Symptoms linked to breast cancer treatment may be linked to disease, City of Hope finds
December 9, 2015

Other research at Breast Cancer Symposium examines possible complication of immunotherapy drug

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Letisia Marquez
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DUARTE, Calif. — The severity and duration of breast cancer symptoms, the potential complications of a new immunotherapy drug and bladder problems among women recently diagnosed with breast cancer are among the latest research City of Hope doctors and researchers will share at the San Antonio Breast Cancer Symposium, taking place Dec. 8 to 12.

Each year, nearly 8,000 physicians, researchers and other health care professionals attend the annual San Antonio conference, which examines new breast cancer research and helps guide treatment of women nationwide. Among the research presented by City of Hope scientists and physicians:

Hot flashes, fatigue may start before treatment

Breast cancer patients are often treated for symptoms such as hot flashes and fatigue once they start treatment, and such symptoms have long been thought to be a side effect of treatment. But a City of Hope study found that nearly all women who had been recently diagnosed with breast cancer actually reported such symptoms before any treatment started.

The findings are based on data from nearly 240 survivors who had Stage 1, 2 or 3 breast cancer. The women answered questions about their symptoms, including hot flashes, pain during sexual intercourse and weight gain, at time of diagnosis and after six and 12 months of treatment. Although most women reported symptoms when they were diagnosed and during treatment, they reported fewer or none after treatment ended.

“Doctors may need to start assessing and even treating women for their symptoms at the time of diagnosis versus waiting until patients receive treatment,” said Jessica Clague DeHart, Ph.D., M.P.H., a City of Hope assistant professor of population sciences and the study’s lead author. “If we can start dealing with patients’ symptoms as soon as they start, we may be able to decrease how severe they become once treatment starts.”

The study, which will be presented Dec. 11 in a poster session, also examined how the severity and duration of symptoms differed between premenopausal and postmenopausal women, as well as among the types of treatment breast cancer patients received.

Skin and nail infections in women receiving new immunotherapy drug with chemotherapy

Women with HER2-positive breast cancer who received the new immunotherapy drug pertuzumab in combination with the chemotherapy drug trastuzumab, reported skin and nail infections, some of them quite severe, a City of Hope study found.

Two years ago, after the Food and Drug Administration approved the use of pertuzumab for HER2-positive breast cancer patients, some patients at City of Hope began receiving pertuzumab and trastuzumab together because that combination was found to be more effective in treating patients with that type of cancer.
 
Among 28 women, about 30 percent ultimately reported skin or nail infections, the study found. Most of the infections resolved with treatment, but one 57-year-old woman developed a staph infection that led to sepsis and died. A 62-year-old woman also developed a skin infection that led to sepsis and kidney failure, and another woman had two fingernails removed due to an infection.

“A lot of these women have potentially curable disease, so no one should stop using pertuzumab,” said Joanne Mortimer, M.D., vice chair of medical oncology, director of the Women’s Cancers Program at City of Hope and the study’s lead author, who will present the study on Dec. 9 at a poster session. “But doctors and patients should be aware of the problems because these infections can become serious.”

Bladder problems reported in women with newly-diagnosed breast cancer

In addition to dealing with the shock and confusion that comes with a breast cancer diagnosis, many newly-diagnosed patients also must cope with bladder problems.

City of Hope researchers asked nearly 50 women who had recently been diagnosed with breast cancer if they suffered from bladder problems. Younger and older women alike often reported such bladder problems as frequent urination (65 percent), bladder leakage with physical activity (55 percent) and small amounts of bladder leakage (55 percent).

Some of the women also had urinary tract infections that they had not reported to a doctor.

“Many older women were not bringing up these problems with their doctor because they thought it was related to old age,” said Louise Wong, a City of Hope nurse practitioner in medical oncology and a study author who will present the research at a poster session on Dec. 9. “We believe that breast cancer is causing the bladder problems because younger women reported having these problems as well.”

The next phase of the study will examine bladder problems among women receiving chemotherapy and endocrine therapy.

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About City of Hope
City of Hope is an independent research and treatment center for cancer, diabetes and other life-threatening diseases. Designated as a comprehensive cancer center, the highest recognition bestowed by the National Cancer Institute, City of Hope is also a founding member of the National Comprehensive Cancer Network, with research and treatment protocols that advance care throughout the nation. City of Hope’s main hospital is located in Duarte, California, just northeast of Los Angeles, with community clinics in southern California. It is ranked as one of "America's Best Hospitals" in cancer by U.S. News & World Report. Founded in 1913, City of Hope is a pioneer in the fields of bone marrow transplantation and genetics. For more information, visit www.cityofhope.org or follow City of Hope on  Facebook, Twitter, YouTube or Flickr.