Reduce Recurrence: The Buzz from the White Coats

Medical researchers are digging into ER- and PR- negative cancers and finding good stuff about treatment and follow-up care.

A diagnosis of any kind of cancer is terrifying. A diagnosis of hormone-negative can be especially traumatic, because the typical follow-up care—tamoxifen or arimidex doesn’t apply here. These are anti-estrogen drugs and offer little help to a cancer not fueled by estrogen.

So what can you do? Take chemo—it works better against the negative nasties than against the positive. And eat well and exercise. You can reduce your risk of recurrence by 40 percent by eating a low-fall diet. And strenuous exercise significantly cuts the risk of getting ER or PR-negative in the first place. Docs say it makes sense that it can also reduce recurrence.

Read on for some of the current studies that specifically deal with treatment and follow-up care for hormone-receptor-negative breast cancer. As I find something new, I will post it.

CHEMO: NASTY STUFF, BUT IT WORKS
Advances in chemo within the past 20 years have upped its success rate for hormone-negative cancer with only negligible improvement for hormone-positive. Newer forms (high-doses of cytoxan and adriamycin every two weeks plus taxol) reduced the risk of death by 55 percent as compared with older forms (low-doses of cytoxan and adriamycin plus fluorouracil every three weeks) in women with hormone-negative cancer that had spread to the lymph nodes.

That means a five-year overall survival rate of 83 percent (compared to 66 percent for older forms) and a five-year disease-free survival rate of 73 percent, (compared to 50 percent.)

So look at that: Almost three-quarters of the women with hormone-negative cancer that had spread to the lymph nodes who had chemo were disease-free after five years. That’s disease-free, in case you missed it. Disease-free! So chew on that for a while. And, remember that death stats don’t necessarily mean death from cancer. You can have the bad luck to survive cancer and still get hit by a falling piano. So deal with the chemo, and watch your head when walking through a cartoon.

Read More About This At
Journal of the American Medical Association, April 12, 2006

Chemo before surgery is also a shot in the arm—or, in this case, a syringe—to hormone-negative patients. More than 75 percent of women with aggressive, hormone-negative cancer who had chemo before surgery saw their tumors shrink by more than half; in 20 percent of the cases, the tumors disappeared completely!

Read More About This At
European Journal of Cancer, January 2004

DIET—DO IT
Reduce your daily intake of fat to about 20 percent of your total intake of calories—to about 33 grams of fat—and you can significantly reduce your risk of recurrence. Doctors studied 2437 postmenopausal women with early-stage cancer for ten years. Women with both hormone-positive and hormone-negative cancers benefited from the change in diet—9.8 percent of those on the low-fat diet had their cancer recur, while 12.4 percent of those on a standard diet—about 51 grams of fat—had theirs recur. Women with hormone negative benefited the most, with a 42 percent reduction in recurrence. That’s a pretty impressive number. Researchers note, however, that because hormone-negative is less common than positive, the percentage of women in the study who had hormone-negative was relatively low, making the results in our case exploratory—they’re continuing to study the relationship between diet and hormone-negative cancers.

Read More About This At

Journal of the National Cancer Institute, December 2006