BREAST CANCER.
APPROXIMATELY ONE IN EIGHT AMERICANS WOMEN WILL DEVELOP
BREAST CANCER DURING THEIR LIFETIME.
BREAST CANCER IS THE SECOND MOST COMMONLY DIAGNOSED FORM OF
CANCER IN WOMEN.
SOBERING STATISTICS WHICH REALLY UNDERSCORE THE EFFORTS TO
MANAGE, CARE FOR AND ULTIMATELY BEAT THIS DISEASE.
WITH US TODAY DR NANCY PEACOCK A MEDICAL ONCOLOGIST SPECIALIZING
IN BREAST CANCER TREATMENT WITH TENNESSEE ONCOLOGY AND CHAIR OF
THE SAINT THOMAS HEALTH NETWORK CANCER COMMITTEE AND COMING UP A
LITTLE LATER ON THIS MORNING A BREAST CANCER SURVIVOR WILL
SHARE HER INCREDIBLE STORY, BUT FIRST WANT TO WELCOME DR.
PEACOCK TO THE SHOW, GOOD MORNING TO YOU DOCTOR.
GOOD MORNING DANIELLE.
THE FIGHT AGAINST BREAST CANCER HAVE WE SEEN QUANTIFIABLE
IMPROVEMENT WOULD YOU SAY OVER THE LAST, LETS SAY TEN YEARS OR
SO?
YES, I THINK WOMEN ARE MUCH MORE AWARE ABOUT THE NEED FOR
MAMMOGRAPHY AND SEEKING THAT OUT FROM THEIR HEALTH CARE PROVIDERS
IN A PROACTIVE WAY.
I THINK WE'VE MADE QUANTIFIABLE IMPROVEMENTS IN OUR APPROACHES
TO SURGICAL TREATMENT TO RADIATION TREATMENT AND ACTUALLY
OUR ABILITY TO PREDICT WHO'S GOING TO RESPOND BEST TO
SYSTEMIC CHEMOTHERAPY OR BIOLOGIC THERAPY OR HORMONAL
THERAPY...AND FINALLY I THINK WE ARE ABLE TO BETTER IDENTIFY
WOMEN WHO HAVE GENETIC MUTATIONS OR FAMILIAL RISK FOR BREAST
CANCER.
FROMA BREAST CANCER PATIENT PERSPECTIVE WHAT ARE SOME OF THE
BIGGEST CHALLENGES?
ACUTE TOXICITIES FROM CHEMOTHERAPY SUCH AS HAIR LOSS,
NAUSEA AND VOMITING, ORAL MUCOSITIS, FATIGUE, NEUROPATHY,
WHICH IS NUMBNESS OF THE FINGERS AND TOES, RADIATION DERMATITIS,
I THINK THAT HORMONAL THERAPY ALSO CAUSES TOXICITY, THIS IS
HORMONE BLOCKING AGENTS THAT PREVENT ESTROGEN FROM CAUSING
BREAST CANCER CELLS TO GROW AND DEVELOP.
ANYTIME YOU DEPRIVE A WOMAN OF ESTROGEN YOU MAKE HER FEEL A
LITTLE MORE TIRED, SHE HAS HOT FLASHES.
WHAT WE CALL VASOMOTOR SYMPTOMS, HOT FLASHES, NIGHT SWEATS, JOINT
ACHES, IRRITABILITY, INSOMNIA, MOST WOMEN KIND OF GO THROUGH
THAT GRADUALLY AFTER THE AGE OF FIFTY BUT YOUNG WOMEN WHO HAVE
ESTROGEN POSITIVE BREAST CANCERS ARE FORCED INTO THAT EARLY
BECAUSE OF THEIR TREATMENT.
SO FOR PATIENTS WHO ARE ESTROGEN RECEPTOR POSITIVE, CAN YOU
EXPLAIN THIS SIGNIFICANCE FOR THOSE WHO ARE UNDERGOING
TREATMENT?
ABOUT SEVENTY-FIVE PERCENT OF WOMEN WITH BREAST CANCER WILL
HAVE EITHER THE PRESENCE OF THE ESTROGEN RECEPTOR, THE
PROGESTERONE RECEPTOR OR BOTH OF THEM.
UM, WHAT THAT MEANS TO THE PHYSICIAN IS THAT WE CAN USE
HORMONE BLOCKING AGENTS SUCH AS TOMOXIFEN OR THE AROMA TASTE
INHIBITORS AS A REAL STRATEGY TO REDUCE THE RISK OF THOSE BREAST
CANCERS FROM COMING BACK.
INITIALLY WE JUST THOUGHT THAT WE NEEDED TO USE THEM FOR FIVE
YEARS BUT THERES MORE AND MORE EVIDENCE EMERGING THAT CARRYING
THESE HORMONAL BLOCKERS OUT FOR TEN YEARS OF THERAPY OPPOSED TO
FIVE IS PROBABLY GOING TO BE A STRATEGY THAT REDUCES LATE RISK
OF RELAPSE EVEN MORE.
IN YOUR OPINION WHAT WOULD YOU SAY IS THE BIGGEST REASON THAT
WOMEN FALL SHORT IN MAINTAINING THEIR THERAPY REGIMENT?
FIRST OF ALL, THEY ARE DEALING WITH THE SIDE EFFECTS OF THEIR
TREATMENTS.
THE CHEMO THERAPY THAT WE'VE ALREADY TALKED ABOUT.
THEIR GOING THROUGH TOXICITIES OF HORMONAL THERAPY, AGAIN JOINT
PAIN, UM WEIGHT GAIN, HOT FLASHES, NOT SLEEPING WELL AT
NIGHT AND YOU MIX THAT IN WITH LIFE ISSUES SUCH AS CHILD
REARING, ISSUES WITH THEIR RELATIONSHIP WITH THEIR SPOUSES,
THESE WOMEN MAY BE CONCERNED ABOUT THEIR JOBS AND KEEPING
THEIR INSURANCE COVERAGE, ALL OF THOSE THINGS WILL HAVE TO HAVE
ONE BAD GUY AS THE CULPRIT, AS THE THING THAT'S CAUSING THE
SIDE EFFECTS AND THE LIFE ISSUES AND I THINK THAT THE THING THAT
MOST COMMONLY IS PICKED OUT AS THE BAD GUY IS THE HORMONE
BLOCKING AGENT BECAUSE BEFORE THEY HAD IT, THEY DIDN'T HAVE
ALL THESE PROBLEMS, BUT I THINK THERE ARE REAL WAYS THAT WE CAN
DEAL WITH TOXICITIES.
WE HAVE PRETTY GOOD PHARMACEUTICAL INTERVENTIONS
THAT WE CAN USE TO HELP WITH SPECIFIC SIDE EFFECTS AND
PROBLEMS AND SO A WOMAN JUST REALLY NEEDS TO TALK TO HER
HEALTH CARE PROVIDER.
WELL I WANT YOU TO STICK AROUND BECAUSE WE'RE GOING TO MEET A
BREAST CANCER SURVIVOR HERE TO SHARE HER JOURNEY AND HER ROADS
TO RECOVERY, WE'LL BE RIGHT BACK.
(MUSIC).
WELCOME BACK TO OUR SEGMENT ON BREAST CANCER AND THERAPIES
ASSOCIATED WITH THIS DISEASE.
WITH US ONCE AGAIN DR.
NANCY PEACOCK,A MEDICAL ONCOLOGIST
SPECIALIZING IN BREAST CANCER TREATMENT AND JOINING US BREAST
CANCER SURVIVOR JULIE MCGEE.
JULIE WELCOME TO THE COUCH, GLAD TO HAVE YOU WITH US THIS
MORNING.
THANKS FOR HAVING ME.
DR.
BEFORE WE HEAR FROM JULIE I WANT TO PROBE A BIT FURTHER IN
TERMS OF THE OPTIONS THAT WOMEN WHO FALL SHORT IN THEIR THERAPY
REGIMENT SUCH AS TOMOXIFEN.
WHATS BEING DONE TO ENSURE THAT THEY DO CONTINUE AS PRESCRIBED?
THERE ARE OPTIONS FOR PEOPLE BESIDES PILLS.
THERE IS A LIQUID FORM OF TOMOXIFEN THATS AVAILABLE.
THERE ARE WAYS TO TREAT HOT FLASHES AND NIGHT SWEATS WITH
PHARMACEUTICALS.
THERE ARE WAYS TO TAKE CARE OF IRRITATING MOUTH ULCERS WITH A
DRUG CALLED GELCLAIR.
WE HAVE WAYS TO PREVENT AND TREAT RADIATION DERMATITIS WITH
ANOTHER PRODUCT CALLED BIONECT.
SO THERE ARE LOTS OF SUPPORT OPTIONS OUT THERE, WE JUST NEED
TO MAKE SURE WE ARE ASKING THE QUESTIONS TO THE PATIENT TO FIND
OUT WHAT THEY NEED.
JULIE, HOW DID YOU FIRST DISCOVER YOU HAD BREAST CANCER?
DANIELLE I WAS DOING A ROUTINE BREAST EXAM AND FOUND A LUMP
THAT I HAD BEVER FELT BEFORE AND IMMEDIATELY CALLED MY DOCTOR AND
HE SET UP AN APPOINTMENT FOR A MAMMOGRAM WHICH WAS FOLLOWED BY
A BIOPSY AND I WAITED A GOOD WEEK AND A HALF AND I HEARD THE
WORDS THAT NO BODY WANTS TO HEAR, YOU HAVE BREAST CANCER.
IT WAS VERY HARD.
REALLY HARD.
I HAD A LUMPECTOMY AND FOLLOWING THAT I HAD RADIATION TREATMENT.
I WAS THEN PUT ON TOMOXIFEN BY MY ONCOLOGIST WHICH IS A TABLET
FORM AND I CAN'T TAKE PILLS, NEVER HAVE BEEN ABLE TO AND SO
HE GAVE ME AN ALTERNATIVE CALLED SOLTAMOX, WHICH IT'S THE EXACT
SAME DRUG AS TOMOXIFEN.
IT WORKS THE EXACT SAME FOR REDUCING MY RISK AND I'VE BEEN
TAKING IT FOR A WHILE NOW AND HAVE HAD NO SIDE EFFECTS FROM
IT.
AND THE GREAT THING ABOUT THAT IS THAT'S A LIQUID FORM.
DR.
PEACOCK IS JULIES STORY FAIRLY TYPICAL AND ARE THERE
OTHER KIND OF SUPPORTIVE CARE ISSUES THAT CANCER PATIENTS
SHOULD BE AWARE OF?
THE IMPORTANCE OF HERE STORY IS THAT SHE RECOGNIZED THERE WAS
SOMETHING DIFFERENT,SHE PAID ATTENTION TO IT AND SHE GOT HELP
FOR IT.
A LOT OF WOMEN WILL TEND TO BLOW THAT OFF OR NOT PAY ATTENTION
AND JUST SAY OH IT'S NOTHING AND JUST GO ONWITH THEIR DAY.
ESPECIALLY IF YOUR YOUNGER.
SHE HAS A HARD TIME TAKING TABLETS AND SO SHE HAD A LIQUID
FORM OF THE SAME MEDICATION AVAILABLE.
SO MANY OF MY PATIENTS WILL COME IN AND TELL ME I JUST CAN'T TAKE
ANOTHER PILL, I CAN NOT TAKE PILLS.
DON'T YOU HAVE ANYTHING ELSE FOR ME?
I THINK THAT ITS REALLY IMPORTANT FOR THE MEDICAL PEOPLE
TO SAY ARE YOU TAKING YOUR PILLS AND IF NOT, WHY?
ONE THING PEOPLE HAVE TO DO IS EDUCATE THEMSELVES ABOUT THEIR
BREAST CANCER , TREATMENTS, breastcancer.org IS A GREAT
WEBSITE, IT'S SO INFORMATIVE AND I DEFINITELY BELIEVE THAT
KNOWLEDGE IS POWER.
YOU KNOW I WAS JUST THINKING HERE, YOU KNOW CERTAINTY YOU
DOING YOUR SELF BREAST EXAM MAY HAVE SAVED YOUR LIFE AND I
WANTED TO POSE THAT LAST QUESTION TO YOU DR.
WHAT ARE SOME CLOSING THOUGHTS?
I THINK THE GREAT NEWS IS THAT SURVIVAL IS IMPROVING WITH
BREAST CANCER, I THINK IT'S ALSO IMPORTANT THAT PEOPLE KNOW THAT
THERE ARE SUPPORTIVE CARE OPTIONS OUT THERE, IT'S NOT ALL
ABOUT WHAT'S THE BEST TREATMENT OPTION, IT'S ABOUT HOW DO WE
SUPPORT PEOPLE THROUGH THEIR TREATMENTS.
PEOPLE NEED TO BE AWARE THAT THERE ARE OPTIONS OUT THERE FOR
THEM.
THANK YOU SO MUCH JULIE, I'M SO GLAD YOU'RE HERE TO TELL YOUR
STORY AND DOCTOR I HAVE TO TELL YOU TERRIFIC INFORMATION, THANK
YOU FOR JOINING US AS WELL THIS MORNING...AND IF YOU'DE LIKE TO
GET MORE INFORMATION ON TODAY'S TOPIC JUST GO TO THE WEB AT
breastcancer.org OR VISIT thebalancingact.com AND SHARE
YOUR THOUGHTS AND CONCERNS RELATED TO BREAST CANCER WITH
US.
YOU CAN ALSO LOG ON TO FACEBOOK AND SEARCH FOR BALANCING ACT
FANS.