A review of breast cancer research in Malaysia shows a poor survival rate, and an estimated half of those deaths could have been prevented. Many Malaysian women still have poor knowledge regarding the risk factors and the importance of early detection.

Nonetheless, survivorship studies show that self-management programmes and exercise have improved the quality of their life, which places the focus of psychosocial impact on breast cancer. Nine-time Grammy Award winner and rock star, Sheryl Crow was diagnosed with ductal carcinoma in situ, a non-invasive form of breast cancer at 44 years old. She came out being a survivor after seven weeks of radiation therapy. At 36 years old, actress Christina Applegate beat breast cancer by getting a double mastectomy.

One woman’s inspirational journey in battling cancer

A 36-year-old special student teacher, Sarah White tells her story about how she defeated breast cancer in 2013. She had undergone a double mastectomy, radiation and chemotherapy in her efforts to eradicate this cancer. But she unexpectedly experienced a malignant relapse in October 2015 that turned out to be a stage four, Triple-Negative Breast Cancer (TNBC), having spread to her chest wall, spine and lungs. This aggressive and rare TNBC that only affects 15% of breast cancer patients, occurs when the oestrogen, progesterone and Human Epidermal Growth Factor Receptor 2 (HER2) receptors is negative.

The medical leave that she had to take rendered her emotionally drained. She resorted to planning a bucket list of things she has always wanted to do in her lifetime. Unbeknownst to White, the act of writing the list made her rediscover a childhood dream – beauty pageants – which ultimately led her on a path towards self-acceptance and courage. That dream grew and became more than just a means to cope emotionally, but also a channel to interact and inspire other women who were also struggling in the same battle against this disease.

Encouraged by a friend, White participated in the Miss All-Star United States Pageant, a beauty pageant for women of all ages. She came out winning the Mrs. West Virginia title in April, which motivated her to run for the national title in July.

White was determined to raise awareness of breast cancer, knowing the battle all too well herself. She also proposed a new breast cancer-related legislation and at the same time, worked to educate the public regarding the progress of clinical trials such as METRIC, an ongoing clinical trial conducted at the Cleveland Clinic that she voluntarily participates in. She somehow managed to juggle all these responsibilities while managing her symptoms, despite having to drive five hours to the clinic, once every three weeks.

Thus far, the IV treatment has been showing promising results in White’s condition after she received the study drug. The director of the breast oncology programme at the Cleveland Clinic, Dr Jame Abraham, who is also her doctor, reported that the lesion in her bone, lung and chest wall are nearly completely gone.

This targeted treatment involves a new class of drugs that only destroys diseased cells, and spares the healthy cells. The study aims to study the efficacy of the CDX-011 (glembatumumab vedotin, an antibody-drug conjugate) in TNBC. The trial estimates a primary completion date on December 2017.

Although White did not win the national title, the pageant gave her a platform to publicise the legislation in West Virginia which has begun to see the recruitment of more delegates. The bills aim to aid in early diagnosis, provide better mammogram services and better standard of care for patients with aggressive forms of breast cancer.

Resensitivity to trastuzumab

Trastuzumab, also known as Herceptin has been on the front lines of breast cancer treatment. A recent study published in Oncotarget report findings of a team of Case Western Reserve University School of Medicine cancer researchers who resensitised the tumour by blocking a gene called S100P in tumours that were previously resistant to this drug. S100P was known to be a key gene as it showed significant different expressions.

Tratuzumab resistant tumours are seen in relapse patients who were initially treated with this drug. Assistant Professor Khalil says that discovering the mechanism of resistance will allow for more discoveries in reversing the resistance, and potentially curing more patients.

With many more pharmacotherapeutic interventions on the horizon, we are hopeful to see a rise in survival rate amongst women battling this disease. MIMS

1. http://www.ncbi.nlm.nih.gov/pubmed/25417947
2. http://www.nationalbreastcancer.org/about-breast-cancer/celebrities
3. http://www.foxnews.com/health/2016/08/08/woman-battling-stage-4-breast-cancer-uses-beauty-pageant-to-inspire.html
4. https://tnbcfoundation.org/understanding-triple-negative-breast-cancer/
5. https://clinicaltrials.gov/ct2/show/NCT01997333
6. http://medicalxpress.com/news/2016-08-drug-sensitivity-breast-cancer-tumors.html

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