BREASTMATTERS - A BETTER WAY Inside - Johns Hopkins Medicine
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THE JOHNS HOPKINS KIMMEL CANCER CENTER BREAST MATTERS 2020/2021 [Inside] A BETTER WAY Harnessing the Power of Breast Cancer Prevention WOMEN’S WELLNESS ANGELA’S STORY AND MUCH MORE
THE JOHNS HOPKINS KIMMEL CANCER CENTER BREAST 2020/2021 MATTERS UPCOMING EVENTS Retreat: A Journey of Courage and Hope for Women with Metastatic Breast Cancer April 12-14, 2020 page 2 Support Groups, webinars and more Women’s on page 12 Wellness CONNECT! HopkinsCancer.org Facebook facebook.com/HopkinsKimmel Twitter twitter.com/HopkinsKimmel Instagram Instagram.com/HopkinsKimmel Youtube youtube.com/HopkinsKimmel Podcast page 4 Cancer News Review: HopkinsKimmel.libsyn.com A BETTER WAY Blogs Cancer Matters (timely topics) cancer-matters.blogs.hopkinsmedicine.org On the Cover: Leslie Ries and her daughters, Carly and Emily
Li v i n g with Metastatic Breast Cancer Angela always made sure she went for her annual mammogram. Angela’s Often times, the results showed spots that were suspicious for story cancer, but she said it always turned out to be a false alarm. SO, IN 2013 when the then- 54-year-old chalked it up to the strenuous remodel- and Pain Program began treatments received several telephone calls about ing process. She went to see a doctor, that got it under control so she could her mammogram, she assumed it was who said it was bursitis and began begin radiation therapy. the same scenario. At the time, her pri- treatment. Surgeon Dan Sciubba then removed ority was caring for two siblings who She didn’t give cancer a thought and cancerous tumors that spread to verte- had both suffered strokes. neither did the doctor. Given the work brae in Angela’s “They were so persistent, so I she was doing in her home, bursitis back. When a thought I better call them back,” says seemed to make sense. However, when small dot that ap- Angela, but she decided to wait until the pain became so severe and unre- peared on follow her brother and sister were better. lenting that it kept her up at night and up scans began to When she finally scheduled time to made it almost impossible to walk, her grow, Sciubba op- see her doctor, the news was shocking. husband took her to the emergency de- erated again. “He told me I had breast cancer,” says partment of the hospital where she was “I’m so glad I Angela. Her husband went with her to first treated for cancer. Angela was came to the the appointment, and she recalls that shocked when she received the news KatiePapathakis,C.R.N.P. Kimmel Cancer he began to cry when the doctor deliv- that the pain was not bursitis or an- Center,” says Angela ered the news. Angela remained stead- other strain or injury. Instead, her who says she and her husband are fast, however. “I was ready to do breast cancer had returned, and worse grateful to the community physician whatever I had to,” she says. yet, the source of her pain was from who advised us to come here. What a Her cancer was diagnosed early, cancer that had spread to her bones. difference they have made. I went from and her doctor referred her to a com- Radiation therapy was recom- a wheel chair, to a walker, to a cane, to munity hospital, where she had a mas- mended, but the pain was so severe, nothing,” she says. A car accident tectomy, radiation therapy and Angela could not lay still long enough caused a bit of setback, so Angela again chemotherapy. to receive treatment. Her oncologist uses a cane when she walks. “I’m a positive person, so I went on told her husband, “Take her to Johns Angela’s mother also had breast with life,” says Angela, who saw her on- Hopkins,” Angela says. cancer. She died in 2000 when the can- cologist for follow up visits to make Once she arrived at Johns Hopkins, cer spread to her brain, and Angela was sure the cancer remained in check. she was transferred to the Kimmel sure that was her fate. “I didn’t think I Angela thought cancer was in her Cancer Center. Her discomfort was so was going to make it,” says Angela. “I past, so she and her husband bought a severe, even the slightest touch caused told my husband to start donating my fixer upper house. When she began ex- Angela to scream out in pain, but exerts clothes. I was sure I wasn’t going to periencing sharp pain in her leg, she from the Duffey Family Palliative Care live, but Johns Hopkins gave me hope. They tell you about options and ad- vances. The message is that you can live with cancer.” “JOHNS HOPKINS GAVE ME HOPE. THEY TELL YOU When the first treatment she tried didn’t work, Angela recalls her nurse ABOUT OPTIONS AND ADVANCES. THE MESSAGE IS CONTINUED ON BACK PAGE THAT YOU CAN LIVE WITH CANCER.” 2020/2021 • BREAST MATTERS 1
“I’m glad these doctors recognize what I’ve been through. I know they’ll take my symptoms seriously and be proactive.” Women’s Wellness BEFORE, DURING AND AFTER MENOPAUSE 2 BREAST MATTERS • 2020/2021
Clara is a busy 46-year-old mother of two. She’s also a breast cancer survivor. Diagnosed in 2012 with hormone receptor positive breast cancer, she underwent a bilateral mastectomy and, for the past seven years, has taken tamoxifen. She says symptoms of the medication, which blocks hormone receptors to prevent her hormone-triggered cancer from recurring, have been fairly mild and manageable. But Clara recognizes that, as she gets older, her medical history and the menopausal transition will put her at greater risk for other health issues, such as osteoporosis and cardiovascular disease. She’s not too worried about it, for good reason. CLARA PLANS TO TAKE ADVANTAGE says breast cancer expert Vered Clara sees the benefits. “I’m glad of a brand new program at Johns Stearns, Women’s Malignancies these doctors recognize what I’ve Hopkins dedicated to coordinating and Program Director and the new been through. I know they’ll take my providing women’s health care before, women’s wellness program co-director. symptoms seriously and be proactive.” during, and after menopause. The “Women with breast cancer, regardless she says. As a physical therapist, Clara program was launched with founda- of age at diagnosis, are very likely to understands and values the concept of tional support from Robin and Mark encounter symptoms of menopause, a multidisciplinary team of medical Rubenstein and the Bauer Foundation, such as hot flashes, vaginal dryness and professionals. “It’s good to know that bringing together a hand-picked multi- bone loss,” says Stearns. While she has they’re talking to one another behind disciplinary team of medical experts referred many of her breast cancer the scenes,” she says. from the Kimmel Cancer Center and patients to Shen over the years, this Although the public is beginning to throughout Johns Hopkins. “It’s a pas- new program provides patients access become more aware of the need for a sion,” says the program’s co-director to more timely appointments and focus on women’s care in midlife, other gynecologist Wen Shen of developing coordinated care with dedicated programs currently available to this de- the women’s wellness program to de- experts. mographic are limited, Shen explains. liver robust, coordinated care to Under Shen’s and Stearns’ leader- “We are broadening the focus, includ- women. ship, the expanding multispecialty ing a wide range of specialists and Johns Hopkins Medicine team includes experts in: gynecology getting to the core of how women and women’s health; wellness services can age healthy,” she says. for breast cancer patients, the care of “We anticipate that our survivors and women at risk; cardio- program can both serve as the vascular health; treatment of uterine primary clinic for some women, and vaginal prolapse, incontinence and or provide a consult with a related conditions; mood and anxiety roadmap that can be carried out disorders; arthritis and other joint, lig- by the women’s own physi- ament and muscle disorders; bone cians,” Stearns says. Wen Shen, M.D. Vered Stearns, M.D. health and osteoporosis; treating To learn more about women with more than one health our new program for Managing Wo men’s This may be especially relevant to issue; and combining conventional and women’s wellness or to ask Healthcare Be fore, During & Beyo nd patients who have had breast cancer, integrative medicine. a question, email us at Menopause womenswellness@jhmi.edu. 2020/2021 • BREAST MATTERS 3
[Feature] A BETTER WAY Harnessing the Power of Breast Cancer Prevention Her diagnosis came decades before drug and radiation therapies for breast cancer. The cutting edge science at the time was very literally focused on the cutting edge of the scalpel with surgery— in the form of Halsted’s radical mastectomy—that removed the breast, muscles and lymph nodes under the arm. Later on, parts of her brain were When Leslie Ries’s removed after the cancer spread there by grandmother was metastasis. diagnosed with Leslie imagines how it must have been for her breast cancer in the grandmother, when more and more of her body was carved into and cut away as the disease early 1940s, there spread, ultimately claiming her life. Although was no understanding her grandmother died before Leslie’s parents of BRCA mutations were even married, the source of this cancer was already eerily shaping Leslie’s future and that of or the grip the disease her daughters. would have on future As far as we’ve come in understanding and treating generations of the breast cancer, the life-altering experiences of family. women and their families is a jolting reminder of how much farther we have to go and the dire need for prevention. 4 BREAST MATTERS • 2020/2021
“I’ve seen the devastation too many times,” says Leslie. “Mothers gone, leaving behind young children. We have to intervene to protect ourselves, our children and others from getting this disease. Breast cancer is a trauma to the whole family.” She understands that trauma all too well. Her own diagnosis came 15 years ago. Leslie tested positive for a BRCA mutation, a genetic alteration that can occur to one or both types of breast cancer susceptibility genes (BRCA1 and BRCA2). It alters the body’s ability to repair DNA, placing those affected at From left, Carly Ries, Leslie Ries, Emily Ries higher risk of developing breast cancer. This inherited alteration, potentially affecting multiple generations of fami- lies, is also associated with other can- cers in men and women, including “There has to be a better way than cutting off body parts.” ovarian, prostate and pancreatic can- – CARLY RIES cers. The mutation caused her cancer and now also threatens her two daugh- seen and been affected by the limita- for families who have already been ters. tions of treatment. Even with major ad- touched by breast cancer as well as for Leslie is grateful to be a survivor vances, too many patients are not cured others who may not even know that and for the progress that has been and die of breast cancer, he says. they are at high risk. made since her grandmother’s diagno- “After trying to cure patients with Leslie and Tom’s daughter Emily sis more than 70 years ago. After en- breast cancer for 30 years, we need to calls herself a pre-vivor. She has the during a double mastectomy and implement another approach in our same BRCA mutation as her mother, reconstructive surgery, and 4 months battle,” says Fetting. “For all of the and that puts her at much greater risk of chemotherapy, she considers herself success of treatment, the experience for breast and ovarian cancer. For fortunate and grateful. She doesn’t is punishing and leaves physical and many women who inherit a BRCA mu- deny that treatment saves lives, but she emotional scars. After treatment, sur- tation, it’s not a matter of “if” they de- also knows it’s not enough. vivors and their family members live velop breast cancer but “when” they “The improvements in treatment with fear of recurrence, and their lives develop breast cancer. options and reconstruction are wonder- are forever different.” She can still recall the pain at 21 of ful, but they still come at a great cost,” she Among these tolls is the threat of learning about her mother’s breast can- says. “The long-term emotional, physical breast cancer that looms so heavily over cer diagnosis. At that time, her mind and financial tolls are immense and often so many families, including that of was focused on the unthinkable possi- irreparable. We have to do better.” Leslie and her husband Tom. In honor bility of losing her mother. “I won- Leslie’s own experience and that of of Dr. Fetting, they gave a lead gift in dered, what if she’s not there when I get so many other families made her real- 2011 to start the John Fetting Fund for married or have kids,” says Emily. She ize, “We have to think differently.” She Breast Cancer Prevention to move pre- wasn’t yet aware of what lay ahead for wasn’t alone. Her oncologist, breast vention to the forefront of breast cancer her or the cruel reach of breast cancer. cancer expert John Fetting, had the research. Using the latest technological When genetic testing showed that same realization. advances, the team of Johns Hopkins Emily inherited the BRCA mutation, In the decades Dr. Fetting has been experts in breast cancer and genetics is she’d hoped less invasive ways of treating breast cancer patients, he has committed to developing better options cancer prevention would become 2020/2021 • BREAST MATTERS 5
available before she had to take action. Leslie and Tom’s daughter Carly on, yet Emily and Carly consider them- She didn’t want cancer to be her legacy. was just 17 years old, a high school selves lucky. “I got to make my own de- Now, in her 30s, married and the senior, when her mother was cisions. I didn’t have to wait to have mother of a young son, the thought of diagnosed. Like her sister Emily, she cancer, but what a choice to have to not being around to see him grow up has inherited the BRCA mutation. make,” says Emily. Carly agrees. She weighed too heavily on her to wait for For now, at 32, Carly has chosen says, “There has to be a better way than those advances. Yet to do the most she surveillance, close monitoring aimed cutting off body parts.” That better way could do to try to prevent breast cancer, at early detection. she hopes will come from the research the options were strikingly similar to “I totally understand and support the Fetting Fund is making possible. her mother’s options, though without the decision my sister made, but for Fetting’s goal, shared by the Ries the need to have chemotherapy. She me, at this stage of my life, I want to family and the patients, families and made the difficult decision to have a wait until I have children before I others who support the Fetting Fund, is double mastectomy. The night before move forward with cancer-preventive to bring an end to these kinds of ago- her surgery, she recalls looking at her surgery,” says Carly. nizing decisions and the trauma of perfectly healthy, unscarred breasts breast cancer by shifting the focus from ROUGHLY 30% OF BREAST CANCER cure alone to cure and prevention. wondering why the best prevention CASES COULD BE PREVENTED BY available to her was lopping off body MODIFYING KNOWN RISK FACTORS As Leslie and Tom’s daughter Carly parts. continues to think about the unthink- This was just the beginning for The heartbreak is that she has to able and whether her only option for Emily. She had more surgeries over two think about this at all. The Fetting breast cancer prevention will be to years, including a hysterectomy and Fund’s goal is to change this trajectory have healthy body parts removed so oophorectomy to remove her uterus through research. they don’t become cancer later, she vol- and ovaries to prevent other cancers “This was a pivotal time in my unteers for studies, donating blood caused by the BRCA mutations. She has life and my sister’s life. Emily was samples. Like her sister Emily, she a hormone patch that helps ease the about to graduate college, and I was hopes researchers can use them to un- symptoms of the resulting early onset graduating from high school,” Carly ravel the very origins of breast cancer of menopause. The surgery means remembers. “I don’t want to live my and find better ways to prevent breast Emily and her husband cannot grow life scared.” Carly’s hope is for progress cancer in the future. It would be ideal if their family, but eases some of the that will mean one day women won’t these answers came before Carly has to worry that she won’t be around to see be confronted with decisions like these. make a decision about surgery. She un- her son grow up. It’s a lot for a young woman to take derstands the timing might not work out. “I may not see the benefits, but someone will in the future, and that’s important,” says Carly. Lorraine Schapiro understands. Breast cancer abruptly entered her life John Fetting, M.D. 14 years ago when her daughter Jill Mull was diagnosed. When she heard about the Fetting Fund, she and her husband Mark joined the cause with- out hesitation. Prevention was already on Lorraine’s mind. “We hear so much about cure, and I thought what about prevention?” Tears still fill Lorraine’s eyes when she recalls the day she received the call from Jill delivering the shocking news that she had breast cancer. As the real- ity sank in and Jill underwent a lumpectomy to remove the cancerous tumor, Lorraine says, “I remember thinking, please don’t let it be in her lymph nodes.” The pathology from the lumpectomy found unclear margins between cancer and normal cells, 6 BREAST MATTERS • 2020/2021
PROTONS ARE THE MOST NOVEL DEVELOPMENT IN PATIENT-CENTERED RADIATION THERAPY, AND CAN BE TAILORED SO THAT THEY PENETRATE ONLY A SELECTED DEPTH THROUGH TISSUE. CONSEQUENTLY, RADIATION STOPS AT THE TUMOR, PRESERVING HEALTHY, NON-CANCER TISSUE BENEATH. Jill Mull and family, from left:Jacob, Jill, Mike, Ethan “We cut, burn and poison, and even that doesn’t always work forever.” – JILL MULL meaning the cancer may have begun to When she lost her hair during Lorraine says. She credits Dr. Fetting spread. Lorraine once again pleaded, chemotherapy, her son announced to with getting them both through the di- “Please don’t let her need a mastec- his kindergarten class that Jill was agnosis, treatment and recovery. tomy,” but the unclear margins of the bald. Later, when she was having her Genetic testing revealed that Jill cancer required a mastectomy. “Please mastectomy, he told his teacher that had not inherited a BRCA mutation. don’t let her need chemotherapy,” his mommy was having her boobies There was no answer for why she devel- Lorraine thought, but Jill’s cancer thrown in the trashcan because they oped breast cancer at such an early age. required six months of chemotherapy were very bad. Whether there were genetic clues that and an additional nine months of treat- Funny yes, but also a sober re- could have predicted and prevented it ment with the drug Herceptin and 10 minder of the intrusion of breast can- is the type of research the Fetting Fund years of tamoxifen therapy. cer into too many families. supports. Herceptin and tamoxifen are Jill was diagnosed at just 32 years AN ESTIMATED 232,000 NEW BREAST major success stories in the treatment old. For the young mother of 4-year old CANCER CASES ARE DIAGNOSED IN of breast cancer. They block the hor- twin boys, breast cancer was the last THE UNITED STATES EACH YEAR mones and other signals that certain thing she was expecting, but she re- types of breast cancers need to grow mained positive, never asking “Why “We are in the process of identify- and spread. These drugs work well, but me?” Lorraine, on the other hand, re- ing genetic changes in breast tissue they cause side effects, and they don’t calls being in denial, certain Jill’s ab- that convert normal cells to cancer work in every patient. normal mammogram was just a cells. I believe we can figure out which Jill tried complementary ap- mistake. Lorraine was in a Pilates class changes are necessary for breast cancer proaches, such as acupuncture to ease and didn’t answer the phone when Jill to develop and intervene,” says Fetting. her symptoms. Mostly, she is grateful first called. When the phone immedi- When Jill realized breast cancer for the support of her family, particu- ately rang again, Lorraine instantly was going to be a part of her life, she larly her husband Mike. knew. Her heart filled with dread and turned it into a way to help other pa- A little laughter helped as well. she answered. “It was devastating,” tients, joining the Breast Cancer Pro- 2020/2021 • BREAST MATTERS 7
tion endeavor focused on a better un- derstanding of prevention, health and wellbeing. “Normal,” however is rela- tive, Erin pointed out. “The weight of recurrence never goes away no matter how well you feel.” Erin had surgery, chemotherapy, ra- diation therapy and hormone therapy— everything doctors have in their arsenal to fight breast cancer and still, in 2017 she learned her cancer had re- turned and spread throughout her body. There would be no cure for Erin, who passed away in 2019 at 38, leaving behind her devoted husband Steve and their 8-year-old-daughter. Erin, a Fetting Fund advocate, left a powerful message, “Early detection does not necessarily mean survival or better outcomes. I was diagnosed at Stage 2, and it still advanced to the worst stage,” she said. “We can make a differ- ence in the world. We need prevention. We need the Fetting Fund so people don’t go through what I went through. I don’t want that for my daughter.” Her call is championed by Fetting, Jill Mull with her mother, Lorraine Schapiro Leslie and Tom, Emily, Carly, Jill and Mike, Lorraine and Mark, and echoed by women and families around the world. GENETIC TESTING REVEALED THAT JILL HAD NOT INHERITED A BRCA As the Fetting Fund pioneers a new MUTATION. THERE WAS NO ANSWER FOR WHY SHE DEVELOPED BREAST way of thinking about breast cancer CANCER AT SUCH AN EARLY AGE. WHETHER THERE WERE GENETIC CLUES THAT COULD HAVE PREDICTED AND PREVENTED IT IS THE TYPE OF care, it is an uphill battle, as the lion’s RESEARCH THE FETTING FUND SUPPORTS . share of research dollars go to study new therapies. Stories like these are gram at the Johns Hopkins Kimmel Erin Yale is among the women who inspiring change, however, and the Cancer Center as a patient navigator remind us of the limitations of treat- early success of Fetting Fund research for newly diagnosed patients with ment, even when it is diagnosed early. shows what is possible through breast cancer. Her focus is on patients Erin was supposed to be one of the lucky prevention. under age 50. ones. Her breast cancer was detected in ROUGHLY 40,000 WOMEN DIE IN Sharing her story brings them hope. what is considered a curable stage. THE UNITED STATES FROM They see a survivor in her. She sees a big- In 2012, at age 30, she nursed her BREAST CANCER EACH YEAR ger need in them. She has seen too many newborn baby for the last time before young women lose their lives to breast she went to the operating room for a “We know it will not be easy, but cancer, and she yearns for the day when mastectomy. After learning she inher- this cannot continue,” says Fetting. she doesn’t have to sit with women as ited a BRCA mutation, she had surgery “We need the same kind of concerted they write letters for their children to to remove her fallopian tubes and effort for prevention that has been open on special occasions in their lives— ovaries in 2014 to ward off cancer. mounted to treat breast cancer.” birthdays, graduations, weddings, Erin recalled in a video made of her The Fetting Fund is investigating the births—because their mothers may not be talk at a 2018 Fetting Fund event that, scientific benefits of natural remedies there. For Jill, Fetting Fund research is as the years passed, she tried to return such as the spice curcumin, broccoli the key to changing this reality. to her normal life as a young wife and sprouts tea and a magnolia tree extract “We cut, burn and poison, and even mother, working in the corporate world that may contain properties that detoxify that doesn't always work forever,” says and launching Pushing Pink Elephants, carcinogens or reset the molecular errors Jill. a breast cancer awareness and educa- that initiate breast cancer. Technological 8 BREAST MATTERS • 2020/2021
“We need prevention. We need the Fetting Fund so people don’t go through what I went through. I don’t want that Erin Yale with her family for my daughter.” – ERIN YALE, 1981-2019 advances mean we no longer have to wait until a cancer is visible through imaging or a lump can be felt to detect it. New molecular tests that make the THE PATH TOWARD A BETTER WAY invisible visible can detect early MISSION OF THE JOHN FETTING FUND changes that precede breast cancer. This includes understanding the con- FOR BREAST CANCER PREVENTION nection between genetic and epigenetic The mission of the Fetting Fund is to identify the one woman in eight who is at (reversible chemical changes to DNA) high risk for developing breast cancer in her lifetime and to develop safe, effective that contribute to breast and other can- natural products and drugs to prevent that breast cancer. Of equal importance, the cers Then, injecting anticancer drugs or research supported by the Fetting Fund seeks to identify the seven in eight women a drug like tamoxifen directly into the who will not develop breast cancer. Medical caregivers will be able to provide more breast ducts could eliminate these prevention efforts for those at risk and reassure those who are not. changes before a cancer has a chance to Traditional funding sources are focused on advances in treatment and the quest grow. Vaccines that train the immune for a cure for breast cancer. As a result, funding for prevention research has system to patrol and destroy breast can- lagged. The Fetting Fund relies on private philanthropy to support pilot preven- cer cells are another promising area of tion studies that will produce results and allow Johns Hopkins prevention scien- study. Lifestyle research, such as the tists to design more substantial research plans and compete successfully for role of alcohol in promoting breast can- larger grants. Our vision is to support enough high quality pilot studies that our cer development, could yield simple breast cancer scientists will be able to attract funding for a rich portfolio of large changes that can ward off breast cancer. breast cancer prevention studies. The Fetting Fund is a catalyst for development “This is just the beginning,” says of a critical mass of breast cancer prevention science and breast cancer preven- Leslie. “There is so much promise. I tion scientists resulting in a world class breast cancer prevention program at the can see it, and I feel that it’s going to Johns Hopkins Kimmel Cancer Center. happen.” l 2020/2021 • BREAST MATTERS 9
WHAT’S NEW Study Helps Breast Cancer Survivors Reach Their A Patient App Weight-Loss Goals Hormone-blocking drugs are a pow- Attaining a healthy weight is erful weapon against breast cancer. even more important for breast At the same time, these drugs can cancer survivors, says new Kimmel have significant side effects—some Cancer Center breast cancer expert so uncomfortable that they drive pa- Jennifer Sheng, M.D. Studies show tients to quit taking them before that losing just 5% body weight can completing the typical help survivors combat fatigue, im- five-year course, often prove their body image, and simply without notifying their doctors until the next feel better after the trying rigors of breast cancer treatment. scheduled appointment weeks or months away. In addition, research suggests that weight loss can lower the Breast cancer expert Karen Smith, M.D., says a risk of breast cancer recurrence. A new study open to over- new app called Thrive delivers education, weight breast cancer survivors treated at Johns Hopkins who helps patients track their appointments, and have completed treatment and want to lose weight will offer communicate with their care providers about behavioral intervention that’s been tested before. After two their treatment plans. Now, a new electronic months, if logging calories, tracking and increasing physical patient reported outcomes module called activity, and working a coach doesn’t work, the FDA-ap- ePro helps patients to report what medicines proved weight loss drug naltrexone/bupropion (Contrave) they were prescribed and symptoms they are will be prescribed for the next four months. having. It also notifies the care team if the Read more: http://bit.ly/2n6qG80 symptoms pass a severity threshold or if { Tracie} they’ve unexpectedly discontinued taking their medications. Read more: http://bit.ly/2pnHaJr A New Leader of the Gene Team Jessica Tao, M.D., is the new direc- tor of the GAITWAY program, short for Genetic Alternations In Targets With Actionable Yields. This special- ized tumor board is filled with ex- perts in cancer medicine, genetics, and biology, including clinical oncol- ogists, laboratory scientists, and molecular pathologists, who keep tabs on the latest research and targeted drugs to help match the right medicines to A Model for Breast Cancer Care and Wellness cancer patient’s specific genetic alterations. She received a Mary Wilkinson, M.D., new clinical director for the Johns grant from the Maryland Cigarette Restitution Fund to better Hopkins Kimmel Cancer Center Under } { MiaArmour Breast understand how tumor cell-free DNA—tiny bits of genetic ma- Health Innovation Center, is overseeing a new model of terial shed from malignant lesions that can be breast cancer care in which illness and wellness exist in the extracted from a blood sample—might better benefit patients same space. Read more: http://bit.ly/2pqeWxL and guide treatment. Read more: http://bit.ly/2mXg4rM 10 BREAST MATTERS • 2020/2021
WORLD-CLASS CARE IN A COMMUNITY SETTING The Possibility for Better Results With Fewer Treatments As our knowledge of breast cancer has grown, so have the number of therapy modalities and proto- cols used to treat this disease, from combi- nations of chemotherapy to targeted treatments that attack The Breast Center at Green Spring Station moved to a malignant cells carrying specific genetic variations. Antonio brand new space in its existing suburban location. Wolff, M.D., and colleagues are investigating ways that patients can get more from less by using more targeted treat- When patients come to the Kimmel Cancer Center at ments, changing the way that treatments are administered, Greenspring Station Pavilion III, they are greeted by more or even carefully stratifying patients to determine who might than gleaming new private exam rooms; modern infusion be able to avoid certain treatments altogether. bays; and on-site imaging, pharmacy and lab services. The Read more: http://bit.ly/2n0te7s entire practice is designed to provide an optimal cancer Cancer Treatment care patient experience which now also includes surgical Without Hair Loss oncology onsite. Read more: http://bit.ly/2oAPHsb Starting this fall, Kimmel Cancer Center patients “I’m excited to be part of a with breast cancer or other practice that’s offering more services in a setting where gynecologic cancers will many patients want to be. have the option to use a It’s a beautiful site. The new, FDA-approved device building is new, and the called a “cooling cap” that services are world-class.” –R I M A C O U Z I , M . D . prevents or minimizes chemotherapy-induced hair loss. Read more: http://bit.ly/2Mo3iLE Beginning this fall, patients will be able to undergo surgical procedures at the Green Spring Station pavilion. Surgical oncologist, Lisa Jacobs, M.D., calls the change a “huge advantage” for this patient population. 2020/2021 • BREAST MATTERS 11
EVENT Prior Events Recap Survivor Soul Stroll On Saturday, May 11, 2019, Team Hopkins participated in the 3rd Annual ROUNDUP Survival Soul Stroll: A Breast Cancer Awareness Walk at Canton Waterfront Park. Our team included employees, volunteers, cancer survivors, and community members. Upcoming All events are FREE and open to all Breast Cancer Survivors Program Survivorship Day breast cancer survivors, thrivers and 4th Thursday of the month caregivers unless otherwise noted. 6-8 p.m., Johns Hopkins Bayview, Medical Education Center Support Groups Contact: cklein3@jhmi.edu, Early Stage Young Women’s (410) 550-6690 Support Group 1st Monday of the month Integrative Medicine Lunch Workshop 6-7:30 p.m., A monthly workshop on integrative Green Spring Station Pavilion III medicine modalities. Topics vary, but On May 5, 2019, our Breast Cancer Contact: jmull1@jhmi.edu, previous ones include yoga, medita- Program hosted its 5th Annual Breast (410) 583-2972 tion, nutrition, acupuncture, hypnosis Cancer Survivorship Day at the BWI and traditional Chinese medicine. Marriott Hotel. More than 100 Metastatic Support Group Dates vary. participants attended, learning about 3rd Monday of the month Contact: ebantug1@jhmi.edu, (410) integrative medicine, medical 6-7:30 p.m., 502-3472 marijuana, metastatic breast cancer, Green Spring Station Pavilion III clinical updates, immunotherapy, Contact: jmull1@jhmi.edu, Webinars “chemo brain” and exercise. Keynote (410) 583-2972 Exercise and Breast Cancer speaker, Susan Love, M.D., M.B.A., Dec. 4, 2019, 12-1pm discussed breast cancer prevention and emerging new treatments. Methods to Enhance Breast Cancer Survivorship Swim for Engie Against Cancer Jan. 9, 2020, 12-1pm The 4th annual swimathon was held Updates in Breast Cancer Research Aug. 24, and Clinical Care 2019, Feb. 26, 2020, 12-1 pm honoring Registration is required metatatic https://public.onc.jhmi.edu/ breast Walk and Talk survivorshipwebinars/ cancer survivor Engie Mokhtar. This Open to all breast cancer survivors Contact: ebantug1@jhmi.edu, (410) year’s event supported research by and thrivers 502-3472 Otis Brawley, M.D., to close racial, 3rd Friday of of the month economic, and social disparities in 9-10 a.m., Meadowood Regional Park or Retreat cancer prevention, detection and Towson Towne Center (weather dependent) A Journey of Courage and treatment. Registration is required Hope for Women with Contact: jmull1@jhmi.edu, Metastatic Breast Cancer Promising New Treatments (410) 583-2972 April 12-14, 2019 Brian Christmas, Ph.D., who works in A weekend retreat for metastatic breast the laboratory of breast cancer expert cancer patients and women who support Evanthia Roussos Torres, M.D., Ph.D., them to gather information and support presented advances in immunother- on confronting metastatic breast cancer. apy for breast cancer at the Judith A. Discussions include routines of treat- Lese Breast Cancer Foundation annual ment, daily life challenges, reflections, dinner. The foundation has supported and networking with others in a healing breast cancer research at the Kimmel and renewing environment. Cancer Center since 2004. Contract: kviands1@jhmi.edu, (443) 287-2964
NOTEWORTHY Targeting Sukumar lab investigator Bradley BRCA1 and 2: Downs assembles the cartridges. A research team led by Victor Velculescu, M.D., Ph.D., was among seven awarded grants from the Gray Foundation for new ap- proaches to the early detection, diagnosis, and therapy of cancers related to BRCA1 and BRCA2 New Laboratory Test Could Make Global Impact: The journal Clinical gene mutations. Cancer Research reported on a new laboratory test developed by Saraswati Velculescu will Sukumar, Ph.D., that identifies chemical changes to a group of cancer-related collaborate with genes and can accurately detect which breast tumors are cancerous or benign, and Vered Stearns, do it in far less time than gold-standard tests on biopsied breast tissue. The test has M.D., and Kala the potential to dramatically reduce the time needed to make a definitive breast Visvanathan, cancer diagnosis in poorer countries. Breast cancer incidence is rising around the M.B.B.S., on world, and the test—an easy-to-use cartridge—could be especially useful in places research aimed at early detection of with fewer resources and where mortality rates from breast cancer are much breast and ovarian cancers. higher compared to the developed world. The research was supported, in part, by the Breast Cancer Research Foundation. Navigating Breast Cancer: Kimmel Cancer Center Advisory Board HONORS AND AWARDS Member Debra Huber made a gift to support a social worker/breast cancer patient navigator. Huber was inspired by her sister, a breast cancer survivor, Dipali Sharma, Ph.D. to do what she could to ease the trauma Katy Gaffney, R.N. Society of American Asian of cancer diagnosis and treatment. Friends of Oncology Scientists In Cancer Research Nursing Clinical Outstanding Achievement Award Excellence Award Roisin Connolly, M.B.B.Ch. Daniele Gilkes, Eastern Cooperative Oncology Ph.D. Group-American College of The Best of the Radiology Imaging Young American Investigator Award Association for Cancer Research Stephanie Gaillard, M.D., Journals Collection: Author Ph.D. ProfilesMost-cited Article. Read it Gynecologic Oncology Group here: http://bit.ly/2ml3ySx Foundation Scholar Investigator Award 2020/2021 • BREAST MATTERS 13
Living with Metastatic Breast Cancer (continued from page 1) practitioner Katie Papathakis, Stearns. “As our program grew, we oncologist or a nurse practitioner as a C.R.N.P. telling her, “Don’t worry. We recognized the need for new approaches ‘quarterback’ who will coordinate the have something else we want to try.” to specifically support individuals living care plan, navigator, nutritionist, social Now, Angela takes a pill called pal- with advanced breast cancer and began worker, palliative care provider to bociclib (Ibrance), a targeted therapy working to raise funds for this new clinic." manage pain and other symptoms, and for patients who have a type of breast Stearns says the needs of individu- an exercise and rehabilitative medicine cancer classified as hormone receptor als living with advanced breast cancer expert. Optional services will include a positive but HER2 negative. She also are different from those with early spiritual provider, financial counselor, comes to the Kimmel Cancer Center stages of the disease and change and in- integrative medicine, sexual health ed- every four weeks for an injection of tensify over time. The specialty clinic ucator and child life specialist. fulvestrant (Faslodex) to slow the for those with advanced breast cancer Angela feels fortunate that she got growth of her breast cancer. will be set up to provide the most ad- to the Kimmel Cancer Center, and al- The treatment is working. Angela’s vanced cancer treatment while sup- though she knows it may sound odd, cancer is under control and she is pain porting patients’ unique needs. Stearns she says breast cancer has had a posi- free. “All I take now for pain is a little says this includes emotional and spiri- tive impact on her life. “It has made me Tylenol,” she says. tual support while living with an un- a better person,” she says. “People see “We want all women to be aware of known prognosis, guidance concerning me and can’t believe I have breast can- new treatments, clinical trials and sup- complex treatment decisions, manage- cer. I feel like I am spreading joy and portive care options available to them,” ment of disease symptoms and medica- hope to others.” says Vered Stearns, a breast cancer tion side-effects, support for all family The experience also inspired expert and Director of the Women’s members, including specialized, age Angela to turn a hobby into a business. Malignancies Program at the Kimmel appropriate programming for children, A good eye and knack for interior de- Cancer Center. “With the right care, and advanced care planning. sign led to a career, working with real women can live with advanced breast Patients will benefit from a core estate agents to stage homes, boosting cancer for years and decades.” group of providers, including a medical their appeal to prospective buyers. This is the inspiration for a new multispecialty clinic for patients living with advanced breast cancer planned “WITH THE RIGHT CARE, WOMEN CAN LIVE WITH by Stearns and colleagues. “About 30% of the breast cancer ADVANCED BREAST CANCER FOR YEARS AND patients seen regularly in our clinic have advanced breast cancer,” says DECADES.” - VERED STEARNS Help Us Make To make your donation online: hopkinscancer.org and click a Difference Make a Gift Each contribution to the Johns Hopkins To mail your donation: Kimmel Cancer Center makes a differ- Johns Hopkins Kimmel Cancer Center ence in the lives of cancer patients here 750 E. Pratt St., Suite 1700 at Johns Hopkins and around the world. Baltimore, MD 21202 Our physician-scientists are lead- ing the way on many of the scientific To contact our development breakthroughs in cancer, and your do- office: nation will support patient care and Phone: 410-361-6391 innovative research that is translated Fax: 410-230-4262 to better, more effective treatments. Email: KimmelGiving@jhmi.edu We are also focusing on ways to pre- If you prefer not to receive fundraising communications from vent cancer and support survivors. Visit us on the web: the Fund for Johns Hopkins Medicine, please contact us at You may designate a gift to a spe- hopkinscancer.org. 877-600-7783 or JHHOptOut@jhmi.edu. Please include your name and address so that we may honor your request. cific faculty member.
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