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The power to fight breast cancer Print E-mail
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Cancer campaigner Anni Matthews has tackled her breast cancer head on. She tells Woman's World why learning as much as possible about the disease and a positive attitude are so important. 

I was told in 2002, with months to live, don't bother buying green bananas. I had breast cancer and my prognosis was grim. But here I am and the reality is that ever more people are living with cancer.

One in eight women have breast cancer and one in three people will have cancer of some sort. Statistically, it is reasonable to assume some of you reading this will have been affected by the disease already.

Early detection

Early detection is so important because it means more choices available to you. We are all entitled to be screened on the NHS aged 50 plus, but if you are high risk (i.e. history of cancer in the family) you may be entitled to earlier screening.

Awareness is much greater now than it was even five years ago. I thought at 48 I was far too young to have cancer, that my lump was a strained pectoral muscle because it was the size of a duck egg and not a pea or a bean. I cannot stress enough how important it is to catch this early. If you cannot face mammograms, ultrasound - particularly in the hands of an expert - can give good indications and there are new methodologies in the pipeline using heat detectors. Do not delay!

Chemotherapy

The debate about whether or not to have chemotherapy rumbles on. The first time I had to make this decision I agonised, but in retrospect I would not be here unless I had used all the tools in the toolbox - and that includes chemo. It should not be the fearsome experience it was 50 years ago because management of the side-effects is now so much more advanced. I have, for example, experienced only a little nausea, no vomiting, and hair loss, which I am fighting at the moment - and winning! (my blond wig is on standby - just to see if blondes really do have more fun).

The main question to ask the oncologist is whether they are going to recommend chemotherapy, a targeted therapy or both. To date, it is usual to be offered a combination chemotherapy such as FEC (5 Flouricil, Epirubicin and Cyclophosphomide) or AC (Adriamicin and Cyclophosphomide). It is often referred to as the 'gold standard' of care, but it is not new and so is a relatively inexpensive option for the NHS. It's a whole body (systemic) treatment to mop up and deter any cancer cells escaping from the prime site. The question now is: are the new chemotherapy drugs such as Taxotere (which cost more) having significantly better results in terms of survival benefit?

The most significant advance in treating cancer apart from new chemo drugs is the arrival of targeted drugs such as Tamoxifen and Herceptin, which have given real hope for longer-term survival. These drugs are groundbreaking because, unlike the chemotherapy before, they attack the tumour itself, a bit like guided missiles. The success of Herceptin particularly encouraged drug companies to follow this different methodology rather than the chemo 'kill all' approach, and as a result there are a whole raft of new drugs on their way.

I firmly believe that we need to put as much pressure as possible on the Government to make sure funds are available for these drugs to be accessible to all. It is simply not good enough to have invested millions in finding a cure for cancer and then, on the threshold, to be told they are unaffordable.

Clinical trials

Part of the process of assessing whether or not a drug is more effective than the 'protocol gold standard of care' is the meticulous and careful research obtained from trialling new drugs. From a patient's point of view, it is a bit nerve-racking but it is important not to lose sight of the facts:
  1. If this is a miracle new drug - you are on it.
  2. You have access to a professional research nurse 24/7 for any help you may need.
  3. You are monitored, scanned and very carefully assessed during the whole process.
In June 2006 I was shown to have seven tumours. I started a clinical trial of Lapatinib TYKERB) and the first scan, six weeks later, showed a significant response in that there was no tumour activity. The tumours were gone. In the US this drug, pioneered by GlaxoSmithKline, and made in Ware, Hertfordshire, was fast-tracked so that it is readily available to those that need it. In spite of being made in England, TYKERB is still in discussion in the UK and then has to be passed by NICE (National Institute for Health and Clinical Excellence) so that British people cannot access this amazing new drug unless they are lucky enough to have it on a trial basis.

Sadly these drugs and surgical advances do not mean the end of the mastectomy, the surgical removal of the breast. However, the knife is no longer the only option. With these targeted chemotherapies, sometimes chemo is suggested before any surgery. The great advantage of this is that you can actually see if the chemo, or targeted therapy, has worked from successive scan reports.

If mastectomy is the recommended way forward, reconstruction at the same time may be an option. It was in my case and the silver lining to this cloud is that fatty stomach tissue may be used for the reconstruction. So when I awoke from my operation, not only did I have a perfectly formed right breast, but I had a lovely flat stomach that would have taken me a lifetime in the gym to achieve.

The future

In the future cryosurgery may be an option for an early contained breast tumour. Liquid nitrogen is injected into the tumour, which destabilises it and causes apoptosis (death of the tumour). This technique has had very good results in the treatment of early contained prostate cancer, liver and renal cancer and certain skin cancers. It may prove to be a useful treatment for breast cancer, too. This may mean that in some cases the patient may be able to avoid major surgery, a long stay in hospital and, perhaps most importantly, it may minimise disfigurement.

In hospitals around the country different ways of treating cancer are being pioneered that only a few years ago were regarded as unorthodox. Vaccines for breast cancer are a good example of this. With the success of a cervical cancer vaccine and vaccines for kidney and bowel cancer on the way, I feel a vaccine for breast cancer is only a matter of time.


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