Winning Battles Against Breast Cancer

Last spring 39-year-old Teri Licastro found a lump and an indentation in her breast. When it didn't go away by July, she worked up the courage to have a mammogram and biopsy.

"I was diagnosed with Stage 3A breast cancer," says Licastro. It was an especially aggressive form of cancer; abnormal cells found in her lymphnodic fluids tested positive for an overproduction of a growth protein, HER2. Still, Licastro found some comfort in the diagnosis. "It's almost a positive because there's something they can give you for it," she says. Licastro has been taking the drug Herceptin for the past year. It specifically kills cancer cells and keeps them from spreading. So while Licastro's lumpectomy removed the bulk of the tumor, the Herceptin treatments will hopefully kill any remaining rogue cells that may have traveled. "It eases your mind," she says. "I feel like it's that extra reassurance."

Licastro's experiences with Herceptin make her part of a growing patient group benefiting from a new class of treatments called targeted therapies. Instead of simply cutting out cancer, the idea is to stop cancerous cells from reproducing altogether by targeting their root causes and mechanisms. Drugs designed to recognize cancer proteins (like Herceptin), precision radiation treatments and vaccines that actually prevent cancer are some of the hottest new tools in the arsenal against cancer.

"What we've done is really harness the biology of cancer," says Dr. Edith Perez, an oncologist and researcher at the Mayo Clinic's center in Jacksonville, Fla. Herceptin has been around for advanced metastatic cancer since 1998, but by using it early and in combination with chemotherapy and surgery, it can actually reduce reoccurrence of cancer by 50 percent, which is why the FDA approved it for early stage breast cancer this past August.

Drugs that use similar protein pathway technologies have recently been approved for kidney cancers and some forms of leukemia, and many clinical trials are underway for other types of cancer. Perez, a principal investigator of the clinical trials leading to Herceptin's newest FDA approval, says these drugs are, "one of the magic bullets we've been looking for."

Like targeted drug therapies, the most cutting-edge surgical developments fight cancer cells on a molecular level. Delivering external doses of radiation through a machine called the CyberKnife, doctors can now treat what would have once been considered inoperable tumors. As much a Star Trek set piece as its name suggests, the CyberKnife kills cancer cells as it passes over a patient's body like a radiation-emitting magic wand. It is administered in a series of out-patient procedures with no scalpel necessary. "It is a bloodless form of surgery," says Jennifer Barolo of NCH Healthcare System's oncology research department.

"I've been cured of prostate cancer after lying on a table and playing golf in the afternoons," says Ron Spears. When the 66-year-old investment securities broker learned he had cancer, he did his homework and scheduled surgery with the best doctors he could find. But when friends put him on to the CyberKnife, he cancelled his surgery and made an appointment at NCH.

"We can now shorten treatment down from nine weeks to one week," says Spears' physician, Dr. Jay Friedland of the NHC CyberKnife team. Friedland has used CyberKnife to treat prostate cancer in more than a hundred patients. "We've taken something that involved two invasive procedures and replaced it with something noninvasive," he says.

The cyberknife produces a controlled, measured beam of high-energy radiation particles. Those particles in small quantities usually shimmy through a cell without damaging it, but the CyberKnife revolves around the patient, delivering many individual beams from different angles. The device locates the target spot with X-ray mapping of the skeleton for reference points. When all those beams bombard the same point, the radiation particles knock around the molecular structures of the targeted cells. Proteins bust apart, the cells can't grow or divide or even carry out normal survival functions, and the cancer dies out.

"I was fascinated watching this awesome machine do its thing," says Spears, who was awake and listening to music during the procedure. He didn't feel anything while the device moved around him and he took no other drugs or treatment. Aside from symptoms akin to a mild stomach flu that appeared a week-and-a-half after the treatments, Spears experienced virtually no side effects. "I have not slowed down one bit," he says.

As impressive as these new treatments are, the best approach for any illness is prevention. For that reason, Gardasil, the new vaccine against the human papillomavirus (HPV), functions as a preventive component in the targeted therapy movement. HPV infection is responsible for most cervical cancers and is also linked to vaginal and throat cancers.

While the cancer caused by HPV is generally associated with women, the vaccine will prevent the virus in women and men, reducing the overall spread of HPV. By vaccinating patients against the virus that causes the cancer, Gardasil effectively vaccinates against the cancer itself. And that could have a profoundly positive effect on the nearly 10,000 American women diagnosed with cervical cancer each year. "It's the first vaccine ever to prevent cancer," says Dr. Richard Murray, an obstetrician-gynecologist in Fort Myers.

These targeted therapies and prevention methods are just the beginning. With constant advances in technology, applications of cell-specific treatments are limited only by our understanding of biology. "It's unprecedented, ground-breaking," says Murray. "It's going to save some lives."

Sherry Mearns contributed to this report.