Love labors to put end to current cancer treatments
UCLA professor and noted breast cancer specialist Susan Love envisions
a time in the not too distant future when breast cancer — and especially
today's treatment of it — will be a thing of the past.
"I'm very, very excited. We're heading into a whole new era with
breast cancer. I think we can eradicate this disease and I don't think
it's a pipe dream." she told a packed auditorium in Bldg. 123 Love,
who is an adjunct professor of surgery at UCLA and medical director of
the Susan Love M.D. Breast Cancer Foundation, spoke at the Lab Tuesday
as part of the Director's Distinguished Lecture Series. Her talk was also
the final installment in the Lab's monthlong Cancer Awareness Campaign.
Her presentation, "Wishful Thinking Is Not Enough," was engaging,
informative and often humorous. She spoke off the cuff for more than an
hour on a wide range of subjects, from describing new research on improving
detection, treatment and recovery to hormone replacement therapy. She
answered questions from the audience for nearly a half hour more in the
auditorium and spent another 30 minutes signing books and answering still
more questions.. Scores of women in the auditorium not only had copies
of her books for her to sign afterward, but also took copious notes during
her talk.
Love, who was appointed by President Clinton to the National Cancer Advisory
Board and is one of the founders and a director of the National Breast
Cancer Coalition, calls today's treatment of cancer — surgery, chemotherapy
and radiation — "slash, burn and poison."
"They are very crude. But it's all we have. If I had cancer today,
I'd be first in line for those treatments," Love said. "We've
been thinking of cancer cells as if they're foreign invaders and we have
to blast them away. But these are our own cells gone crazy.
"Maybe they're not all irrevocably bad. Maybe we can rehabilitate
them, give them food and sunshine and they will behave normally."
For too long, she said, cancer cells have been studied in isolation. By
studying cancer cells and how they interact with healthy cells, researchers
may be able to determine how to change their behaviors, she said.
Researchers are also looking into how to "put cancer cells to sleep"
for 10 or 20 years, and believe one of the ways to do that is through
hormones.
There are new hormonal drugs that are now being studied, she said, noting
that tamoxifen has been shown to prevent breast cancer from coming back
when given for five years.
"We’re moving into control instead of kill," Love noted.
"Treatments are shifting from chemotherapy for everyone to treatments
for tumors sensitive to hormones. They are treatments targeted only to
the cells that are abnormal."
New research is also starting to look at how to eliminate some of the
side effects of the harsher treatments, such as chemotherapy. Love refers
to this treatment as a "poison" that not only kills the cancerous
cells, but destroys healthy tissue as well.
Too often, breast cancer survivors who complain after treatment about
swollen arms and limited mobility, fuzzy thinking and other uncomfortable
side effects are told, "you’re lucky to be alive, dear,"
Love said.
"It’s beyond ‘you’re lucky to be alive.’ We’re
finally getting to the point that we realize we need to pay attention
to the side effects of treatments."
One of the biggest side effects is premature menopause, which can lead
to other health problems, Love said. "That’s a whole other area
we’re just starting to figure out," Love said. "I’ve
been asked why, as a surgeon, I’m looking into menopause. Well, my
patients are asking me about it, and I’m 53 and flashing," she
added, drawing a laugh from the crowd.
"After menopause, our ovaries don’t shrivel up and fade away.
When they are done with reproduction, they shift into a different function
and still produce hormones into your 80s," Love said.
Contrary to popular belief, this declining hormone production can be enough
for most women, she added.
She also discussed imaging methods, such as mammograms. By the time tumors
are seen on mammograms, they have been there eight to 10 years, Love said.
Mammograms are most effective for women over 50, she said, because younger
women have denser breast tissue, making it difficult to spot tumors.
"When you go through menopause, you lose breast tissue. It turns
to fat and cancer shows up great against fat. We need something that will
show cancers in younger women," Love said.
She has spent much time studying ductal cancer, which is breast cancer
that starts in the milk ducts. "I want to find those cells before
they're criminals, when they are cells that are just thinking about going
bad," Love said.
She has developed a method to insert a tiny catheter into a breast duct
to extract cells. It’s called ductal lavage and is now FDA-approved
for high-risk women. It is being used at a number of clinics, including
UC San Francisco.
Right now, it’s good for providing additional information for women
who are at a high risk for breast cancer, but Love hopes it will lead
to figuring out how breast cancer starts and, ultimately, how to prevent
it.
"A lot more research needs to be done," she noted.
During her talk, she also addressed hormone replacement therapy in menopausal
women, although she objects to the name of the treatment.
"The way you position something really affects how you think about
it. With hormone replacement, you’re saying premenopausal women are
normal and we have to get postmenopausal women back to normal. But menopausal
women don’t need that high level of hormones. We’re now starting
to figure out that much lower doses may be enough for older women who
don’t need as much," Love said. "If you don't have breast
cancer, you can take hormones for two to five years for symptom relief
and then taper off."
New studies are showing that long-term hormones do not necessarily reduce
an older woman’s risk of heart disease and osteoporosis, she said.
Lifestyle changes are the best defense, she noted. "Exercise helps
prevent heart disease, osteoporosis and you feel morally superior doing
it," she said, again drawing laughter from the crowd.
Other changes include following a low-fat diet and not smoking. "You
should have lifestyle changes first and then add drugs if they are needed,"
she added.
Love’s talk will be rebroadcast on Lab TV channel 2 on Thursday,
July 19, at 10 a.m., noon, 2, 4 and 8 p.m. and Friday, July 20, at 4 a.m.