Radiation boost reduces breast cancer recurrence

By Andrew Czyzewski
01 November 2007
49th annual meeting of The American Society for Therapeutic Radiology and Oncology; Los Angeles, USA: 28 October - 1 November 2007

MedWire News: Breast cancer patients who receive an extra dose of radiation after undergoing lumpectomy and standard radiation treatment are more likely to be free from cancer 10 years after treatment, compared with those who do not receive the boost dose, say Dutch researchers.

"The study found that the largest benefits of the boost dose of radiation after standard breast conserving treatment is seen in young women, who have a higher risk for breast cancer recurrence to begin with," said Harry Bartelink (The Netherlands Cancer Institute, Amsterdam) at the recent 2007 meeting of The American Society for Therapeutic Radiology and Oncology in Los Angeles, USA.

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Linchpin Gene May Be Useful Target For Breast Cancer Therapies

University of Iowa researchers have discovered a gene that plays a linchpin role in the ability of breast cancer cells to respond to estrogen. The finding may lead to improved therapies for hormone responsive breast cancers and may explain differences in the effectiveness of current treatments.

Estrogen causes hormone responsive breast cancer cells to grow and divide by interacting with estrogen receptors made by cancer cells. Interfering with estrogen signaling is the basis of two common breast cancer therapies -- tamoxifen, which blocks estrogen's interaction with a primary estrogen receptor called ER alpha, and aromatase inhibitors that reduce the amount of estrogen the body makes and therefore affect any pathway that uses estrogen.

The study, led by Ronald Weigel, M.D., Ph.D., professor and head of surgery at the University of Iowa Roy J. and Lucille A. Carver College of Medicine, reveals a central role for transcription factor AP2C (TFAP2C) in controlling multiple pathways of estrogen signaling. The findings are published in the Sept. 15 issue of Cancer Research.

"Estrogen binds to estrogen receptors and triggers a cascade of events including gene regulation," said Weigel, who also is a member of the Holden Comprehensive Cancer Center at the UI. "We found that elimination of the TFAP2C from the cell causes all of those cascades that we associate with estrogen to go away. The treated cancer cells were not able to respond to estrogen by any normal pathway."

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Excercise And Yoga Can Improve Quality Of Life And Physical Fitness In Women With Early-Stage Breast Cancer

Two studies report that exercise and yoga can help maintain and in some cases improve quality of life in women with early-stage breast cancer. The first study found that resistance and aerobic exercise improved physical fitness, self-esteem and body composition, and that resistance exercise improved chemotherapy completion rates. The second study demonstrated that yoga was particularly beneficial for women who were not receiving chemotherapy during the study period. Both studies will be published online September 4 in the Journal of Clinical Oncology(JCO).

Resistance and Aerobic Exercise

In the first study, Canadian investigators explored the effects of exercise on quality of life, physical fitness and body composition in women receiving chemotherapy for early-stage breast cancer. This study, the Supervised Trial of Aerobic versus Resistance Training (START) trial, is the largest to date to explore the effects of exercise during chemotherapy and one of the first to evaluate a regimen of resistance exercise.

Researchers divided women into three groups: supervised resistance exercise three times weekly (82 women), supervised aerobic exercise three times weekly (78), and no aerobic or resistance exercise, also known as the "usual care" group (82). The median duration of chemotherapy and exercise was 17 weeks. Participants were surveyed at the beginning and middle of chemotherapy and up to four weeks after completing treatment.

They found that resistance exercise was better than usual care for improving muscle strength, lean body mass and self-esteem. Aerobic exercise was better than usual care for improving aerobic fitness, self-esteem and body fat percentage. Exercise did not cause lymphedema or other adverse side effects.

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