DUARTE, Calif., December 11, 2009 — City of Hope researchers will present data from a variety of studies, ranging from treatment barriers for breast cancer patients to the treatment potential of analyzing circulating tumor cells in metastatic breast cancer patients, during the 32nd annual San Antonio Breast Cancer Symposium.
Following are two of the featured studies:
“Barriers to treatment in patients with locally advanced and inflammatory breast cancer”
Poster
Abstract # 3084
A new City of Hope study has found that patients may delay seeking treatment for suspicious breast symptoms for many reasons, including difficulties obtaining insurance authorizations and scheduling tests, and fears they might lose their breast.
Patients often presented for treatment after waiting more than three months from the time they first had symptoms, said Laura Bourdeanu, R.N., M.S.N., nurse practitioner, Department of Medical Oncology & Therapeutics Research at City of Hope and lead author of the study. “Any type of delay in seeking treatment may lead to a possible larger tumor, a higher risk of metastasis and a higher stage breast cancer with inherently worse prognosis,” said Bourdeanu.
“We wanted to examine the causes behind why patients come to City of Hope with such advanced stages of breast cancer,” said George Somlo, M.D., co-director of the Breast Cancer Program at City of Hope and the senior author on the study. “Was it lack of insurance or financial issues, lack of awareness on the patient’s part that something is wrong, fear of surgery or system delays? What can we do in the health-care system to avoid this situation in the future?”
From 2005 to 2009, 34 patients diagnosed with stage III breast cancer responded through questionnaires as to why their care was postponed.
Some patients cited system barriers: 38.2 percent reported delays in scheduling tests, and 26.5 percent cited delays due to obtaining insurance authorization for tests, treatments and doctor visits.
They also cited physician barriers: 23.5 percent said their primary doctors did not believe that the breast lumps or symptoms were related to cancer and 17.7 percent said their physicians thought biopsies were unnecessary.
Patients sometimes put up their own barriers: 47.1 percent said they waited for their regularly scheduled doctor visit instead of requesting an earlier appointment, 35.2 percent delayed treatment because of fear of losing their breast and 35.3 percent of patients thought the lump or changes were due to an infection, muscle strain or were related to their menstrual cycle, and believed they would disappear. Less than 20 percent of patients said they were unable to take time off from work or had transportation or child-care issues.
“The system and physician barriers contributing to the delays we identified could serve as the basis for future intervention studies to decrease the time lapsed between the presentation of signs and symptoms of breast disease, and diagnosis and treatment of breast cancer,” said Bourdeanu.
“Further studies are needed to better identify factors that may help us predict women at risk for encountering barriers to health care so that interventions can be implemented to reduce breast cancer morbidity and mortality,” she concluded.
“Multiple biomarker expression in circulating tumor cells from metastatic breast cancer patients”
Abstract # 3007
Doctors usually recommend therapies for breast cancer to target certain characteristics of a patient’s primary tumor. But tumors can shed cancer cells that spread throughout the body, and in 25 percent of metastatic tumors, the cancer’s characteristics actually differ from those of the original tumor.
Thanks to the development of a new optical enrichment technology, Fiber Array Scanning Technology (FAST), which can quickly detect and analyze these tumor cells in blood, researchers at City of Hope and Palo Alto Research Center (PARC) are studying the molecular characteristics of these “circulating cancer cells.”
The cells are responsible for metastatic breast cancer, which claims an estimated 40,000 lives each year.
George Somlo, M.D., co-director of the Breast Cancer Program at City of Hope, explained that these circulating cells travel around the bloodstream and deposit in other organs.
“What’s new is that we’re not just trying to find these cells, but also to characterize them to find out how can we treat patients with circulating tumor cells differently than those who do not experience this,” said Somlo, whose team is working with Richard Bruce, Ph.D., director, Scripps-PARC Institute for Advance Biomedical Sciences at PARC.
In the study, blood samples were taken from newly diagnosed or relapsed stage IV metastatic breast cancer patients before they began treatment or changed therapy, then the samples were sent to PARC for FAST processing.
Somlo noted that studying each patient’s circulating cancer cells could help physicians better understand what drives their metastatic tumors, and may lead to the selection of therapies more likely to work against their metastatic cancer.
