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Advances in Screening

Program: My Journey from Pathologist to Breast Cancer Survivor
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Andrew Schorr:

Let’s talk about science just for a minute because you are, after all, a breast pathologist.  So you mentioned earlier that your tumor type, the cells, had been HER-2/neu positive.  And if we go back a few years women talked about, well, gee, what’s the size of the tumor, and maybe where are there — is it in more than one place, is it spread?  But they talked about it sort of physically.  But in recent years we’ve talked about it biologically, and there have been in some cases medicines developed to target those biological types, Herceptin, in your case, and there are other drugs in development as you mentioned. 

So from a pathology point of view you’re looking at a lot more variables, and when a woman gets their report — and I know you conduct seminars sometimes to explain that to people — it’s a lot more detailed, isn’t it?  It’s not just how big the breast cancer cells are or where they’re located, but it’s all this other stuff. 

Dr. Allison:

Exactly.  You’re absolutely right.  So there are so many details that I look at and analyze in my reports that each one of them can make a treatment difference in a patient.  And you’re right, we’ve understood so much more about the biology of breast cancer offer the last 10, 15 years, and it’s clear that they’re not all the same and that, you know, they can express different things like estrogen or have different genetic profiles that make them more likely to respond to specific drugs that target those.  And that’s really been a huge step forward in cancer treatment in general, and, you know, a lot of it really started with breast cancer and now it’s starting to crop up in other cancers as well. 

So, yeah, HER-2 has been a real big success because it was a molecule that was identified that could be targeted with antibody therapy like Herceptin in addition to chemotherapy and make a poor prognosis cancer, you know, a lot less guarded of a prognosis.  So I think there’ll probably be more drugs like that, and those are active areas of investigation.

Andrew Schorr:

So the lesson for a women diagnosed is, she’s told she has breast cancer, and maybe someone else she knew, the woman down the street, one of her friends or acquaintances, also diagnosed with breast cancer, it’s not just has it spread or not, but her situation may be very different based on the biology, the exact biology of the kind of cancer cells she has.

Dr. Allison:

Right.  Everybody’s cancer is unique, so neighbors could have completely different types of breast cancer that respond to very different therapeutic agents.

Andrew Schorr:

So how do you look at the future — we talked about it sort of emotionally, but from a science point of view?  Because you’re in a science world -

Dr. Allison:

Mm-hmm

Andrew Schorr:

--and so we talked about the variables that you’ve identified now and there may be others.  There may be a report or a journal article that says, oh, now you should look at this or that.  Are you encouraged?  Are you hopeful that not just in an emotional way but from a scientific way that for people like you who have been diagnosed with breast cancer, hopefully treated successfully but you always worry will you need other treatment, that that will emerge? 

Dr. Allison:

Yes.  I think that we’re making great strides already, and, you know, one of the big areas of interest are the cancers that don’t express hormone receptors or HER-2, so they don’t really have a targeted therapy.  They’re called the triple negative cancers.  And so that’s a really active area that I think there will be some new agents emerging.  There are already are some sort of on the horizon.  And hopefully every patient’s individual cancer will be — you know, their treatment will be very personalized for their specific cancers, you know, find its Achilles heel, basically.

Andrew Schorr:

Right.  I sure hope so.  Well, I’m glad you’re encouraged.  So, Kim, just wrapping up, it — you know, as you said, when you carried the slides to the lab for your friends to read, and it was surely going to be nothing and it wasn’t, your world was turned upside down.  That’s going to happen to other women.  Women who are listening, maybe it’s already happened to.  What’s the message you want them to know that helps keep you going but you hope would encourage them because you said the women you spoke to were kind of on the other side it of it, had been through treatment, that was very helpful.  What do you want to say now? 

Dr. Allison:

Basically to just keep living.  You know, if you’ve been diagnosed it’s not the end of your story, and it can be even a better story than it was before.  So, you know, having cancer is not something you chose to do, but you get to choose how you react to that experience.  And hopefully, you know, you can gain new insights as you go through a difficult time, but to keep living and having positive attitude.  And hopefully you can find your red sunshine, you know, your inner strength within that maybe you hadn’t tapped into in a long time.

Andrew Schorr:

Well said.  Now, how old are the kids now? 

Dr. Allison:

They are seven-and-a-half and four.

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