Video Q&A about Cancer Immunotherapies

In September 2017 I went for my yearly mamo/ultrasound and something showed up in both. I immediately went to my breast surgeon who had done a lumpectomy in my other breast 11 years ago (DCIS). He sent me for an MRI and I had that in October 2017. The report from that said it was a birads 3...probably benign and to repeat the MRI in six months. I went for the six month MRI in April 2018 and the report was birads 2...benign. At that point I told my surgeon that I wanted a biopsy which he immediately scheduled. So, less than 2 weeks later, I had the biopsy which showed invasive ductal cancer and DCIS. My surgeon was also excellent in getting me in for another lumpectomy by the end of April 2018. In 3 weeks I went from benign diagnosis from MRI to invasive breast cancer and DCIS. Has anyone else had this experience? Needless to say that not only did I have to deal with the physical and psychological affects of this event, I had huge anger issues at the radiologist that read both MRIs and got neither right. How many other people has he misdiagnosed who have not felt they had to peruse the issue? Other than my two questions, I advise people with the same circumstances to go for the biopsy immediately if it is possible. It may just save your life. I hope I have put this in the right place.

I am so sorry that you had to go through this. I had an incompetent gyne who did not take my symptoms seriously and I was dx with stage 1a grade 3 serous endometrial cancer. As a result, I question everything.

Thank you. I did listen to the presentation by Dr. Dronca as I am interested in any research on women's cancers, however, I appreciate your letting us know that you will be sending our questions to the appropriate physicians for answers. My focus is ovarian clear cell research.

Hi @odette, I sent your question to Dr. Gerardo Colon-Otero. Here is his response: I agree there is a need for more research on clear cell carcinomas of the ovaries. I saw 2 patients this week. Early detection will remain a challenge since there is early dissemination through the peritoneum.

Hey @gemma1960, your question was sent to Dr. Gerardo Colon-Otero. Here is his response: Recent data suggest marked tumor heterogeneity in many different tumors including ovarian cancer, renal cell clear cell carcinoma and lung cancers, which makes treatment decisions based on tumor genetic analysis difficult.

Hey @cmd03, I sent your question to Dr. Dawn Mussallem. She had several deadlines she was up against and apologized for the delayed response. Here's what she said:
Great question! This is one that physicians and cancer researchers are interested in too. To date, the relationship between cholesterol and breast cancer risk has not been a consistent finding in high quality human studies. IN other words some research suggests high cholesterol may be protective when other studies suggest the opposite. This is because when known breast cancer risks such as postmenopausal obesity and diet are factored into the research it is really challenging to make a conclusion specific to cholesterol and breast cancer risk. The UK ACALM Big Data registry is the most recent, comprehensive well designed study on the topic. In this study of over 16,000 patients, those with hyperlipidemia were almost half as likely to develop breast cancer and in those that did there was a 40% reduction in mortality and improved long-term survival. Statins are suggested to be the possible link. Other studies have suggested similar benefit of statins however due to conflicting evidence to date it would be misleading to suggest that statins prevent or treat breast cancer. Bottom line: the importance of maintaining a healthy body weight, regular exercise and a low fat diet should be emphasized first and if one continues to have high cholesterol despite lifestyle change then statins should be considered when recommended by your physician.

It is important to know that natural products are not standardized and can cause harm. Just because something is natural doesn’t mean it is safe. So replacing a statin with something natural isn’t necessarily better for you.

Metformin has been used for over 50 years to improve blood sugar levels in patients with type 2 diabetes. It may also lower LDL-cholesterol levels and reduce the risk of cardiovascular disease and cancer. Research is ongoing.

Hey @susu2, I sent your question to Dr. Dawn Mussallem. She was delayed in her response due to some pressing deadlines, but she just sent her response:
So your question, does diabetes cause cancer….

Type 2 diabetes either on its own and when combined with being either overweight or obese is associated with an increased risk for several cancers, including colon, gallbladder, pancreatic, liver, esophageal, postmenopausal breast, ovarian, endometrial, renal, bladder, and thyroid cancers, non-Hodgkins lymphoma and multiple myeloma. Lifestyle factors including dietary intake, physical activity, and body fatness appear to promote or inhibit cancer development.

Here are some healthy living suggestions:

--It is important to eat a low fat, sugar free diet rich in whole foods including an abundance of vegetables, non-sweet fruit especially berries, whole grains that are high in fiber, legumes, low fat dairy, and fish. Avoid anything white, this includes sugar, white flour, white potatoes, white rice, etc. Also avoid processed meat and try to reduce consumption of red meat too. Include healthy fats in your diet such as extra virgin olive oil, avocado and a small serving of nuts especially walnuts, almonds, and cashews. But if you are overweight/ obese, don’t eat too many nuts because these are high in calories.

--Be active. Move your body every single day!

--Practice relaxation/ deep breathing exercises, pray and/or meditate 10-20 minutes every day.

--Good sleep hygiene is important, aim for 7 hours sleep a night.

Lastly, you mention that you take a statin and metformin. Studies suggest both these medications have favorable benefits in patients with cancer!

20%?? @ihnsbc? Recent studies show it is closer to half that do not complete the full course of anti-hormonal treatment due to the debilitating side effects. (Links supporting that statement and quotes from the studies are below.) Other sources do show higher compliance, more like the 80% you state.

That is good your oncologist supports you in maintaining a reasonable quality of life. One encouraging comment I was given was that women who could not tolerate the drugs initially sometimes did better 5-10 years later. You could also give Tamoxifen or Raloxifene a try. Very recent studies show that low-dose Tamoxifen is effective.
https://journals.lww.com/amjclinicaloncology/Abstract/2018/05000/Patient_reported_Adherence_to_Adjuvant_Aromatase.14.aspx
“Using the MMAS (Morisky Medication Adherence Scale), only 50% of women with stage 1 to 3 breast cancer reported high adherence to AI therapy, consistent with other reports showing suboptimal adherence to adjuvant endocrine therapy.”
https://www.nursingtimes.net/home/behind-the-headlines/women-who-stop-taking-breast-cancer-drugs-risk-early-death/5056861.article#
“Looking at prescription data the researchers found women were on average less likely to stick to their treatment over time. This is known as adherence to treatment. In the first year, for example, women adhered to treatment 90% of the time. This figure dropped to 50% by the fifth year."
https://www.karger.com/Article/Abstract/100444
"In clinical practice settings, only 2 reports addressed longer-duration (>4 years) adherence to adjuvant tamoxifen use. In these, tamoxifen was prematurely discontinued by 30–50% of the patients. Conclusion: Adherence to prescribed breast cancer hormone therapy has not received concerted attention."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731975/:
Van-Herk-Sukel et al. reported that about 50% of the breast cancer patients discontinued tamoxifen or any endocrine treatment before the recommended treatment period of 5 years [13]. Hershman et al. suggested that only 49% of breast cancer patients took adjuvant endocrine therapy for the full duration.
https://www.ncbi.nlm.nih.gov/pubmed/20058066
"Half of breast cancer patients discontinue tamoxifen
and any endocrine treatment before the end of the recommended
treatment period of 5 years: a population-based analysis" That’s the title of the report
https://www.sciencedirect.com/science/article/pii/S0748798311006986
"Non-compliance rates are similar in patients treated with AIs, tamoxifen (TAM), or a sequence of both, and ranges between 40 and 60%. Reports confirm that these high rates are largely attributable to the presence and severity of adverse effects."

Well-researched information.