October is breast cancer awareness month, and University researchers are more focused than ever on unmasking the secrets of the disease -- which affects one in eight women at some time in their lives.
Breast cancer first begins as a cell mutation in the lining of the milk-producing breast ducts. The mutated cells then grow at rapid rates, forming a tumor.
"A tumor must be five to six millimeters in diameter before it can be picked up on a mammogram, one centimeter before it can be felt by hand," said Marcia Moore, Cancer Center director of High-Risk Breast Cancer and assistant professor of surgery.
Long before they are detectable on a mammogram, "cells become cancerous upon the elimination of a gene called P53, which normally tells extra cells to commit suicide," said Charles Meyers, Cancer Center director and professor of medicine and urology.
"The cells are then genetically unstable, evolving and changing on a weekly basis," he said.
Magnetic Resonance Imaging (MRI) of the breasts is more expensive -- costing $1000 as opposed to $65 for a normal mammogram -- but can detect tumors much more effectively than a mammogram.
While there are treatments for every type of cancer, some are curable and many are not.
Breast cancers called Duct Cancer In Situ (DCIS) "are curable with surgery and or radiation," Moore said. But "'invasive' breast cancers have spread into the blood and can move to other parts of the body. Those that spread to the bones are not curable."
Breast cancer is only one of the numerous types of cancer, which are treatable by a variety of methods.
"The best way to fight cancer is to avoid it by using all the preventative measures available to you," Meyers said.
These include a healthy diet, regular exercise and self-examinations.
"Just by eating a Mediterranean diet, your risk of getting cancer can be cut by 60 percent," Meyer said.
The diet stresses large amounts of greens, vegetables, pasta, and olive oil which some health experts say are healthy for the heart.
Once cancer has been detected, the simplest methods of treatment include surgery and radiation, which focus on one specific area of the body and do not work well on invasive cancers which have spread.
Chemotherapy uses harsh chemicals to attack cancerous cells all over the body. The chemicals are designed to hurt cancerous cell maximally while hurting normal cells minimally.
Differentiation-inducing drugs attempt to coax cancer cells back into the normal cell lifecycle, effectively putting them into hibernation from their restless division.
Antiangiogenesis drugs stop formation of new blood capillaries, which must form to supply blood to growing tumors. Without a blood supply, tumors cannot continue to expand.
Hormone therapy attempts to slow cell division by lowering the amount of hormones that induce cell division.
While all cancers have a genetic basis, they usually involve mutation of genes in an individual that are not passed on to offspring. But, there are still several examples of genetic mutations that can be inherited.
A gene called BRCA "causes people to get breast cancer early in life and frequently," Meyers said. "For people with the [BRCA] gene, regular screening is the only prevention."
BRCA is the cause of between 5 and 10 percent of all cases of breast cancer cases and is most common in people of Jewish origin, Moore said.
The reason that breast cancer is the second most prevalent cancer in women is not entirely understood, but the reception of the hormone estrogen by breast cells appears to play a major role. Estrogen acts as a growth factor in breast cells causing them to divide and reproduce their DNA, exposing the possibility of mutation.
New funding has allowed the pursuit of a variety of new research directions at the University.
Dr. Jennifer Harvey, assoc. prof. of radiology and director of breast imaging, currently is doing research on new techniques of breast imaging used for detection of tumors.
Asst. Prof. Meei-Huey Jeng is currently researching the use of an estrogen receptor gene as a prognosis indicator that would allow hormonal treatment to be chosen over chemotherapy or other treatments on newly diagnosed patients.
The University even has a mouse farm in which mice with altered genes are bred to test new drugs being developed before they are put into clinical trials on humans.
As the basic mechanisms of cancer growth become clearer and clearer, the results of new drugs will continue to improve.
"It is possible -- possible that we could reduce cancer death rates by 90 percent in the next 10 years with preventative methods and treatments," Meyer said.
In other news, over 170 University Cancer Center investigators are working to combat cancer from a variety of angles. Research into the basic science of the disease as well as clinical trials of newly discovered drugs are being paired with use of current proven treatments. The center has a combined annual endowment of $43 million and last month, the National Cancer Institute named it as one of only 13 national clinical cancer centers, an accomplishment which doubled federal funding and will provide almost $9 million to researchers over the next five years.
U.S. News and World Report also named the center twelfth in the country in a ranking of the country's top cancer centers.
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