How to Monitor Response to Breast Cancer Treatment: New Method

Sunday, August 12, 2012 Stef dela Cruz 3 Comments

A new way to monitor response to breast cancer treatment is on the horizon. Breast cancer is a common health issue, more common than we would want to believe – it’s the top cause of cancer deaths in women. It’s sad to think that when you get breast cancer, a big part of your breast – or even your entire breast – gets surgically removed. It results in a major image change and leads to considerable financial expenses, not to mention a life-altering death scare that every breast cancer warrior wants to overcome.

We have guidelines to help us determine a treatment protocol for every breast cancer patient. But according to a 2009 article entitled Response to Therapy in Breast Cancer, only about 2 out of every 10 patients show a complete response – and this means monitoring the response to breast cancer treatment is a very important part of the management protocol.

Monitoring Patient Response to Breast Cancer Treatment: Current Protocol

It is important to detect ineffective treatment of metastatic breast cancer so that palliative treatment may be introduced. The health article summaries below might give you a nosebleed, but indulge me for a minute as I introduce current protocols in monitoring response to breast cancer treatment.

  • Histopathologic findings may reveal if response to breast cancer treatment is adequate. But the histopathology criteria used to determine a patient’s response to breast cancer treatment is unreliable. Regressive features happen a lot, yet these don’t necessarily mean a lack of response as their sensitivity and specificity in detecting breast cancer are low.
  • Change in tumor size may be used to detect response to breast cancer treatment. Histopathology may not be ideal in metastatic disease. In this case, imaging using MRI, CT scan, or ultrasound may be done. The Response Evaluation Criteria in Solid Tumors (RECIST) indicates that a decrease of 30 percent in tumor diameter is enough to say there is a response.
  • Another standard in monitoring breast cancer treatment response is the detection of changes in metabolic activity. These changes happen way before a tumor changes in size. There are imaging techniques that detect metabolic activity, such as a PET scan. Much cheaper than a PET scan is an MRI scan that can also successfully gauge breast cancer treatment response: the more blood vessels a tumor has, the more it takes up the contrast agent.

Monitoring Patient Response to Breast Cancer Treatment: NEW Approach

There are several things to consider in choosing a method of monitoring breast cancer treatment response. Is the monitoring method effective? Does it detect treatment response early on? Does it cost a whole lot for patients, especially in the Philippines and other developing countries?

The modalities mentioned above have their own advantages, but a new way of monitoring treatment response for breast cancer patients may prove less expensive and more effective. Labeled tissue polypeptides are now being dubbed as the novel monitoring option for treatment response. In a 2011 study on peptides determining tumor response to cancer therapy, peptides can be used to seek out specific antigens on breast tumor tissues. Prepare for another nosebleed as I talk about these peptides below.

  • Labeled tissue peptides can monitor treatment response in breast cancer in several ways. They can detect proteins in cancer tissues that undergo a change in how they are expressed after treatment. These tissue polypeptides can also detect mediators of apoptosis. Peptides that can bind only to responsive tissues but not to unresponsive tissues were also identified.
  • Labeled tissue polypeptides can detect apoptosis products after breast cancer chemotherapy. In a study that explores the response to neoadjuvant chemotherapy in breast cancer, caspase-cleaved cytokeratin 18 can help predict treatment response. A tissue polypeptide called M30-monoclonal antibody can detect the apoptosis products of a specific antigen (cytokeratin 18). The presence of these apoptosis products signifies treatment response in an early as 1 to 2 days after treatment. Non-responders don’t show high levels of cytokeratin-18 apoptosis products.
  • Tissue polypeptide specific antigen levels are present even in breast cancer patients in remission. Does this mean that peptide use for monitoring treatment response is not effective? Actually, these patients in remission who are antigen-positive may benefit from secondary adjuvant chemotherapy, as mentioned by a 2006 article published at Breast Cancer Research.

Although available in other countries as mentioned in the many studies on labeled peptides worldwide, the last time I checked, there are very few institutions in the Philippines – such  as National Kidney Transplant Institute - that offer tissue polypeptide specific antigen as a way to monitor breast cancer treatment response. It may take time before status quo changes, but any good change is bound to be discovered – and thoroughly welcomed – by the people who need it the most.

Stef dela CruzAbout the blogger
Stef dela Cruz is a doctor and writer. She received the 2013 Award for Health Media from the Department of Health. She maintains a health column in Health.Care Magazine and a cat welfare column in The Manila Bulletin's Animal Scene. Add her to your circles.

3 comments:

  1. It's good that there are new and more efficient ways to monitor breast cancer so that there are more options on the part of the cancer patient.

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  2. it's always inspiring to know about new methods to treating breast cancer. I have a few friends battle the big C recently, and I am inspired by the strength they are showing, and now, they are on their way to recovery. i love the information you shared, hope they all stay in my long term memory :)

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  3. Franc, breast cancer is now very common. We all know at least one person with breast cancer - and that's something that never happened 20 years ago.

    Betchai, sorry for the nosebleed moments. :) I know, the info here is rather heavy. I just couldn't do away with all the facts, especially coz it's a new modality. Thanks for visiting my blog!

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