Understanding the diagnosis

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Transcript

I don’t think the medical community has a full understanding of it. To be truthful, if you start to look at what we know about tumour markers and prognoses, and if you look at tumours that have high hormone receptors and express the HER2 *(Human Epidermal Growth Factor Receptor-2) proteins and also express progesterone, then I don’t think we know that when you start slicing and dicing your tumour so that there aren’t millions of you. But now there’s thousands of you worldwide, then you don’t have the current survival curve anymore, because you can’t get it for that type of tumour. You don’t really know as much anymore about that particular type of tumour. So as we get to more personalized medicine in breast cancer and more knowledge about pathology and tumour pathology, those survival curves are going to have confidence bounds on them, like this wide, because there’s not enough people in each of the categories anymore. So how do I answer that? By saying that some people with my type of disease do fabulously well and never have a recurrence, and some of them don’t, and that’s all we know about it. Breast cancer is really sneaky. Sometimes the most innocent looking tumours tend to be difficult later on and some of the tumours that present with sort of really horrible characteristics and that look like bullies, you stand up to those bullies and they go away. And when you ask an oncologist this question, they all tell you, “Hmm I don’t think we have a survival curve for you,” because there’s so much misclassification. So if you look at a survival curve for hormone positive tumour, but your tumour also has another characteristic. Well which bin should you be in? The hormone positive one or the HER2 positive one, or the combined HER2 positive one? But what if you have the PR positive* (Progesterone-Receptor-Positive)? Well then there’s no bin for you. So you’re misclassified all the time.

  • *HER2: A gene present in cells that, in some breast cancer cases has a mutation. This mutation causes the HER2 gene to be overproduced in breast cells, causing cells to be more aggressive. However treatments that target HER2 are very effective."
  • PR Positive: The cancer cells’ growth may be promoted by signals from the progesterone hormone.
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