Though it is the spread of breast cancer, or breast cancer metastasis, that ultimately takes the lives of women who die from the disease, only a fraction of the research into the disease is aimed at a greater understanding of this process. And the public dialogue, including government officials, is too often focused on screening mammography as the best or only solution, with the false claim that metastasis could be eliminated simply through widespread use of mammography.1 Sure, industry continues to focus on metastasis – nearly 2,000 drugs for the treatment of cancer are under development. 2 But these drugs can win FDA approval and generate huge profits while providing little or no meaningful benefit for patients. Think of Avastin, costing approximately $8,000 a month,3 showing no increase in survival from breast cancer in randomized clinical trials but increasing a risk of death from side effects. 4
It is time to change the conversation. We need to talk about why and how metastasis happens. And then figure out how to prevent it. Let’s face the reality that mammography is not enough. Women, even those receiving mammograms, will continue to be diagnosed with metastatic breast cancer, sometimes years after an initial “early” breast cancer.5 And for these women, drugs that may or may not add a few more weeks or months of life, and can have lethal side effects of their own, are not enough. We must do more.
Since setting Breast Cancer Deadline 2020 last fall, NBCC has begun taking steps to change that conversation. We have pulled together a diverse group of 20 advocates and scientists who are working to plan a Metastasis Summit, to be held August 24-26, 2011. The Summit will bring together 35-50 stakeholders, leading investigators, regulators, and advocates, to develop a strategic plan to answer the question: what must be done to determine, by 2020, how to prevent breast cancer metastasis and save women’s lives?
Members of the Metastasis Summit Planning Committee are beginning their work by looking broadly and identifying a wide range of ideas worth investigating and researchers worth interviewing. Advocates on the committee will be conducting interviews over the coming months with the identified investigators, and then the work will begin to narrow the focus, and to identify the topics and participants for the Summit. The goal of the Summit will be to identify the key questions to carry into catalytic workshops in 2012, in order to get the research accomplished and translated to the clinic as quickly as possible.
But changing the conversation around breast cancer and metastasis must be much more than our Summit. The conversation needs to change in laboratories and classrooms, in the media, in the workplace, the halls of Congress, online, at the kitchen table. We want to hear from you. How are you changing the conversation? What do you think needs to happen to meet Breast Cancer Deadline 2020?
Work has also begun on NBCC’s other major focus for Breast Cancer Deadline 2020 – prevention of breast cancer all together. Look for information on the Prevention Summit in a future blog.
NBCC Breast Cancer Deadline 2020 Metastasis Summit Planning Committee
- Shirley Brown, Advocate
- Frank Calzone, PhD, Amgen, Inc.
- Suzanne Fuqua, PhD, Baylor College of Medicine
- John Glaspy, MD, PhD, UCLA Medical Center
- Sherry Goldman, Advocate
- Kathleen Harris, Advocate
- Patricia Haugen, Advocate
- Michelle Holmes, MD, DrPH, Harvard School of Public Health
- Debbie Laxague, Advocate
- Debra Madden, Advocate
- Silvano Martino, DO, The Angeles Clinic & Research Institute
- Musa Mayer, Advocate
- Marlene McCarthy, Advocate
- Shirley Mertz, Advocate
- Laura Nikolaides, NBCC
- Patricia Steeg, PhD, National Cancer Institute
- Fran Visco, NBCC
- Sandy Walsh, Advocate
- Danny Welch, PhD, Kansas University Cancer Center
- Maria Wetzel, Advocate
1”But under the law, every American who buys a new plan can access free preventive care like Pap smears and mammograms. That means women are no longer going to have to put off breast cancer screenings, taking the risk that their cancer could be caught late – when chances of survival can be as low as 23 percent – instead of early – when the survival rate is 98 percent.” Secretary of Health and Human Services Kathleen Sebelius in a blog post on Huffington Post, Protecting and Strengthening Women’s Health, Feb. 18, 2011.
2 “Since the introduction of Herceptin® in 1998, manufac¬turers have been flocking to oncology, creating an R&D arms race. Several large pharmaceutical companies (some of which have little or no prior experience in cancer thera¬peutics) have committed more than 20% of their late-stage pipeline projects to oncology molecules.…. Nearly 2,000 individual molecules for the treatment of cancer are under development—a measure of the indus¬try’s determination and ongoing commitment to finding new and innovative treatments for cancer.” The Oncology Pipeline: Maturing, Competitive, and Growing by Steven J. Gavel. http://www.imshealth.com/imshealth/Global/Content/Web%20Article/The_Oncology_Pipeline3.pdf
4 Treatment Related Mortality with Bevacizumab in Cancer http://jama.ama-assn.org/content/305/5/487.abstract
5 Soliman H. Developing an effective breast cancer vaccine. Cancer Control. 2010 Jul;17(3):183-90.