Study: Chemo avoidable for many breast cancer patients
MANKATO — Chemotherapy is no one’s idea of a pleasant experience, but a new study determined a significant segment of patients with the most common form of breast cancer could avoid it.
The New England Journal of Medicine’s report found patients with early-stage, invasive breast cancer who fall in an intermediate risk zone for recurrence could do just as well with hormone therapy alone.
The risk score is determined by a genomic test called Oncotype DX, which measures removed tissue to determine a patient’s chance of recurrence on a zero to 100 scale. Previous research determined a score more than 25 meant chemotherapy could benefit the patient, while a score less than 10 made the treatment unnecessary.
The journal’s latest study cleared up what doctors should do with the patients falling within the 11 to 25 range. About 70 percent of the 10,000 patients in the study were within this intermediate risk zone, which wouldn’t benefit from chemotherapy.
Mankato Clinic oncologist Dr. Suresh Devineni said doctors will begin incorporating the new finding into their practices.
“This definitely helps us going forward in saying confidently that you don’t need chemotherapy if you’re in the intermediate grouping,” he said.
One exception, he noted, is for women younger than 50. Chemotherapy would still be beneficial for this group, especially if their recurrence score is between 21 and 25.
The finding means many women won’t have to face chemotherapy’s most glaring side effects like hair loss and nausea, said Dr. Stephan Thome, Mayo Clinic Health System in Mankato’s regional oncology medical director.
“The results from this study will take a lot of that stress away,” he said.
The study was underway for nearly a decade, during which time Thome said doctors were eager to see the results. Without clarity on the 11 to 25 risk range, doctors had to weigh various factors against each other in consultations with patients.
Area breast cancer survivors still dealing with chemotherapy’s longer-term side effects said they were happy to hear most women diagnosed in the future won’t need the draining treatment. Mitzi Roberts, of Mankato, said avoiding her chemotherapy, and the hair loss and other side effects that came with it, would’ve been huge.
“I think it was for sure the most dramatic part,” she said of chemo. “It just labels you so quickly the minute you don’t have hair and you’re hooked up to a machine. It feels so much more real.”
She still carries chemo’s longer-term effects in her feet, a particular annoyance considering she owns the Dance Express studio. Both her feet have neuropathy, a weakness or numbness caused by nerve damage.
“It feels like pins and needles tingling on the bottom of your feet,” she said.
Cheryl Olson, a breast cancer survivor from St. Peter, said her chemotherapy experience wasn’t quite as negative. The worst immediate effects were aches and pains in the days after each treatment, but another longer-term side effect called “chemo brain” eventually set in. The condition is marked by forgetfulness and a general mental fogginess.
“There are times I’ve got the word in my head and can’t pull it forward,” Olson said.
Like Roberts, Olson’s cancer spread to her lymph nodes by the time she was diagnosed. Both women wouldn’t have been able to avoid chemotherapy, but they expressed happiness for those who won’t need to have the treatment in the future.
Jodi Boisjolie, of Le Sueur, dealing with her second breast cancer diagnosis in the last two-plus years, said she’s hopeful the study’s finding could benefit her.
“It very much intrigues me to know what are the possibilities instead of chemo,” she said.
Previous chemo treatments weren’t successful, she said, but they did leave their mark. She experienced extreme nauseousness, strep throat and intestinal infections afterward.
“There are so many factors of what chemotherapy changes in your life,” she said of the experience. “You go from what was quote ‘normal’ to more or less disarray.”
She said studies like the Journal of Medicine’s represent hope, something she can ask her doctor about to see if it applies to her.
“You have to be hopeful,” he said. “There has to be something you can do to change your life and you can’t be afraid to try it.”