Making Headway: Researchers Tout Advances in Cancer Care
by Amy Martinez
Updated 5 yearss ago
In 2009, Dr. Beth-Ann Lesnikoski became the first medical director of the breast institute at JFK Medical Center in Palm Beach County. After eight years, she moved to Jacksonville to head the breast cancer program at Baptist MD Anderson Cancer Center, where she now helps oversee both patient care and research.
Lesnikoski, a practicing breast surgeon, spoke to Florida Trend about the progress being made in treating breast cancer and new prevention methods.
- Link Between Obesity and Cancer: “Five particular cancers are associated with obesity: Breast, uterine, prostate, esophageal and pancreatic. If we could get people’s weights optimized and get them doing vigorous exercise, we’d have much lower rates of these cancers. A lot of women complain of getting thickening in their middle after menopause, but it’s also a time when many women stop exercising as much as they used to. The only thing that seems to get at that central obesity is vigorous activity, and it’s central obesity that’s driving these cancers. Figuring out how to get people up and around is where the money is.”
- Preventive Medicines: “Antiestrogen pills can be used for women at higher risk of breast cancer. Typically, they’ll reduce whatever risk the patient started out with by 45%. There also are some other commonly used medications that are showing promise in terms of breast cancer prevention. The three that come to mind are aspirin (we’re opening a clinical trial here for women with breast cancer to see if aspirin can reduce their risk of recurrence); Metformin, which typically is used for diabetes; and curcumin, a component of turmeric that’s been shown to have anti-breast cancer properties.”
- Mammogram Guidelines: “The U.S. Preventive Services Task Force has recommended every-other-year mammograms for women in their 50s and maybe skipping mammography in their 40s. But that task force didn’t have any clinicians on it. The American College of Radiology, the American Society of Breast Surgeons and the American College of Obstetricians and Gynecologists have all come out and said, ‘We still recommend annual mammography from age 40 until your life expectancy is less than five to 10 years.’ I don’t think it’s unreasonable for women who are at average risk of breast cancer to consider doing everyother- year screening.”
- Targeted Therapies: “In the cancer world, we’re moving toward more targeted therapies, targeted toward factors in the tumor cells or targeted toward improving the immune system. For instance, there’s a drug called Ibrance, which works to put the brakes on the division of estrogen receptor-positive cells. We’ve known for years that we can improve survival rates for people with estrogen receptor-positive breast cancers if we place them on anti-estrogen pills. But say they get metastatic disease. Ultimately, a subgroup of them will develop a resistance to anti-estrogen therapy. Ibrance seems to bypass that resistance and improve the survival of patients with metastatic breast cancer.”
- Genetics of Breast Cancer: “We’re learning more and more every year about how genetics play a role. Everybody knows about Angelina Jolie. That’s only going to be between 5% and 8% of all patients with breast cancer. There’s another 15% with familial breast cancer — breast cancer runs in your family, but there’s not a known gene in play. When we identify a patient with a family history or a known gene, we can actually alter their care to reduce their risk of developing breast cancer.”
- Advances in Treatment: “We’re doing less and less with better and better results. What I mean by that is we’re doing less surgery, less radiation and less chemotherapy than ever, and we’re better able to tailor treatments to the individual. We may at some point not even have to do surgery anymore in some individuals with breast cancer. To actually think about being out of a job because the treatments are so good, I love that.”
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