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Women’s Cancer Q&A: Advances in Care

WebMD’s women's cancer expert, Harold J. Burstein, talks to WebMD's chief medical editor about treatment advances, research breakthroughs, and the prognosis for the future.

WebMD Magazine - Feature

How far have we come in women’s cancer? Keeping up with the latest treatment trends and studies about cancer of the breast, ovary, uterus, and cervix can be daunting. New studies come out seemingly every week with hot-off-the-press -- and often contradictory -- results. Mammograms? They’re either the key to prevention or misleading at best. And what’s the final word on hormone replacement therapy? Does it prevent or cause cancer? Experts have even recently challenged the value of sticking to a low-fat diet to help keep cancer at bay.

We need answers. An estimated 251,140 U.S. females will battle breast, ovarian, uterine, or cervical cancer in 2007. For a clearer picture of the state of women’s cancer treatment today and tomorrow, WebMD chief medical editor, Michael W. Smith, MD, turned to WebMD’s resident cancer expert, Harold J. Burstein, MD, PhD.

What breast cancer advances are you most excited about?

Two big ongoing trends in breast cancer medicine today offer patients tremendous promise. One is the development of new drugs that target cancer cells directly. Some interfere with specific molecules involved with cancer cell development or tumor growth. Others slow the growth of breast cancer cells that enlarge in response to the hormone estrogen. These drugs work by blocking estrogen’s effect. Still others target the vascular system and block development of blood vessels that help feed the cancer cells.

These drugs are an exciting development for a couple of reasons. One, targeting a cell process that has gone awry allows the treatment to actually get right at the molecular process that has contributed to developing cancer. Second, these treatments have much less effect on normal, noncancerous cells. This usually leads to fewer side effects than with typical chemotherapy.

What is the second trend?

Breast cancer treatment is much more personal than in the past, and we’re able to tailor a woman’s treatment based on the genetic makeup of her own cancer cells. It perhaps sounds obvious, but what we’re finding is that not all breast cancers are the same.

Specific genes in these cells can tell us how the tumor will grow, how likely the cancer is to recur, in general how it will behave. This information helps shape treatment -- how aggressive to be with chemotherapy, for example, or even which patients really need chemotherapy and which patients don’t.

Women hear a lot about the benefits of a low-fat diet and exercise, and popular rumors advocate avoiding chemicals such as those in antiperspirants. What’s your take on breast cancer prevention strategies?

With some cancers, we do know what the major risk contributors are. For instance, we know smoking is directly associated with lung cancer, bladder cancer, head and neck cancer, cervical cancer, and pancreatic cancer.

But with breast cancer, we don’t have such clear risk factors; in fact, most are fairly weak -- such as whether you had children or at what age you first became pregnant, how much you weigh, and how much alcohol you drink. They increase the risk of getting diagnosed with breast cancer only by a little bit. For most women, we don’t really know why they develop breast cancer.

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