Not so Fast

You’d have had to be mostly asleep during the last couple days to miss the news that a big breast cancer study has come out of the National Institutes of Health’s Cancer Genome Atlas Project, a government effort that has already analyzed the genomes of certain ovarian, colorectal, lung, and brain cancers.

The traditional press and the blogosphere have been all a-twitter about how the several hundred researchers involved in the breast cancer study analyzed the genome of the breast cancer tumors from about 800 women and that they’ve “identified four genetically distinct types of breast cancer.”

I wondered about that when I first heard it. When I was first diagnosed—thrown into the deep end of the pool—that was one of the first things that I learned: There are four basic types of breast cancer:
1) Estrogen-reactive (me).
2) Progesterone-reactive (not me).
3) Her-2 positive (me).
4) “None of the above” Formally known as “triple negative” (not me).

As I followed the news coverage, it seemed to me that the big deal was not that they’d “discovered” four new types of breast cancer, but that they’d been able to analyze those four types in stunning depth and that that has revealed some surprises. For instance, they found that some breast cancers seem to have the same genetic mutations as ovarian cancers, opening up the possibility that ovarian cancer drugs might be useful in breast cancer cases. They also identified many, many genetic targets that might lead—someday—to better drugs.

Then, today, I came across a post from MIT’s Knight Science Journalism center that echoed the questions that had been rolling around in my head.

We’ve known since about 2006 that there are four broad sub-types of breast cancer; we just haven’t analyzed the full genomes of those subtypes until now.

The more I follow cancer news, the more it seems that we’re constantly setting ourselves up for disappointment. “Fill-in-the-blank just discovered! Cancer cure on horizon!” We want the cure so badly that we go nuts over every step forward.

Alas, it’s unlikely that there will ever be a single “cure.” It’s more likely that we’ll find a constellation of different targets for drugs, and different constellations for each kind of cancer, and for each subtype of cancer.

This new study is amazing work. It will undoubtedly lead to more research, and, in a few years, new drugs. But it’s not the end to the fight against breast cancer, just one step toward that goal.

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About leftbreast

I have had breast cancer. I was diagnosed at 47, and am now 49. I have finished "active treatment," two surgeries, chemo, radiation, monoclonal antibodies. These days, I only take a drug to suppress my uptake of estrogen, since my tumor was highly reactive to that hormone. I have been married to my husband Pete for 21 years. I have a stepdaughter, Maureen, 30, and a daughter, Erin, 10. I've been a freelance magazine journalist for 20-plus years, covering everything from Chinese foreign policy to Catholic nuns to endangered species. I have had a great life. I have lived in Asia and all over the United States. I have spent nights with tree-sitters in Oregon and with astronomers at the Mauna Kea observatory in Hawaii. I've been to a cocktail party on the poopdeck of a British destroyer docked in Shanghai. I've taken the bus to Tibet, and tramped through the cloud forests of Panama with biologists. A magazine sent me on a raft trip down the Colorado through the Grand Canyon; another sent me to cooking school for a week. I have spent time with celebrities, presidents and heroin dealers. I love my work. I have a loving, supportive family and more friends than I probably deserve. I have had the space and time to camp, ski, cycle, garden, cook and spoil my pets (an Australian shepherd, a German shepherd and a tabby cat). If it all ended tomorrow, I would have to say that it has been a really, really good ride. When I was in thick of treatment, I was simply fighting for more time. Now, I'm trying to connect the experience of cancer with the rest of my life, with the time that's been won. I hope the cancer never comes back, but if it does, I'll be ready. That's what this blog is about.
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