Medicine went to three doctors for their discoveries concerning genetic
regulation of organ development and programmed cell death.
Researchers also know now
that the impact is not just limited to the tumor. The immune system throughout
the body is compromised. Tests show that Taxol disables cancer cells,
particularly in the cancers that affect women's reproductive systems.
If tumors didnít
metastasize weíd just cut off the breast and be done, Lippman said. But they
The speakers ended on a high
note. They said they would be exchanging ideas and discoveries over the
following two days and would then go home to spread the word.