in the face of so much grief
 

I was looking for something hopeful to add here--I attended a hopeful lecture at Stanford this morning and talked with a researcher (on a topic unrelated to the talk) who has an interesting idea which
I will post more on later as she fills in the details.

The lecture was about genotyping (identifying the genes which characterize) circulating tumor cells and what that can tell you about which breast cancers metastasize, how they do it, and how one can tell if a particular treatment is working in a particular patient and how to tailor treatments to prevent resistance.

They looked at circulating tumor cells in real patients (as well as in mice with human bc implants). Interestingly, and scarily, the CTCs in the patients with metastatic breast cancer were not all the same in any one patient at any one time ie, there was a mix of ctcs with different genetic identities. There were two patients whose primary tumors were her2+ who developed metastasis among whose ctcs some were her2+ and some were triple negative while still continuing on herceptin!
Dasatinib was said to be helpful in treating triple negative patients ( determined by primary tumor) with ctcs so they proposed that a trial of herceptin+ dasatinib might help prevent the emergence of triple negative ctcss

Again, this is all very new and not yet published. Estimated publication date is in June.
The machine for finding CTCs and the microfluidic chips for genotyping them have already been developed, so things are well underway.

The interesting idea involved a target on some breast cancer patients' tumor cells called Na/Iodine symporter. The researcher is interested in looking at the primary tumors of bc patients for the presence of this marker.

If present, she would like to do a nuclear scan to determine where the breast cancer has spread to and then in a clinical trial use radioactive iodine like they do to cure thyroid cancer to kill the breast cancer cells.

Since the technology is already present and approved for another use, this bit of research looked closer to fruition, if perhaps not as widely applicable (the tumor has to have this marker)

I remember several people here have posted on their thyroid cancer treatments, and thought they might be able to give some input on this idea.

In the meantime, let's try to emerge from our grief ever more determined to make progress against this disease--and soon!

Dear Lani

I agree and thank you for all your scientific posts. It was terrible to read about Michelle this morning but then you, Hopeful and Jean posted articles that I found fascinating. Although they were unrelated, the more I thought about them, they ended up related in my little biochemical mind. I'll explain. The articles were about what makes DCIS morph into invasive cancer, another was that BRCA negative women have more contralateral abnormalites than BRCA positive women (I'll think of the last one as I type).

As I thought about the DCIS (which is a favorite topic of mine and the fact that each and every one of us had DCIS at one time), I thought about Dean Ornish's Breast health book that I read even prior to starting chemo. I had started to take Omega 3 several months prior to diagnosis (as heart disease runs in my family) but Ornish's book recommended taking 8 per day and I was taking 1. He said that you need to take that many per day for at least 4 months to change the fatty microenvironment in the breast (so the ratio is right). Well, these 2 things clicked for me with the DCIS article today. You can change your microenvironment. This is why some DCIS becomes invasive or even why there are different grades and why food can be medicine as well as exercise. Epigenetics - how the environment acts on your genes. Turning on a gene when it should be off and vice versa. Then the BRCA article! Well, women who are BRCA are born with a mutation on one of two matched chromosomes. When the match "mutates", then cancer occurs. However, BRCA negative women may have a problem with the microenvironment of the ducts and lobes caused by "whatever". But that "whatever" is everywhere. Not just one specific place in the breast. It is affecting all the fatty microenvironment. If it is off, it is off and that may be why it is more likely these women have more than one bad area in the breasts. It is fascinating to think about and in a way, how you can influence it. For example (and I am only thinking out loud), does taking the spice/supplement Tumeric (which in mice slows and stops bc tumor growth) actually act as a "chemo" or does it modify the microenvironment so that tumor suppressor genes stay on instead of turn off (due to some other modifying chemical in the microenvironment that should have not been there).

I am not a doctor nor a researcher but if I can think this way, certainly they are (or some of them are) to come up with the answers that get closer to prevention and cure/permanent remission.

Every paper and study that we each come up with is related - even if they don't seem to be (6 degrees of separation) and this site is so great for at least getting the info out there and getting it in here. I am probably going on too long so I'll end for now. Thanks for listening

thanks you
 

brilliant analysis Becky...makes a great deal of sense even to me!
Marcia

thanks Lani and Becki
 

Lani:

Thank you so much. The gifts that you give, your time and knowledge, are so very generous. Please know that I definitely find comfort in your posts.

Becky:
I did not know that every Her2+ had DCIS at one time. I had always wondered that about my sister as part of her tumor was DCIS. We have an aunt that had only DCIS. I am wondering if that would have eventually evolved into Her2+............

thank you both!

Lisa

All breast cancer starts as DCIS - not just Her2+ bc.

thanks Becky
 

Thanks Becky

I did not know that. Once again, learning is one of the biggest reasons I am here. I appreciate your posts very much.

Lisa

Lani and Beck, thank you both. And, Becky, "thinking out loud" is akin to "thinking outside the box" which is akin to "Eureka!". If we think out loud more, it becomes a very large brain-storm and who knows where that can lead. I, personally, want to hear all ideas, and everyone "thinking out loud".

Speaking of DCIS, a dear woman in my support group had it 7 years ago and had a double mastectomy because she is bipolar and didn't want to take tamoxefin or radiation. The doctors told her she didn't have to worry any more. She has bone mets now. Interesting, her doctors at two major cancer centers recently told her that she is the 1% of DCIS that recurs. None of them had seen a recurring DCIS person until they treated her. This is a complicated disease.

even stranger is that tamoxifen has been found to be
 

helpful in bipolar disease!

I hope she doesn't find that out. Which goes to show that some of this is a crap shoot. Seven years ago her doctors agreed with her when she expressed concerns about depression on tamoxifen. Today, as you say, it's been found to be helpful in bipolar disease.

What about this?
 

A question for you........Fifteen years ago I had a lumpectomy in the exact same are that I developed breast cancer in.

After the lumpectomy my surgeon called me and said that the results were inconclusive and they were going to send the tissue sample to another pathology lab. Final pathology .... "atypical hyperplasia cells" which I was told is "typical in women who develop breast cancer."

I always would inquire about these "atypical hyperplasia cells" at every annual exam but honestly don't feel I was ever answered in any way and of course, nothing was ever going to happen to me anyway so I think I pretty much just let it go.

Anyway, was that my dcis??? It just seems funny that my lump was growing in that same area.

Thanks for your help....

Mary Jo

Becky,

One of the reasons I post as many articles as I do is so that "propeller heads" like you and Lani can try to fit the pieces of the puzzle together. I do like to try and do a little of that "intuitive reasoning" myself from time to time. Keep "thinking out loud" - you never know when an idea will click for someone, or you will say something someone else will be able to extend to yet another conclusion. For me, that is a lot of what this site is all about.

Hopeful

Marejo

Atypical hyperplasia is the step before DCIS (which is really non-invasive breast cancer).