Around the Web: Sore & Bruised Edition

I'm pretty sure I gave myself whiplash last weekend when I tripped on the laces of my sandals during an aggressive game of duck-duck-goose. One minute I was the "goose" chasing Quinn, the next I was smacking the cement with such force and velocity that my sunglasses went flying, I scraped most the skin off my right elbow, and all of my pride went floating away like a lost balloon.

Remember? I told you I'm a bit of a klutz.

I woke up on Monday with a headache and a sore neck, both of which have gotten better as the week goes on. My elbow too. That hasn't stopped me from wondering if I have brain mets due to the headaches or bone mets due to how sore my elbow is. 

Hey, I never said cancer made me more rational. 

Speaking of sore, I've started a new exercise routine, although calling it a routine is a bit of a stretch since I've only gone four times in two weeks. I'm started doing Pilates with a couple of girlfriends after one of them roped the other two of us in like cattle about to be slaughtered.

My texts with my other new-to-Pilates friend have gone a bit like this over the last 24 hours: 

Me: My calves are burning!!!!

My friend: I mean, my calves hurt so bad that if I stay stagnant for too long, the second I get up, I almost crumble.

Me: Every time I go to stand up, my legs seize up. I might sleep on the couch just so I don’t have to move again.

My friend: OMG...I know. I just walked from the couch to the desk (and you know how short of a distance that is) and about fell over.

Here's the deal, though. I figure if I exercise enough that I'm always sore somewhere, it somehow makes the pain less likely to be from cancer. Or takes my mind off of cancer (a little, anyway).

And speaking of cancer, here's why you're here, the things I saw in the world of research around the web this week.

***

Do Patient Navigators Actually Help?

What do you think? Have you used services like this? Would you? I haven't, but then I kind of have because I have my husband Chris, who is basically my extra set of eyes and ears and most definitely my extra memory. 

Also, this: 

"In the end, many say, debating patient navigation may be asking the wrong question. Why not, they wonder, spend the money and energy needed to overhaul the entire cancer-treatment system?

“One question worth asking is why do [patient navigators] exist,” Ramsey said. “And the reason is the cancer community has done a very poor job of helping patients through the system. The fact that navigation exists is kind of an indictment of the cancer-care system.”'

Why BRCA Genes Eventually Resist Cancer Treatment

"Now, scientists at Yale School of Medicine in New Haven, CT, have pinpointed a key molecule called co-factor DSS1 that helps the BRCA2 gene to repair DNA.

They note how "DSS1 acts as a DNA mimic," and without it, BRCA2 mutations cannot do their job of repairing DNA - which is key to the survival of cancer cells.

The team says the findings point to a possible way to decrease drug resistance in cancers involving BRCA genes.

Senior author Patrick Sung, a professor of molecular biophysics and biochemistry, suggests drugs that interfere with DSS1 function could be developed and used with existing drugs to overcome this resistance."

A Clue About Why Brain Metastases Occur, And One Possibility for Stopping Them

This is at a way early stage (mouse models), but looks promising. 

"Removing a single protein from the blood could stop breast cancer spreading to other part of the body, scientists have discovered.

They identified a key molecule, which triggers the growth of blood vessels in tumours that have spread to the brain - a common secondary site for breast cancer to spread.

By withholding the protein, called DOCK4, a particular part of the blood vessel did not form as quickly, meaning tumours grew at a slower rate, scientists found.

Dr Georgia Mavria, from the University of Leeds, said the discovery could help develop new drugs and identify people at risk of their breast cancer spreading."

How Many Studies Like This Do We Need?

"The increased use of mammograms to screen for breast cancer has subjected more women to invasive medical treatments but has not saved lives, a new study says.

After reviewing cancer registry records from 547 counties across the United States, researchers concluded that the screening tests aren’t working as hoped. Instead of preventing deaths by uncovering breast tumors at an early, more curable stage, screening mammograms have mainly found small tumors that would have been harmless if left alone."

It's also very much worth reading this piece by the always-insightful Elaine Schattner, who writes, in part: 

"But mainly I’m concerned about the author’s definition of overdiagnosis, and their conclusion. In the paper’s second paragraph they write: “However, there are increasing concerns that screening unintentionally leads to overdiagnosis by identifying small, indolent, or regressive breast tumors that would not otherwise become clinically apparent.”

Yes, there are fast and slow breast tumors; pathology varies. As I will discuss in a post forthcoming, knowing the details of breast cancer should enable women and their doctors to avoid overtreatment, which is a real phenomenon and can be separated from overdiagnosis.

But regressive breast cancers?"

Exactly.

Adding Progesterone to "Double Positive" Patients' Protocols Could Increase Survival

"It turns out that when progesterone sticks to the progesterone receptor in cancer cells, it alters how the oestrogen receptor works, and effectively puts a second brake on tumour growth. Tests showed that mice given progesterone and tamoxifen had breast tumours only half the size of those given the drug on its own.

“Crucially, it provides a strong case for a clinical trial to investigate the potential benefit of adding progesterone to drugs that target the oestrogen receptor, which could improve treatment for the majority of hormone-driven breast cancers,” Carroll added. Details of the study are reported in Nature."

Around the Web: AstraZeneca Edition

Nope, this post is not sponsored. But I did spend last week (well, two days of it) at a conference for oncology bloggers at MedImmune, the global biologics research and development arm of AstraZeneca Pharmaceuticals. It seems more and more companies in the healthcare space are taking note of how patients communicate with each other and realizing it might be useful for them to join the conversation.

Deep in thought about oncology topics

"The role of the patient has evolved over time and today patients are more involved than ever in their healthcare and look to one another online for support, advice and a sense of community. AstraZeneca strives to engage with patients to ensure the latest information and support resources are available, and help determine where unmet needs remain."

You can read more about the AZ summit here.

I flew out to Baltimore for less than 30 hours on the ground, a whirlwind of sessions and lab tours and conversations with women I'd only previously known online, one of whom (CJ) cofounded METAvivor and has now been NED for six years. Talk about inspiration.

Here are a few of us touring the lab and looking "distractingly sexy," if I do say so myself.

Touring the Phase I Oncology Lab at MedImmune

Speaking of sexy --  how was that for a transition? -- I'm working on a separate post about one of the summit's sessions. It was led by Dr. Sage Bolte and focused on intimacy after a cancer diagnosis, which is not a typo.

But we still have a lot going on here as a family and I'm in a chemo fog this week, so please be patient with me. In the meantime, here's what I've seen around the web since I last posted this series. One of these days, I'll try to be regular about it!

Even More Reason to Cut Back on Stress After a Cancer Diagnosis

"Recently, researchers have discovered that the hormone progesterone, an ingredient in contraceptives and menopausal hormone replacement therapies, might stimulate the growth of breast cancer cells that are resistant to anti-estrogen therapy and chemotherapy. Now, new research published June 22nd in the journal Oncogene, a Nature publication, shows that additional hormones, including stress hormones that are frequently used to treat the side effects of common chemotherapy, could make these effective cancer drugs fail sooner in some women with breast cancer. But there may be ways to counteract the effect."

Promising Results in the Paloma-III Trial for Ibrance/Letrozol

(Which, if you'll remember, was fast-tracked for FDA approval pre-trial results back in February.)

Liquid Biopsies Are All the Rage, But Are They Helping Patients Yet?

"So far, most insurers, including Medicare, don’t pay for these kinds of tests. They don’t think it’s their role to underwrite what looks like a research experiment. Health insurer Anthem labels the tests “investigational and not medically necessary.” Cigna calls them “unproven.”

Eventually, the most important use of liquid biopsies should be to catch signs of cancer early, before symptoms arise—when a surgeon can cure it by cutting it out (see “Spotting Cancer in a Vial of Blood”). Such screening could profoundly reshape cancer medicine.

For now, though, they are being used as “theragnostics”—that is, tests that guide decisions about treatment."

THIS is Why We Walked and Lobbied All Over Capitol Hill

"Cyrus Ghajar, Ph.D., a metastatic breast cancer researcher at Fred Hutchinson Cancer Research Center, has received a $4.1 million Department of Defense Breast Cancer Research Program (BCRP) “Era of Hope” Scholar Award.

The Department of Defense’s BCRP is the second biggest funder of breast cancer research in the U.S. Its Era of Hope award encourages high-impact, collaborative research, particularly among innovative young researchers."

Huge Implications for the Future of Treating Genetic Cancers

“In 10, 15 years, our relationship with genetic disease will be very different from today,” says Jacob Corn, managing director of the Innovative Genomics Initiative—a joint effort of UC Berkeley and the University of California, San Francisco—which is collaborating with drug maker AstraZeneca on using Crispr-Cas9 to gain a better understanding of diseases. “It will be, ‘Oh, my child was born with sickle cell. We’re just going to change that.’ ”

Why Nearly EVERYONE is Excited about Immunotherapy

"10 years to cancer cures 'actually plausible,' Fred Hutch president says. . ."

“And I’ve never seen anything like this in my life,” Gilliland continued. “You give this cell-based therapy that was developed by [Drs.] Stan Riddell and Phil Greenberg at the Hutch, and these tumors just melt away. People go into continuous, complete remission. You don’t need to keep giving the drug, you give it once. One infusion — that’s it.”

The potential for extending this powerful approach into other types of cancer, especially solid tumors, has created a sense of urgency among researchers at Fred Hutch and elsewhere."

An Illustration of How Immunotherapy Works

Around the Web: Like Clockwork

I've been chewing my nails something fierce lately, and I haven't been able to put my finger on why (no pun intended). Then it hit me when the scheduler from my oncologist's office called this morning: I am due for my three-month scans.

Except this time I'm not having three-month scans. I got bumped to every four months, which apparently in my world is just going to mean an extra month of anxiety. My body is that well-adapted to this cycle. My brain knows just when to start acting on-edge, when nightly Xanax pills might be in order once again. After all, I've been doing this for almost four years now.

{photo credit}

It's like clockwork over here.

Except it isn't.

So now I'm all thrown off schedule, my right thumbnail is bitten to the quick, and I do have scans on the books five weeks from now. So I better figure out how to get this anxiety under control because I can't take five weeks on high alert. I will literally run out of nails.

I also made the mistake of mentioning this article from last week's round-up to my doctor by way of his assistant, and so my doctor promptly ordered a bone density scan for me. I've never had one, so this will provide a baseline. It is also, predictably, adding to my anxiety. I don't know if it's cancer, or parenthood, or just being in my mid-thirties, but my mind worries about every possible thing that could go wrong, and not just when it comes to scans (from our toaster catching fire, to getting car-jacked at a stoplight because of course, to sinkholes even though we live in Arizona not Florida. The list goes on.)

Anyhow, here's what I saw around the web this week (but I'm not asking my doctor about any of them, lest he order any more tests for me).

At Long Last, Answering Some Questions about 'Exceptional Responders'

"Silva is what researchers call an “exceptional responder,” the rare patient who has a surprising, dramatic response to a drug. . .

Silva’s story, and those of other exceptional responders, have led to an intriguing set of questions: Could researchers use technologies such as genetic sequencing to figure out what made Silva’s tumor respond to treatment? Could they mine that data for clues that might help other patients? Could they ultimately find a way to make the exceptional more routine?"

Actually, I'd happily submit to more tests if it was to figure out why I've been so lucky, why I've responded to drugs the way I have, and maybe lead to answers that could pass some of that luck on to someone else. 

Last Week it Was the Bones, This Week the Lungs?

"Scientists at the University of Edinburgh said they have discovered a “trigger” that allows breast cancer cells to spread to the lungs. . .

Prof Jeffrey Pollard, the centre’s director, said: “Our findings open the door to the development of treatments that target the tumour microenvironment, which may stop the deadly progression of breast cancer in its tracks.”"

Will the Breast Cancer Test Kit be Next to the Pregnancy Tests at the Drugstore?

"Researchers at the Department of Obstetrics and Gynecology of the Medical Center -- University of Freiburg have developed an approach for detecting breast cancer by means of urine samples. The method involves determining the concentration of molecules that regulate cell metabolism and that are often dysregulated in cancer cells. These molecules, referred to as microRNAs, enter into the urine over the blood. By determining the composition of microRNAs in the urine, the scientists succeeded in establishing with 91 percent accuracy whether a test subject was healthy or diseased."

A Case of Two Steps Forward, One Step Back (Or Sideways...)

"Countering previously held beliefs, researchers at The University of Texas MD Anderson Cancer Center have discovered that inhibiting the immune receptor protein TLR4 may not be a wise treatment strategy in all cancers. This is because TLR4 can either promote or inhibit breast cancer cell growth depending on mutations in a gene called TP53. . .

"This looks like a promising avenue to develop drugs for the worst kinds of cancers," says Brown. "However, if we wish to target this immune pathway, we better pay attention to the TP53 status of the tumor.""

Finding Relief from Post-Mastectomy Pain

Mine is not so much pain as it is a significant tightness throughout my right pectoral muscle and armpit region (to use the anatomically correct term, I'm sure) that no amount of stretching seems to alleviate (although yoga helps tremendously). Chris, if you're reading, I think monthly spa massages would help, too.

My goal {photo credit}

"“Pain is a psychological trigger for worry about cancer recurrence,” said Julie Silver, an associate professor at Harvard Medical School who specializes in cancer rehabilitation. “Treating PMPS really helps to relieve that anxiety.”

PMPS is generally defined as nerve-related pain that persists for at least three months after breast cancer surgery, though it can take up to six months to develop. It tends to occur in the upper chest or the underside of the arm, causing pain that women often describe as burning or shooting, and it sometimes presents, as it did in my sister, as an unbearable itch."

I Might Have to Ask My Doctor About A Daily Aspirin Regimen

He can't order any tests based on a question about aspirin, can he? 

"A daily dose of aspirin may be effective at blocking breast tumour growth, Indian-origin researchers have claimed.

Dr Sushanta Banerjee, research director of the Cancer Research Unit at the Kansas City Veterans Affairs Medical Center, and his team found that aspirin may be able to ensure that conditions around cancer stem cells are not conducive for reproduction."

And How Law School May Have Led to My Cancer Diagnosis*

"“People really should elevate the importance of sleep to the same level they do diet and exercise to improve their overall health and well-being,” he said."

On that note, I'm going to bed. 

* Allegedly.

Around the Web: Overdue Edition

Every few weeks, Quinn and I go to the Scottsdale Public Library, which has a superb children's section. There are painted moats on the floor and real castle walls and a drawbridge that leads the way into a reading nook. There are legos for building, a giant stuffed dragon for riding, puppets and a stage for creating stories, and age-appropriate games housed on iPad learning centers. It's a wonderful space. But still, we forget (and by "we," I mean "I") to return in time to get our books in when they're due. I end up logging into my account online and renewing our checked-out books to avoid a late fee and a 15-minute drive.

{We have always loved reading together. Sept. 2012}

Much like our beloved library books, this "Around the Web" series is long overdue for a renewal. Or at least an update, since research is (by all accounts I can find) still happening. Progress, though sometimes achingly slow, is being made.

I don't even know if you guys come here for the research I sometimes post, but I think some of you might. I also think it's important (for my own sanity, if nothing else) to take note of the advances being made on the research side of things. To laud the glimmers of hope out there. Some of them are starting to shine pretty brightly.

***

At the conference I attended in New Jersey a couple of weeks ago, I wondered if I was somewhat of an imposter being at this summit for Online Health Advocates. Was I one? Could I fill those shoes? I mentioned once or twice that I didn't feel so much like an advocate as I did a storyteller, to which a couple of other attendees told me, "Nonsense. That is how we advocate, how we connect with people, through our stories."

Stepping into the role of advocate a bit more fully, for me, means keeping up a little better with the science side of things. (As long as it's not organic chemistry.) I used to be a lobbyist, in my former life back in DC. Yes, stories are how we connect, but when you're sitting in a wonk's office you also better know a little something about the guts of your subject matter. Where is progress being made? What research is most promising? How is it being funded? How can Congress help? I'm exploring a few opportunities that I hope will help me dive even deeper into this arena, and in that vein I'll be brushing the dust off my shoulders to participate in the National Breast Cancer Coalition's annual lobby day before Congress when I'm in DC next week.

{Photo: Mike Boening Photography}

After I walk 39.3 miles.

In the meantime I'm wondering if this is the right format -- or platform even -- for these posts on the research I cull from around the web. What do you think? Keep them here? Or would you subscribe to a newsletter if I promised to keep up with it? Please let me know what you think. And for now, here's the best of what I've found over the past month. (Like I said, overdue!)

Embracing My Inner Pollyanna

via Ann Silberman

"Some cases of metastatic breast cancer are already cured, Sledge said: in the adjuvant setting, where it is micrometastatic disease but still metastatic; and with oligometastatic breast cancer, as the CALOR (Chemotherapy for Isolated Locoregional Recurrence of Breast Cancer) trial has shown recently (Aebi et al. Lancet Oncology 2014;2:156-163).

'So the question is not why can't we cure, but rather why don't we cure more?' he said."

Because Scientists are Doing Things Like This

"Investigators from Massachusetts General Hospital (MGH) and the Harvard Stem Cell Institute have developed an imageable mouse model of brain-metastatic breast cancer and shown the potential of a stem-cell-based therapy to eliminate metastatic cells from the brain and prolong survival. The study published online in the journal Brain also describes a strategy of preventing the potential negative consequences of stem cell therapy.

"Metastatic brain tumors - often from lung, breast or skin cancers - are the most commonly observed tumors within the brain and account for about 30 percent of advanced breast cancer metastases," says Khalid Shah, MS, PhD, director of the Molecular Neurotherapy and Imaging Laboratory in the MGH Departments of Radiology and Neurology, who led the study. "Our results are the first to provide insight into ways of targeting brain metastases with stem-cell-directed molecules that specifically induce the death of tumor cells and then eliminating the therapeutic stem cells.""

Scientists are SO FREAKING COOL.

A Switch to Tame Triple-Negative Breast Cancer?

"Australian researchers have found that so-called 'triple-negative breast cancers'1 are two distinct diseases that likely originate from different cell types. This helps explain why survival prospects for women with the diagnosis tend to be either very good or very bad.

The Sydney-based research team has found a gene that drives the aggressive disease, and hopes to find a way to 'switch it off'."

Promising Outcomes from Early Phase Trials for Metastatic Triple Negative BC

"The high mutation rate of triple-negative breast cancer, which can produce neoantigens that induce an immune response, makes it a candidate for cancer immunotherapy, in particular PD-L1-targeted therapies. In addition, patients with triple-negative breast cancer with high levels of tumor-infiltrating lymphocytes (TILs), have improved outcomes, Emens said."

And for Her-2+ Metastatic Breast Cancers, As Well

""We also saw responses in these women, particularly in those that were anthracycline-naïve," continued LoRusso. "Given that many of the patients had disease that had progressed following treatment with trastuzumab [Herceptin], T-DM1 [Kadcyla], and pertuzumab [Perjeta], these results are encouraging and led to the ongoing randomized, phase II HERMIONE clinical trial, which is testing whether MM-302 plus trastuzumab is more effective than chemotherapy of physician's choice plus trastuzumab for locally advanced/metastatic, HER2-positive breast cancer.

"If the results of HERMIONE are positive, MM-302 may provide another therapeutic option for women with HER2-positive breast cancer," LoRusso added."

Plus a New Signaling Pathway Discovered in Her-2+ Breast Cancer Cells

THIS: "One of the most promising ideas in cancer treatment is to apply a lesson learned in the fight against AIDS (Acquired Immune Deficiency Syndrome): simultaneously attacking a pathological process at different points of weakness can, in some cases, deal a knock-out blow. Just as the so-called AIDS "cocktail" directs multiple agents against multiple targets, so too might future anti-cancer cocktails be directed at multiple, highly specific targets in known cancer pathways."

Don't Worry, Scientists are Finding Ways to Halt Hormone-Driven Cancer, Too

"An experimental drug rapidly shrinks most tumors in a mouse model of human breast cancer, researchers report in the Proceedings of the National Academy of Sciences. When mice were treated with the experimental drug, BHPI, “the tumors immediately stopped growing and began shrinking rapidly,” said University of Illinois biochemistry professor and senior author David Shapiro. “In just 10 days, 48 out of the 52 tumors stopped growing, and most shrank 30 to 50 percent.”"

There's a Lot of Buzz About the Future of "Liquid Biopsies"

"But eventually, we’ll begin to match specific clinical outcomes, such as therapy response, with the circulating DNA that is sequenced. We’re also working on building databases that will show which cancer drugs work most effectively with which cancers at a genetic level. We’re moving forward with this research at an exciting pace; in the next five to ten years, it’s going to make a tremendous difference in how we practice medicine."

The Psychology of Living with Advanced Cancer

“We’re all terminal,” Bellizzi says. “We’re all dying with each passing day, and there’s no way to get around that. I have found that starting my day with that thought helps me change my priorities and perspective. I try to never forget to tell people I love that I love them. If I get in a fight with a family member, I make sure to fix that before I go to bed. We don’t know what’s around the corner. I think it helps us live that way by reminding ourselves that it’s not cancer but life that’s a terminal condition.”

Around the Web: In Memoriam

The cancer community (and at least a few others) reverberated with the death of blogger and frequent tweeter Lisa Adams last week.

{photo source}

One woman posted on Facebook, “It is hard to explain to your family why you’re crying over the loss of someone you’ve never even had a cup of coffee with.” Another explained our collective crying, in part:

#bcsm When a cancer sister dies, it is unavoidable: terror of our own death coming by the same means arises, unexpected and strong.
— Xeni (@xeni) March 9, 2015

It's not just fear of our own mortality, of course. We also miss our friends.

I am not alone in missing Lisa's wit and quick comfort. Even in 140 characters or less, she knew how to get straight to the heart of a matter, what to say, how to be a friend, the right words to use to educate the rest of us about clinical trials, palliative care, end-of-life decisions, and how to stay positive through it all (to paraphrase: find or create a bit of beauty).

My friend Renee's birthday was this week. I miss her, too. And Brigid, and Jen, and far too many others to list here.

So, yes, we grieve for our friends. But there is a large dose of fear. We who are living with metastatic breast cancer can't help it. We wonder: when will our luck run out? How will our families cope? Will our children remember us? Have we done enough to leave our marks, given our limited time (and energy)? Will there ever be an end to this disease? Will it (could we dare to hope) be in our lifetime?

Here is a round-up of the news and research that I hope is moving us in the right direction. My hope sustains me. It brings me out of my fear. Here's to hope. And research.

A New App that May Help Advance Research

"Apple could have slapped a pink ribbon on their iPhone cases during October, or donated a percentage of their October pink iPhone sales to one of the breast cancer organizations, and called it a day. Instead, they chose to put skin in the game, working with Sage Bionetworks to develop ResearchKit -- a completely Open Source (read: FREE) platform for the medical research community to help collect patient-reported data efficiently, effectively, and inexpensively."

You can learn more or download Share the Journey here.

Manipulating Cells' Shapes to Treat Breast Cancer?

"Changing cell shape – through mechanical, chemical or genetic means – could be a new way of assisting the body’s own inflammatory response to fight cancer.

“Interest in using the body’s own inflammatory response to fight cancer has been reinvigorated recently because of the promising results of immunotherapy. Our study further supports the need to explore the role of inflammation and cancer, in order to enhance treatments and the body’s own ability to eliminate cancer cells.”

Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said:

'Cancer cells are in a battle against the body’s natural failsafe mechanisms that seek out and destroy them. This study underlines the importance of a cancer cell’s shape in helping to tip the balance in its favour, not only dodging an immune reaction but actually thriving in response to it. It also shows that manipulating cell shape could help tip the balance back against a tumour.'”

Another Treatment Option in the Pipeline for Her-2+ Cancers

"Poziotinib is a novel oral, pan-HER inhibitor that has shown single agent clinical activity in breast cancer, gastric cancer, lung cancer, and colorectal cancer, and is currently being studied in several Phase 2 clinical trials.

Poziotinib has shown a remarkable 60% response rate in early clinical trials in patients with breast cancer who had previously failed multiple lines of treatment, including HER2-directed therapies trastuzumab and lapatinib."

Hope for Fertility Preservation in Certain Early-Stage Breast Cancers

"A major international clinical trial has found that the risk of sudden onset of menopause can be significantly reduced by adding a drug called goserelin to the chemotherapy regimen. Women who took goserelin and wanted to have children also were more likely to get pregnant and deliver a healthy baby.

'Some of the most distressing side effects of chemotherapy in young women with breast cancer are early and sudden onset of menopause and infertility,' said Kathy Albain, MD, senior author, medical oncologist and Director of Loyola University Chicago Cardinal Bernardin Cancer Center's Breast Cancer Clinical Research Program. 'These findings provide hope for young women with breast cancer who would like to prevent early menopause or still have children.'"

Lowering the Cost of Cancer Medicines

"The Food and Drug Administration approved the first copy of a biotechnology drug for the U.S. market, firing the starting gun on a new industry that could help the U.S. curb its $376 billion in yearly drug spending.

The drug is a rival version of Neupogen, an Amgen Inc. treatment prescribed to chemotherapy patients."

I never needed Neupogen. Instead, I was given Neulasta, a similar drug that is long-lasting rather than fast-acting. Both work to stimulate white blood cell production. My Neulasta shots cost something on the order of $6,000 per infusion, and I got one after every treatment on my old chemo. 

This news could save a lot of people a lot of money. 

Speaking of Money, A Little Grant to Fund Metastatic Breast Cancer

Care to match this, Congress?

The Promise of PARP Inhibitors for BRCA-Mutated Breast Cancer

"The FDA’s recent approval of the first PARP inhibitor, coupled with current research, suggests that this new class of targeted therapy has great potential to help not only patients with ovarian cancer for whom the agent is indicated but also individuals with breast cancer. Mark E. Robson, MD, clinic director of the Clinical Genetics Service at Memorial Sloan Kettering Cancer Center, presented on this topic at the Miami Breast Cancer Conference.

“It is an exciting time. We have an approval for olaparib (Lynparza) in ovarian cancer and there are active phase III studies for olaparib and other PARP inhibitors in metastatic breast cancer for patients with BRCA1/2 mutations,” said Robson."

This One's for My Husband: Chemo Brain Might be Treatable!

Hallelujah. Right, Chris?

Around the Web: Stomp Out BC Edition

There was a movement among the online breast cancer community yesterday to raise awareness for metastatic breast cancer, to call attention to a side of the disease that rarely gets talked about, to make some noise collectively. Stomp Out Breast Cancer Monday was the brainchild of Beth Fairchild (view her news clip here). The goal was to get the hashtags #dontignorestageiv #bckills and #metsmonday trending on Twitter, Facebook, Instagram, or wherever an impact might be felt.

I don't know about you, but my Facebook feed was filled with stories of women I have come to love, women who are facing this disease with so much grace it felt like my heart might burst reading through their experiences. One friend wrote: "The hardest part about living with metastatic breast cancer isn't the treatments. It's looking into my 9 year old's eyes and seeing the pain and fear there. Cancer is a thief that has robbed all of my kids of their innocence." 

Then last night, because Quinn took a weird late-afternoon nap that lasted until 8:30 pm, I was able to participate in the #BCSM Twitter chat that takes place on Monday nights. I got to say hi to some old friends (and new) as we talked about what we'd seen on social media that day: what resonated, what worked, what could be done differently in the future, what our ultimate goal even is. (RESEARCH DOLLARS NOW, PLEASE!!!) Then I found myself crying as we remembered friends who've passed away, and I tweeted this: 

I do not want my son to have to remember me. #bcsm
— Jennifer Campisano (@JCampisano) March 3, 2015

I am also extra emotional because Chris is FINALLY home after four weeks in Africa, because Quinn turns four this week, and because I have a scan on his birthday. It's as if, with Chris back, I can let my guard down and let all this pent up emotion out. I no longer have to run the household by myself, be a single parent (my utmost respect and awe to those of you who are always single parents), or worry as much about the bogeyman every weird noise at night.

Today was emotional, but also inspiring in so many ways. I was proud of how this community rallied to get our voices heard. I hope I can continue to be a part of that rallying cry for many, many years to come.

Here's what else I saw on the web this week.

Basket Studies a Faster Way to Try Many Drugs on Many Cancers

"She is part of a new national effort to try to treat cancer based not on what organ it started in, but on what mutations drive its growth.

Cancers often tend to be fueled by changes in genes, or mutations, that make cells grow and spread to other parts of the body. There are now an increasing number of drugs that block mutations in cancer genes and can halt a tumor’s growth."

A Test to Predict Whether You'll Survive Breast Cancer?

At this point, I'm not sure I'd take such a test. Would you?

"The test uses computerised imaging of tumour samples and statistical analysis to measure the number of immune cell ‘hotspots’.

Researchers found images of hotspots where immune cells were clustered together around breast cancer cells provided a better measure of immune response than simply the numbers of immune cells within a tumour.

Scientists at The Institute of Cancer Research, London, analysed tumour samples from 245 women with ER negative tumours.

They split women with breast cancer into two groups based on the numbers of immune hotspots within their tumours. Women whose cancers had a high number of spots lived an average of 91 months before their cancer spread, compared with just 64 months for those with a low number of spots.

The test is the first objective method of measuring the strength of a patient’s immune response to their tumour."

"This is Going to Happen in Our Lifetimes"

This is long, but so worth the watch. It gave me so many goosebumps. And of course, made me cry. Seriously, by the end I was bawling. But also, so very, incredibly hopeful. 

Around the Web

I woke up Monday morning to the smell of rotten eggs wafting from a rarely-used shower in the bathroom off our kitchen. Through the frosted glass door, I could see a shadowy mass taking over the shower's floor. I hesitated for a minute before opening the door. To sludge? Sewage? It was black and not quite liquid so much as liquid filled with sediment. I quickly closed the door and tried to make my coffee without gagging.

Is Mercury still in retrograde?

Because our stove's gas leak is also back, even though we thought it had been repaired in November. So I'm relearning how to use a slow cooker while I (again) wait for the appliance company to (again) find a part for our thirty-something-year-old beast of an oven.

Clearly, I'm supposed to stay out of the kitchen this week.

(But if you have any winning crockpot recipes, please pass them along!)

The fourth plumber I called was able to come out to the house that day instead of asking me to wait until Thursday. I had just enough time to drop Quinn off at school, drive over to my oncologist's office for blood work, and get back home to meet the guy who'd climb on my roof to snake our shower, which I still don't fully understand. At least my house no longer smells like burning sulfur.

None of which has anything to do with this week's round-up. Except to maybe say that it pays to be persistent.

Case in Point: Slamon's Tenacity Advances the Field of Breast Cancer Research

"Slamon, now director of Clinical/Translational Research at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles (UCLA), conducted the laboratory work and testing that resulted in trastuzumab (Herceptin), the first molecularly targeted therapy for breast cancer. 

His is a particularly intriguing story because the scientist had to fight for 12 years to get trastuzumab from development through approval, keeping the project alive despite a nearly crippling early lack of funding."

A Poignant Call for Action on Metastatic Breast Cancer

Watch the video, too, if you can. 

And this article is helpful for background.

"We don’t really collect meaningful statistics on metastatic breast cancer recurrences. US cancer registry data captures data at the time of diagnosis and death. The registries don’t track what happens in between—i.e., people currently living with metastatic breast cancer.

Remember, about 30% of those originally diagnosed with early stage breast cancer will have a metastatic recurrence. But this information is not tracked–until people die:

NCI and SEER database record incidence, initial treatment and mortality data. Most people do NOT present with metastatic diagnosis. The cancer registry does not track recurrence — which is how the majority of people are thrust into the metastatic breast cancer ranks."

An Interesting Way to Treat Mortality-Induced Anxiety

A long but very worthy read about an experimental therapy. What do you think? Would you try it?

"Every guided psychedelic journey is different, but a few themes seem to recur. Several of the cancer patients I interviewed at N.Y.U. and Hopkins described an experience of either giving birth or being born. Many also described an encounter with their cancer that had the effect of diminishing its power over them. Dinah Bazer, a shy woman in her sixties who had been given a diagnosis of ovarian cancer in 2010, screamed at the black mass of fear she encountered while peering into her rib cage: “Fuck you, I won’t be eaten alive!” Since her session, she says, she has stopped worrying about a recurrence—one of the objectives of the trial."

Chemoprevention Is Not Very Popular

Maybe because risk for breast cancer is not very well understood? 

"Given that these drugs seem to offer some protection, why are they not in widespread use? Serious side effects is one reason. Beyond blood clots and uterine cancer, other known reactions to the drugs include strokes, cataracts, bone pain, hot flashes, nausea and vaginal dryness.

For some women, the risk of such side effects may be worth taking, depending on their particular odds of developing breast cancer. Those odds can be figured by using a commonly used calculator, often called the Gail model, that estimates a woman’s chances of having breast cancer in a five-year period and over a lifetime.

But this is where it gets more complicated. While many experts agree that women at high risk should consider the medications, they do not agree on what Gail score should trigger that consideration."

One Drug's Success Story

"Nobody ever died of cancer cells," says Dr. Larry Norton at the Memorial Sloan Kettering Cancer Center. "You die of tumors."

"I've been doing oncology long enough that I've seen cancers go from incurable to curable at the right moment in history," he says. "It could happen to breast cancer in years; it could happen to breast cancer in days to weeks. We don't know when it's going to happen."

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We had a busy weekend here at the Campisano household. Besides Quinn making a mud pit in our back yard (see photo, below), my mom moved back to town after a two-year stint in Denver.

My younger brother flew down from Alaska to help her make the drive here, and he and I were both close to tears when they arrived Saturday night. Chris would say this is because us Akres are criers. The truth is we might be, but also that I hadn't seen my little brother (who's 6'4") in nearly eighteen months. He was deployed to Afghanistan for nearly half of that time, and the other half it was -38 degrees Fahrenheit where he lives.

So even if us Washingtonians were disappointed by the end of Sunday night's Super Bowl, all was okay in the world for a little bit because I got to watch the game over some chili and queso with my brother (and some other friends and family, including my mom).

(I realize this is not the best picture, but Quinn literally never stops moving and I should probably know by now to shoot everything in "sports" mode. Still, look at that smile. Clearly, this was taken before the Seahawks' last play call.)

With all that's been going on, I've slacked a bit on the "Around the Web" series. But here's what I've seen on the Internet over the past couple of weeks. Have anything to add? Email me at jen dot campisano at gmail. I like hearing from you guys.

The Emperor of All Maladies: A Biography of Cancer Becomes a Movie

Perhaps I'll do better watching this on screen than I did in book form? I picked up the book (some of the best prose I've read) shortly after my diagnosis. It hit too close to home, and I stopped reading. I haven't had the guts to try again. Maybe this will be my impetus.

"So she turned to PBS's premiere filmmaker, Ken Burns — whose mother died of breast cancer when he was eleven — to shepherd the project. The result is a three part, six-hours series arriving on March 30 narrated by Edward Herrmann, who died of brain cancer shortly after completing work on the film."

Or maybe not...

This Is Important: The Pressure to Stay Positive

"I understand the impetus from well-meaning friends who interrupt with "don’t say that, just stay positive!" when you talk about fears of what may come to pass in your cancer treatment, but they don't seem to understand that speaking about these anxieties is a means of release. The patient ends up feeling like she has to act happy and fine all the time, and stifles the desperate need to talk through all of this."

A New Strategy to Fight Cancer Actually Starts by Making Cancer Tougher

"'We think that being relatively soft lets invading cancer cells slip through the body and colonize new areas,' Surcel says. 'You can envision an octopus having a much easier time getting through a small opening than would a lobster. 4-HAP seems to make the cancer cells more like the lobster.'

The team is now testing 4-HAP in mice. The drug is already in use in some countries as a treatment for jaundice, so if it shows success against pancreatic cancer, it could potentially make it to market relatively quickly, Robinson says. But even if that doesn't happen, the study demonstrates that the new drug screen has great potential, he says."

And Yet Another Might Look to Create a Tumor Within a Tumor

"A tumor, as strange as it may sound, is a little society. The cancer cells that make it up cooperate with one another, and together they thrive.

Scientists are only starting to decipher the rules of these communities. But if they can understand how these cells work together, then they may be able to stop the tumor. “You can drive it to collapse,” said Marco Archetti, a biologist at the University of East Anglia and at the Icahn School of Medicine at Mount Sinai."

Why Breast Cancer Education (Rather than Awareness) Remains So Important

"Women with breast cancer often don’t know what kind of tumors they have, a new study found.

Not knowing one’s tumor features isn’t necessarily tied to worse outcomes, but better knowledge might help women understand treatment decisions and take medications as directed, said Dr. Rachel Freedman, the study’s lead author from the Dana-Farber Cancer Institute in Boston.

Based on their medical records, only 56 percent of women reported the correct estrogen status, 58 percent reported the correct HER2 status and 57 percent reported the correct stage. Only about one in five women reported the correct grade.

Overall, only 8 percent of women correctly answered all four questions, but the lack of knowledge was more pronounced among minority women, the researchers report." (emphasis mine)

Scientists Find New Target for Triple Negative Breast Cancer

Triple negative breast cancer (TNBC, for short) is what I lost my friend Renee to late last year. If targeted treatments could be developed for these patients, that is an absolute game-changer. It's not a cure, but — like the treatment I'm on — it's getting closer. 

"The team concludes that increasing expression of beclin 1 could be a promising therapy for breast cancer, especially for patients with the triple-negative type.

Beclin 1 is already a target of four classes of drug approved to treat other types of cancer, and the team suggests more research should now be done to see whether these could also save lives of breast cancer patients."

. . . And Then Boom

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Quinn and I spent most of the day yesterday on the couch. He was recovering from a minor but necessary surgery that left us both exhausted and me frayed all around my edges. (Quinn on the other hand seemed totally fine, as long as I continued to supply him with jello.)

Recovering from (minor) surgery like a champ with some help from his "pets."

A photo posted by Jen Campisano (@jencampisano) on Jan 12, 2015 at 2:14pm PST

The anesthesiologist allowed me to carry Quinn back to the OR, where I held him while he protested (Quinn, not the anesthesiologist). Quinn was screaming and crying that he didn't want the mask they'd tried to tell him was a superhero mask, while the doctor held it gently above my child's face. I rubbed Quinn's sweaty hair off his forehead and told him how brave he was. Somehow, I held it together until he passed out, then broke out in sobs as I walked out of the room.

Quinn and I watched four -- yes, four -- movies in a row yesterday. Three of which we already owned. I hesitated about paying the money to purchase the fourth one.

"It's twenty dollars, buddy," I said.

"I can handle that," Quinn answered.

HA. Ha ha ha ha ha.

I chuckled so hard that I gave in and paid the money. Well handled, indeed, my little man.

***

On to the news I came across over the last week. Is it just me, or is this week's round-up exceptionally full of good news and hope? Here's to 2015, people.

Why Do Some People Develop Resistance to Cancer Therapies? 

Duke researchers may have the answer, according to a couple of recently-published studies.

"The team managed to map the particular steps that breast cancer cells (along with melanoma and blood cancer cells) use to gain resistance to drugs."

And a Potential New Drug Target for Combating Those Resistant Cells

"Researchers have identified a signaling pathway that contributes to the slow proliferation of difficult-to-kill cancer cells. These cells, which are resistant to current treatments, are believed to be responsible for instances of cancer relapse. The researchers believe that the signaling pathway could therefore provide a potential target for new treatments.

'Most cancer treatments target rapidly dividing cancer cells but leave the slowly dividing ones unharmed and still capable of causing disease recurrence after the initial treatment,' Dr. Ramaswamy adds. 'Our goal has been to understand how these slow proliferators are produced in order to devise ways to eliminate them.'"

FDA Fast-Tracks Drug to Treat Advanced Triple Negative Breast Cancer

"The FDA. . . granted fast track status to sacituzumab govitecan, an antibody–drug conjugate in development for treatment of patients with triple-negative breast cancer who failed prior therapies for metastatic disease, according to the drug’s manufacturer.

The FDA’s Fast Track program is intended to facilitate the development and expedite the review of new drugs intended to treat serious conditions, as well as agents that would fill unmet medical needs.

The FDA based its decision on the efficacy sacituzumab govitecan has shown in patients with advanced triple-negative breast cancer."

Well, This is Potentially HUGE for Her-2+ Breast Cancer Patients...

"Scientists at Dalhousie University’s medical school have found a never-before-used combination of drugs that shut down aggressive breast cancer tumours and prevent the disease from recurring."

(I couldn't not put emphasis on that entire sentence.)

Could This Spell the End of Cancer?

"By tapping into a cell's natural processes, researchers may have found a way to inhibit tumor growth and ultimately kill off cancer cells.

'We believe this small molecule will address an unmet cancer need in an underexplored area that will be rapidly applicable to the clinic,' said Dr. Jerry Shay, vice-chairman and professor of cell biology at the University of Texas Southwestern Medical Center and senior co-author for the study."

New Drug for Hormone-Driven Breast Cancer Set for Approval This Spring

"The first in a new class of cancer medicines, Pfizer's Ibrance, appears poised for approval to treat advanced breast cancer within a few months and could quickly become a blockbuster, some analysts believe.

Those drugs are believed to block enzymes, called CDK4 and 6, that help cancer cells divide uncontrollably."

Breakthrough as Gene Driving Triple Negative Breast Cancer is Discovered

"Scientists have identified the gene behind one of most aggressive forms of breast cancer in a breakthrough which could bring life-saving new treatments.

Triple-negative breast cancer is one of the most deadly forms of the disease and nearly one quarter of patients diagnosed will not survive for more than five years.

Now researchers at Cambridge University and the Wellcome Trust’s Sanger Institute have found that the BCL11A gene is overactive in eight out of ten patients."

Personal Liberty vs. An 85% Chance of Survival for One 17-Year-Old Girl

On the one hand, I'm a strong believer in letting children have some say in what happens to their bodies. Meaning: if Quinn says stop tickling, I stop tickling. And I don't force him to give hugs, much to his grandparents' chagrin. 

HOWEVER, I would certainly make my child receive chemotherapy if there was an 85% chance of survival. There would be no question. She would sit in that infusion center and I would hold her hand through side effects and uncertainty and I would hate it but I would make her fight. (This hypothetical 17-year-old girl child of mine.)

Having gone through what I've gone through to spend more time with my family, I cannot wrap my head around this mother's position one little bit. But I'm curious: what's your take?

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As you probably heard, sports anchor Stuart Scott died of cancer over the weekend. The immensity of Scott's love for his daughters is palpable in this ESPY award speech. He calls his girls his "heartbeat." Like almost every parent, I can relate. And watching this (just fair warning), I cried big, ugly tears. A reminder that even though cancer research has come so far, we still have miles to go before we sleep.

 

Here is some of the research I've seen over the past few weeks. If I've missed anything over the holidays that you think should be included, please send me an email and I'll add it next week. Now that I'm done stuffing myself with gingerbread and dark chocolate candy cane bark, I have time again for sifting through articles online. Because, ahem, THAT CANDY CANE BARK WASN'T GOING TO EAT ITSELF.

Zinc Test for Early Breast Cancer Looks Promising

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"For the first time, a study shows that breast cancer cells process zinc isotopes differently to normal cells - leading researchers to suggest this might be a way to detect the cancer early."

No Surprise: Herceptin Improves Long-Term Survival for Her-2+ Patients

"The results show that the 10-year survival for HER2-positive breast cancer patients who received chemotherapy without Herceptin was 75%, whereas for those who also had Herceptin, it was 84%."

Two Pre-Surgical Drugs Improve Survival for Triple-Negative Breast Cancer Patients

"We found that adding either carboplatin or bevacizumab to standard preoperative chemotherapy increased pathologic complete response rates for women with basal-like cancers -- that is, it increased the proportion of women who had no residual cancer detected at surgery."

Disease Progression Delayed by a New Drug Combination in Some Advanced Patients

"A new combination of cancer drugs delayed disease progression for patients with hormone-receptor-positive metastatic breast cancer, according to a multi-center phase II trial.

'Because the study showed a statistically significant benefit among patients whose disease progressed on an aromatase inhibitor, a larger phase III study comparing this combination to other approved therapies used after initial therapies fail, like exemestane and everolimus, should be done.'"

Updated Results of MARIANNE Study for Advanced Her-2+ Patients

"The study assessed the feasibility of three different regimens targetting HER2 in people with previously untreated (first-line) advanced HER2-positive breast cancer. Patients enrolled in the study received one of the three composites: Kadcyla (ado-trastuzumab emtansine) plus Perjeta (pertuzumab), Kadcyla alone, and Herceptin (trastuzumab) plus either docetaxel or paclitaxel chemotherapy.

Results from MARIANNE trial showed that all the three regimens were feasible in progression-free survival (PFS) for a similar amount of time."

Development of Most Cancers Is Beyond Our Control, Study Finds

Notably, breast and prostate cancer were NOT included in this particular study. So the jury's still out as to whether those might be controlled by environmental factors.

"In a groundbreaking paper published in Science, the duo describe a new factor, a tissue’s stem cells, that may explain as much as two-thirds of the difference in cancer risk among different tissues."

What's Blowing Up the Breast Cancer Blogosphere This Week

In case it's not obvious, I'm in total agreement with Ms. Schattner on this one. No amount of whisky could ease the pain I would feel if treatment wasn't an option for me. There were other great articles countering Mr. Smith's blog post -- if you're interested, here are a couple that resonated with me.

"The image of a person retching or in pain, afraid to ask questions of his doctor and not being offered palliative care is outdated by several decades.

Today, cancer surgery and medicines can extend and improve the lives of people who live for years and decades after treatment. Malignancies that were notoriously hard-to-treat just a few years ago, like some forms of lung cancer, melanoma, T-cell lymphomas, Her2+ breast cancer and other conditions have become, in many cases, manageable." (emphasis mine)

Miracles Do Happen (What I Was Thinking About Over the Holidays)

We know very little about spontaneous remission except that it's extremely rare. Most doctors refrain from mentioning it to avoid giving false hope to patients. But the allure is undeniable.

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Call me naive, but I didn't know it would be quite this hard to introduce our cat to our dog. The cat has spent the better part of the last week holed up in a closet in one of our bedrooms. But Luna-Dune, as we've all started calling her, is fitting in with our family nicely. Most importantly, she appears to have sated my urge to have/adopt/somehow acquire another child. This is exhausting enough, thank-you-very-much.

(But look how cute she is...)

When I wasn't busy Instagramming photos of my dog, here's what caught my attention on the internet this week.

Breast Cancer Vaccine Shows Promise (but Phase II Trial Will Exclude Advanced-Stage Patients)

This makes me both hopeful and terribly sad that metastatic patients won't be included in the next phase of research.

"If we give the vaccine to patients at the beginning of treatment, the immune systems should not be compromised like in patients with metastatic disease," Gillanders said. "We also will be able to do more informative immune monitoring than we did in this preliminary trial. Now that we have good evidence that the vaccine is safe, we think testing it in newly diagnosed patients will give us a better idea of the effectiveness of the therapy."

Did You Hear What Melissa Etheridge Said About Breast Cancer?

That her words "stirred debate" is a bit of an understatement, at least in the breast cancer community.

"Singer Melissa Etheridge's comments that breast-cancer genes can be turned on or off by diet are being challenged by doctors and others, who say they are hurtful and could mislead millions of people."

And Speaking of Genetic Screening...

"Most patients with triple-negative breast cancer should undergo genetic testing for mutations in known breast cancer predisposition genes, including BRCA1 and BRCA2, a Mayo Clinic-led study has found. The findings come from the largest analysis to date of genetic mutations in this aggressive form of breast cancer. The results of the research appear in the Journal of Clinical Oncology."

And Speaking of Triple Negative Breast Cancer...

"Scientists at A*STAR's Genome Institute of Singapore (GIS), in collaboration with local clinicians and colleagues in the USA, have identified a biomarker which is strongly associated with triple negative breast cancer (TNBC), a highly aggressive carcinoma that often has early relapse and metastasis following chemotherapy. The newly identified biomarker, a gene called RASAL2, provides a target for developing new therapeutics designed to treat this often deadly disease."

Saying Good-Bye Far Too Young

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Another mother gone too soon because of metastatic, triple negative breast cancer.

"And who are the brave ones in the country's breast cancer conversation? They're so quiet as to be all but ignored. They're the women with metastatic disease, especially the young women I get chemo alongside at Dana-Farber Cancer Institute in Boston, the ones who really may not see their children graduate from kindergarten, let alone high school."

Another Reason I'm Lucky: Where I Live

"In the United States, 9 out of 10 kids diagnosed with acute lymphoblastic leukemia will live. In Jordan, the survival rate is 16 percent.

And while cervical cancer patients have a five-year survival rate of over 70 percent in countries like Mauritius and Norway, the rate in Libya is under 40 percent.

That's the sobering news from the largest cancer study ever published. It surveyed more than 25.7 million patients and reveals a huge gulf in cancer survival worldwide."

3D Mammography Improves Cancer Detection in "Dense" Breasts

"Our findings are extremely promising, showing an overall relative increase in the cancer detection rate of about 30 percent," Dr. Skaane said. "Stratifying the results on invasive cancers only, the relative increase in cancer detection was about 40 percent."

Getting Off the Couch Could Save Your Life

"Women with breast cancer who engage in physical activity, even if at moderate level, have a lower risk of death, cancer-specific or not; according to new research presented yesterday at the 2014 World Cancer Congress in Melbourne, Australia."

The Daily Show Takes On "Fracking for the Cure"

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I took a break from the internet for most of last week (with the exception of this post)...

So this happened today. World, meet Luna.

A photo posted by Jen Campisano (@jencampisano) on Nov 11, 2014 at 1:55pm PST

Between chemo last Monday, Thanksgiving on Thursday, and family in town, I hardly turned on my computer. My dad and his wife came to visit for the week. We only debated a little bit about the recent elections, we ate turkey and pumpkin pie until our bellies ached, and we watched football (where Chris and Quinn cheered for the "Go Niners" and the rest of us celebrated the Seahawks).

And we adopted a dog.

It was exactly the week I needed. How about you? How did you spend your holiday?

Now to panic since it's December and I haven't started Christmas shopping yet. In the meantime, here's what caught my attention on the web over the past couple of weeks.

How Some Breast Cancers Become Resistant to Targeted Drugs

"The team determined that the tumors had developed six different mutations that led to drug resistance. But the result of all these mutations was the same: The tumors had lost the ability to express a protein called PTEN.

The findings suggest a new approach for combating drug resistance by taking advantage of the fact that not all PI3K inhibitors work using the same mechanism."

And What if We Could Drain Cancer's "Fuel Tank"?

They're not talking about dieting to starve a cancer cell.

"Blocking cancer cells' ability to generate the energy they need to grow and divide is an exciting new avenue for future cancer treatments. This research suggests that MCT inhibitors may be particularly effective against breast cancer 'stem cells' that can resist other treatments, and could prevent the cancer from coming back - but further work is needed to find out if these drugs can help patients. Cancer Research UK is funding trials of these drugs in a range of cancer types."

What if We Could Track Circulating Tumor Cells in the Bloodstream?

Before they settle down and form tumors, before they metastasize.

"Once they identified the cancer cells, the researchers were able to separate them from normal cells. This ability to isolate, culture and grow the cancer cells will allow researchers to zero in on the cancer cells that matter to the health of the patient. Most circulating tumor cells may not metastasize, and analysis of the cancer cells could identify those that will."

Are Preventative Surgeries Worth the Risk?

"For Mimi Cavalheiro, who is genetically at risk for both breast and ovarian cancers, the question of a diagnosis is not an “if” but “when.”

Cavalheiro is one of about 100 Bay Area women between 35 and 50 years old with the BRCA1 or BRCA2 mutations who are participating in a clinical trial that is examining changes in cardiovascular health, bone density, sexual function, quality of life and other effects on women who go into early menopause."

And, Yet... New Analysis Shows the Risks for a Secondary Breast Cancer are Significant in Those with Gene Mutations

We're talking about the BRCA1 and BRCA2 gene mutations again here.

"Women who are genetically susceptible to breast cancer and develop it in one breast are at higher than average risk for a tumor in the other breast, and that risk may increase as time goes on, according to a new analysis."

Why Does Immunotherapy Work in Some Patients But Not Others?

Memorial Sloan Kettering scientists may have some answers.

"'For the first time, it might be feasible to develop a reliable diagnostic test to help guide treatment decisions by predicting who will respond,' says physician-scientist Timothy Chan, who led the research. The findings could also inspire new research that potentially may lead to more-powerful immunotherapies for melanoma as well as for other cancers."

A Test for Mutations in Blood Cancers Could Provide More Treatment Options

“This is really the way of the future,” Steensma said. “We are going to be practicing medicine not based on how cells look under the microscope, but rather on what makes a disease tick.”