Focus on breast cancer recurrence

In In The News by Barbara Jacoby

Women have about a 1 in 8 chance of developing breast cancer. But chances of beating it the first time are better than ever. Now, doctors are turning their attention to why it sometimes comes back.Karin Zamborsky was a young, busy mom when she got her diagnosis.

After 9 grueling months of treatment, Karin was cancer-free but not worry-free.

“Because we all know if it comes back, it’s not good,” Zamborsky said.

“Fear of recurrence is really the number one thing my patients are asking about,” Dr. Angela DeMichele of Penn Medicine said.

DeMichele says there’s no accurate way to predict that or in many cases, prevent it.

But she and Dr. Lewis Chodosh are seeking answers.

They’ve learned that even with the best treatment, some cancer cells survive.

“Essentially sleeping for up to 20 years. Those cells can wake back up, they can begin to grow in a different way than the original cancer,” Chodosh said.

From mouse studies and human patients, the team has learned that second cancers are genetically different from the original tumors.

So different drugs are needed to treat them.

Tests are underway on a whole range of medicines, including some you may not expect.

“Chloroquin, which was used for malaria, now seems to have a second life as a cancer therapy. There are drugs that were used for diabetes before now being used for cancer, such as metformin,” DeMichele said.

Karin believes the research will at least be able to remove a little uncertainty for cancer survivors.

“Would you want to know that it will come back? I said absolutely,” Zamborsky said.

Just like with the first cancer diagnosis, detecting a recurrence early increases the odds of beating it.