Posted on Oct 09, 2013 by Michael Loftus
In the UK, more cancer patients suffer from breast cancer than from any other form of the disease. Almost 50,000 women each year are diagnosed with breast cancer, and as with many other cancers that occur in a particular organ or tissue, breast cancer and the patient’s susceptibility to developing it are largely related to genetics. As the human genome becomes better understood, medical specialists are working to find more precise ways to treat breast cancer, and perhaps even prevent it.
Because breast cancer often runs in families, it’s no surprise that cancer patients stand to benefit from genetic testing and intervention. In general, a woman’s risk of developing breast cancer during her lifetime is about one in eight, but a history of cancer in close family members increases that risk greatly. A woman whose mother or sister has been diagnosed with breast cancer has a one in four chance of developing the disease herself. For women with relatives who were diagnosed with breast cancer at a relatively young age, that risk increases even more.
Doctors have for years understood that connection between breast cancer susceptibility and family medical history, and researchers now know that there are specific, inherited genes - known as BRCA 1 and BRCA 2 - that increase the lifetime risk of breast cancer by as much as 90 percent.
Genetic testing can tell a woman whether or not she carries BRCA 1 or BRCA 2, and in many cases, a woman testing positive for either of these genetic markers will elect to undergo a double mastectomy and remove the possibility of cancer developing entirely.
A double mastectomy was the option chosen recently by the actress Angelina Jolie, due to strong evidence that she might develop breast cancer. The disease runs in her family, and in addition, a genetic test showed that the actress was carrying the BRCA 1 genetic markers.
Besides undergoing this elective surgery, women with a predisposition toward breast cancer can also engage in drug therapy before the cancer even develops.
In the UK, more doctors are offering these pre-emptive drug regimens, and the National Institute for Health and Care Excellence has concluded that the drugs tamoxifen and raloxifene, if taken daily for over a five-year programme, may reduce breast cancer risk by some 40 percent. Research has also shown that this treatment has a protective effect lasting for up to ten years. The National Institute for Health and Care Excellence is the first agency in Europe to recommend that doctors consider placing healthy women on long term drug treatment programs, but the Institute has said that it expects equivalent authorities in other parts of the UK and the EU to quickly come into line with this practice.
In England and Wales, pre-emptive drug treatment will be available to some half a million women who are 35 years and older, and who are judged, on the basis of family history or other strong risk factors, as having a moderate-to-high risk of developing breast cancer.
However, some women may be reluctant to start a drug regimen before being diagnosed with an actual disease; especially considering the strength and side effects of the drugs recommended. Research shows that many women who began pre-emptive cancer therapy dropped out of the program due to the unpleasant side effects of tamoxifen, including nausea, exhaustion, loss of hair and severe headaches.
Although these side effects are worrying indeed, some health workers say that high-risk women should persist with the treatment nonetheless - the idea being that it’s better to experience an upset stomach today than breast cancer tomorrow. The Breast Cancer Campaign in the UK has even suggested that as many as 500 women per year might be dying as a result of stopping pre-emptive cancer treatment regimens.
Breast cancer intervention and treatment has been greatly aided by new discoveries in genetic testing and therapy, and other recent cancer research may also help women who have already survived one bout of cancer. Breast cancer recurrence is fairly common, and UK scientists with the Institute of Cancer Researchers have reported that they are developing a genetic test to examine a patient’s likelihood of relapse. With this test, doctors can be more equipped to decide which women will benefit from chemotherapy, and which would do better to engage in an alternative form of treatment.
All of this cancer research and scientific work is promising for a future wherein, by using genetic testing and interventions, breast cancer can be detected and maybe even prevented before it starts.