Guest Editorial | ParkRecord.com

Guest Editorial

JOAN JACOBSON

In case the name is not familiar to you, the Susan G. Komen Foundation was founded on a promise made between two sisters –Susan Goodman Komen and Nancy Goodman Brinker. Suzy was diagnosed with breast cancer in 1978, at a time when little was known about the disease and it was rarely discussed in public. Before she died, at the age of 36, Suzy asked her sister to do everything possible to bring an end to breast cancer. Nancy kept her promise by establishing the foundation more than 20 years ago. The Komen Foundation is a global leader in the fight against breast cancer through its support of innovative research and community-based outreach programs. You may have heard of the "Komen Race for the Cure." The foundation is dedicated to eradicate breast cancer by funding research grants and meritorious awards, and supporting education, screening and treatment projects in communities around the world.

The recent Komen Foundation newsletter (fall 2005) reports on three hopeful research projects. The first is a breast fluid test that could aid in early detection, risk and assessment. The test consists of using a small sample of breast nipple fluid to provide relatively quick answers to a number of urgent questions, like "Do I have cancer?" and "Will I get cancer?" The test, called the QM-MSP, or quantitative multiples methylation-specific PCR, is being developed by a team of researchers at the Johns Hopkins Kimmel Cancer Center. The research team is led by the principal investigator, Saraswati Sikumar, Ph.D. and the project is being funded in part by the Susan G. Komen Foundation.

The research can be useful in detecting breast cancer in its very early stages. It may be useful to substantiate other tests obtained by conventional means. These may include needle biopsies. The test may also be useful in assessing DNA and a woman’s genetic predisposition to developing breast cancer. Key proteins can be found that help to resist breast cancer as well. Another use of the QM-MSP is that it can monitor whether cancer treatments are working. This is based on the level of methylation found in the sampled cells. It may also reduce the need for breast biopsies, and allow for the treatment of the cancer to begin as early as possible following the test results.

At the University of Wyoming, researchers are exploring whether a simple saliva test can, in one rapid and non-invasive step determine whether a patient has the antigen, HER-2 neu. This is a biomarker for an aggressive form of breast cancer, according to Beverly Sullivan, Ph.D., the principal investigator in this Komen-funded research project. Again, with this research it will be possible for early breast cancer treatment so that more lives can be saved.

The researchers in the Wyoming study are working on the simple saliva test following animal studies that suggest that it is possible to detect a fragment or HER-2 neu in the blood, even before a tumor or any other irregularities are clinically evident. For patients, that could mean detection of breast cancer even before x-ray-mammography, breast self-examination, or clinical breast examination by a trained practitioner might by chance find any breast abnormalities.

Presently, techniques such as the enzyme-linked assay (ELISA) use blood samples to detect HER-2 neu. This technique requires multiple steps and can take hours to produce an answer. The ultimate goal of the Wyoming study group is to develop a saliva test technique that can be easily used in a physicians office and provide instant results.

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The HER-2 neu is a protein that sits outside the membrane of breast cancer cells. If the protein is present, some of it is likely to break away from the breast membrane and enter into the blood stream. The fragment is very small and the theory is that it can actually end up in the saliva. Because saliva is so easily obtained, measuring for HER-2 neu fragments is an ideal medium for collecting the cancerous cells. Earliest detection of this particularly aggressive cancer is the goal. Furthermore, the saliva test could enable easy, ongoing measuring of treatment therapies and their effectiveness. Later, it could be useful to detect any recurrence of the cancer. Sullivan says these uses are still under investigation but it seems that the possibilities are very promising.

Finally, in the Komen Foundation newsletter there is a report of a study noted by the National Cancer Institute (NCI). In this study, the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin and their association to breast cancer risk was the focus of a study released last summer in the Journal of the National Cancer Institute. These drugs are widely used for many conditions including arthritis and reducing fever. Additionally, they are used to decrease the risk of stroke and heart attack.

In the California Teachers Study, researchers looked at the use of NSAIDs, the risk of breast cancer and the hormone status of cancer in 114,460 women, ages 22 to 85.

According to the study results: Regular use of NSAIDs, more than once weekly, did not increase breast cancer risk; long-term daily use of aspirin (five or more years) was associated with a reduction in the risk for estrogen and progesterone receptor positive breast cancer. This is not considered to be a significant finding, however, more than five years of daily use increased risk for breast cancer.

Daily use of ibuprofen long-term (five or more years) was associated with more breast cancer risk that was non-localized (breast cancer that was stage two or higher and had spread to the lymph nodes or had metastasized). Whether these observed associations were the cause of the risk were not clear from the study’s findings. It is possible that other factors were in play, and that the use of NSAIDs was only coincidental.

The upside of NSAID use is that in other studies, they inhibited and blocked the COX-2 enzyme that is involved in the inflammatory process. They are actually showing promising results in colon cancer trials. The authors of this study suggest more research is needed. These findings are only a "noted association" of these drugs and breast cancer.

Thankfully, the research is ongoing; it appears that we are on the brink of early detection and prevention of certain cancers. The Susan G. Komen Foundation has been instrumental in moving the research forward. Should you wish more information, the Web site is http://www.komen.org.

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