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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.

Given these new targeted therapies, individualized treatment, and widespread screening, where do you think we’ll be in the near future? What about a cure for breast cancer?

I can tell you where I hope we are. As for a cure, people sometimes imagine we’ll have a magic bullet or a super pill or some other treatment that will make the cancer go away. So far that has proven elusive.

I think that, over the next few years and decades, we’ll continue to devise even more specific, individualized treatments for each woman who is diagnosed with breast cancer. That means that some women will have less treatment, some more.

We’ll also continue to make progress on treatments that have fewer side effects. And I believe we’ll discover more about the risk factors for breast cancer and the behavior of tumors -- both may lead to lower incidence.

Obviously, early detection is key, and that requires more sensitive tools than we currently have. I’m hopeful that we’ll develop increasingly sensitive techniques to catch breast cancer as early as possible.

Let’s move on to ovarian cancer, which is difficult to diagnose and therefore more deadly. What are researchers looking at right now in the fight against ovarian cancer?

You’re right. It has remained a more lethal cancer, for two reasons: One, we’ve lacked good early detection, and two, new treatments have been slow to develop. But we now know that giving chemotherapy drugs directly into the lining of the abdomen means we can target more closely the source of the cancer and also where it’s likely to spread. Emerging data also suggest that newer drugs such as the antiangiogenesis drugs might be valuable for treating ovarian cancer, so that’s an area of active clinical investigation. These drugs essentially starve the cancer by blocking blood supply and depriving the cells of oxygen and nutrients.

Of course, we now have a consensus on early ovarian cancer signs, which are subtle and may not indicate cancer at all. The main value here is to raise awareness of the disease and not to frighten women.

We still need a good tool to catch this cancer earlier. The National Cancer Institute has been sponsoring early detection trials for ovarian (as well as prostate and cervical) cancer for quite some time. Researchers are looking at screening by ultrasound or by a specific blood test, so the results of these trials could someday lead to earlier diagnosis.

What about cervical cancer? The recent HPV vaccine certainly seems to be the biggest news in cancer in recent years. Do you agree?

Absolutely. The HPV [human papillomavirus] vaccine is an amazing breakthrough because it’s the first vaccine targeted against the actual cause of a specific type of cancer. Cervical cancer deaths in the United States are relatively uncommon, though that isn’t true in other parts of the world. Nevertheless, cervical cancer is a great example of how prevention can help. Before the vaccine, the No. 1 prevention tool was the Pap smear. And, like mammograms for breast cancer, fewer deaths from cervical cancer are due to the widespread use of Pap smears, which detect very early precancerous changes.

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