Being a Part of Making a Difference

The 2009 San Antonio Breast Cancer Symposium is now over, and the more than 8,400 attendees are on their way home to 97 countries around the world. After an evening spent with my advocate friends enjoying some Tex-Mex in San Antonio, I’ll be homeward bound, well fed in body and, even more importantly, well fed in spirit.

Every year, I look to this meeting for the inspiration that will sustain me in my work with women who are living with metastatic breast cancer and their families. Like them, I am looking for hope. “You are our eyes and ears,” one woman wrote me in an e-mail I received during the conference. “What do you think were the biggest revelations at this year’s conference? Any disappointments? Any surprises?”

It Can’t Help You if You Don’t Take It

Most women diagnosed with breast cancer have tumors that grow in the presence of estrogen. The anti-estrogen therapies that have been developed to treat these tumors cut the risk for cancer recurrence in half, and reduce deaths by about one-third. Tamoxifen, which has been used and researched for decades, works by binding to the estrogen receptor, which keeps estrogen from getting into the cancer cells to stimulate their growth.

The newer aromatase inhibitors (AI), which include letrrozole (Femara), anastrozole (Arimidex) and exemestane (Aromasin), appear to be even more effective in reducing recurrence and death. The AIs, as they are called, work in a different way than tamoxifen does. These drugs inhibit an enzyme called aromatase, which converts androgens (male hormones) to estrogen. Unlike tamoxifen, which can be used by both pre- and postmenopausal women, the AIs can only be used by postmenopausal women.

When it Comes to Breast Cancer, a Girl Can’t be Too Barefoot and Pregnant—and Thin!

Every year, in early December, I’m irresistibly drawn to Texas, and the annual San Antonio Breast Cancer Symposium (SABCS), where I gather with 9,000 others to learn what insights the past year has yielded about breast cancer causes, prevention and treatment. A joint effort of the American Association for Cancer Research, Baylor College of Medicine and the University of Texas Health Science Center, the SABCS is the largest scientific meeting in the world dedicated exclusively to breast cancer research. For me, the anticipation begins even before I arrive, spotting fellow advocates and oncologists I know at the airport.

Valerie Beral, an epidemiologist at the University of Oxford in England, opened this year’s conference with a plenary session on the causes and prevention of breast cancer. This was hardly new information, yet I found it compelling.

“Why,” Beral asked, “does breast cancer vary across the world so dramatically?” She noted that the cumulative incidence of breast cancer until age 70, by percentage of the population, is only about 1 percent in rural Africa and Asia. In contrast, in developed countries, the cumulative incidence is six- to sevenfold higher, with breast cancer affecting 6 percent of women by age 70. Furthermore, while the rates of new breast cancers have apparently stabilized in developed countries like the U.S., the rates are now rising steeply—just as they did here 30 to 40 years ago—in the crowded cities of the developing world.