Breast Cancer Therapies Improve Quality of Life

Medical advances have given Audrey McEntire a relatively normal life considering she has advanced breast cancer.

At 69, she still does her own housework and landscaping, is active in her church, travels and helps her husband take care of their large spread of land outside of Sidney, Texas, a ranching and farming community of 200 residents northwest of Waco.

"Cancer is a part of my life, and I have adapted and adjusted accordingly, but I still move on with what I have to do," says McEntire, who was first diagnosed with breast cancer 20 years ago. After treatment, she remained cancer-free for 16 years until the disease returned in 2000, having spread to her lymph nodes and bones.

Like many women with recurrent breast cancer, she has undergone various treatments that have worked to a certain extent in stabilizing the disease.

Survival lengthened by targeted therapies

"Audrey is a great example of how breast cancer survival has improved for women with metastatic breast cancer," says her oncologist, Sharon Giordano, M.D., assistant professor in the Department of Breast Medical Oncology at M. D. Anderson. "She has received a lot of the relatively new therapies for breast cancer, and she has very good control of her cancer and certainly has good quality of life."

When McEntire learned her breast cancer had returned in 2000, she began taking aromatase inhibitors, hormonal drugs that help to prevent tumor growth by lowering levels of estrogen, which can make breast cancer tumors grow. She had success controlling the disease until June 2002, when the drugs stopped working.

McEntire then turned to M. D. Anderson where she took other hormonal therapy drugs. In November 2003, she began using the chemotherapy drug Taxol with Herceptin. She has recently completed chemotherapy and will continue taking Herceptin.

Herceptin is the antibody-based drug that has offered new hope for advanced breast cancer patients who possess an excess of the gene HER-2 (human epidermal growth factor receptor 2). Herceptin targets the HER-2 protein found on breast cancer cells, causing tumors to shrink, which sends some patients' cancer into remission.

Drugs only work for some patients

Nearly one-half of all breast cancer patients develop cancer that spreads or keeps coming back, leading to more than 40,000 deaths a year. Herceptin, which can be used in 25% to 30% of those patients, has managed to make a dent in those statistics. But like other tailored drugs that attack only cancer cells, Herceptin can often fail patients. Many patients do not respond to Herceptin, and in most who do, the cancer begins to grow again within a year.

McEntire is one of the lucky patients who has responded to Herceptin, remaining in remission nearly 11 months. The drug has caused the cancer in her lymph nodes to shrink and the bone cancer to stop growing.

McEntire will continue taking Herceptin unless the drug stops working or she experiences drug toxicity problems. "She is doing so well we wouldn't want to rock the boat," Giordano says.

Side effects associated with Herceptin include heart damage in up to 15% of patients, Giordano says, but even with a family history of heart problems McEntire's personal risk is relatively low. "The risk is offset by the benefits of the drug. For most people it is relatively rare to have really serious heart problems, such as heart failure, as a result of taking Herceptin."

More treatment options are available

If McEntire's cancer begins to grow again, there are still other treatment options to consider, Giordano says. There are new chemotherapy drugs and other targeted therapies being studied in clinical trials.

Scientists are continuing to try new options to improve the outlook for advanced breast cancer. "It is our hope that we'll be at the point in metastatic breast cancer where it is treated as a chronic disease, but we're not quite there," Giordano says.

McEntire says she is grateful for the success of her treatments so far, knowing medical advances often take decades. "In the meantime, I've lived longer than I was supposed to live, so I don't feel I was cheated out of anything."