Targeted biological therapies

Approximately 20% of breast cancers are known as HER2 positive. This means that a gene mutation has caused the cells to have an over expression of HER2 receptors and this protein signals the cancer cells to grow and divide.

The HER2 receptor can be tested for by:

1. Immunohistochemistry (IHC)- which shows how much of the protein is on the cell surface
2. In-situ hybridisation (ISH)- which tests the number of copies of the gene inside the cell..

HER2 positive breast cancers tend to be more aggressive than HER2 negative cancers.

Trastuzamab (Herceptin) is a biological therapy that has been designed to specifically target the HER2 receptor in HER@ positive breast cancer. It reduces the risk of recurrence and death in women with HER2 positive breast cancer and prolongs survival in women with HER2 positive metastatic breast cancer.

Lapatinib (Tykerb) is another “HER receptor blocker” that is sometimes used in combination with Herceptin

Side effects:

Although Herceptin has been shown to have greatest benefit when used in combination with chemotherapy, it is not in itself a chemotherapy treatment. Chemotherapy treatments affect all rapidly dividing cells whether they are cancer cells or healthy cells.

Herceptin, however, targets only those abnormal cells with increased display of the HER2 receptor and it spares the healthy cells.

For this reason the side effect profile is substantially less.

Its main possible side effect is on the heart and the use of Herceptin in some patients may require baseline and periodic cardiac function tests. This side effect is usually reversible. In some cases hypersensitivity or allergic reactions can occur and for this reason it should be given in an appropriately equipped facility by staff who are trained to manage a possible reaction. Other less common and mild side effects may include fever, throat irritation and runny nose.

It is an intravenous therapy administered via a peripheral drip into a vein ideally every 3 weeks for one year.

However, it is unfortunately extremely expensive, not yet available in State hospitals and not covered by many Medical Aid schemes.

For those who can afford it, or those whose medical aids will cover it, Herceptin has significantly improved the prognosis and survival of patients with HER2 positive breast cancers to the extent that the outcomes are even better than some patients with HER2 negative breast cancers!

This blog was kindly supplied by Ronelle de Villiers at http://www.capebreastcare.org

 

I look up every morning and I say ‘thank you’

“My colleague at work urged me to go for a mammogram, and she saved my life,” says Suzette Laubscher. “The worst part of it was the waiting, the waiting to find out what the diagnosis is. Its like being in limbo – you hear the words but they don’t sink in,” says Suzette Laubscher.

I expected to die, but 15 years later I’m still here, fit and healthy and positive

“You think you are invincible when you are younger,” says Jennifer Heunis, whose experience with breast cancer opened the eyes of the students that she was teaching. “We all need to educate ourselves about our bodies.”

Cancer changed my whole life

After her cancer diagnosis Roselind Ludolph stayed in bed for ten days because she couldn’t cope with what the doctors had told her. Then, at 3.30am one morning, she heard her mother praying for her and she decided to stand up and face the future. As it turned out, her lump was very small and her breast was not removed. Now she says “that cancer wanted me to just stay in that bed. But I said NO! There is life and hope after cancer.”

Photovoice: Fight the GOOD Fight

 

 

South Africa & Breast Cancer: Great Big Glaring Gaps

In our post, Reality Bites, about the reality of breast cancer in South Africa, we explained what the entire breast cancer basket of services is that one can expect – and has the right to receive. We need to, however, unpack this issue even more.

Specialist Breast Clinics are available in both the Public and Private sectors. Unsurprisingly and inequitably, there are more options in the Private sector.

As per the map, Specialist Breast Clinics can be found in the following South African cities:

• Pretoria
• Johannesburg
• Durban
• East London
• Port Elizabeth
• Cape Town
• Bloemfontein

In effect, this means that if you live in the Mpumalanga, Limpopo, Northern Cape, North-West that there is NO dedicated specialist breast health unit in your province!

This is NOT equal treatment or equitable access which are our basic rights according to the South African Constitution.

A standardised and sustainable Breast Health Policy can change this. 

Cancer is Not a Priority in South Africa!

Breast cancer is a growing problem, aggravated by the fact that it is not regarded as national priority. The severity of the situation is further impacted by the fact that cancer is is not simply one disease like HIV/AIDS, TB or Malaria which all have one simple, uncomplicated, affordable treatment. Compare this to cancer which consists of 300+ diseases – and each one is amplified by endlessly complex environmental causes, genetic causes, complex ways of risk reduction, diagnosis and treatment.

Globally, cancer is a growing problem. But in Africa – and more specifically in South Africa – we are fast heading towards a cancer crisis.

Painting by Joaquin Jara ~ via http://www.humanosphere.org/global-health/2011/09/more-women-in-poor-countries-dying-from-breast-cancer/

‘It is bad to have cancer and worse to have cancer if you are poor. The gap between rich and poor, highly educated and little-educated and the North‐South divide is substantial and continuing to grow. Radical solutions are urgently needed: the status quo is not an appropriate response to the current situation….’ [ *From the State of Oncology 2013, International Prevention Research Institute, Boyle et al. ]

 

Did You Know?

 

• The Extent of financial catastrophe and impoverishment due to direct out‐of‐pocket payments for health impacts at least 10% of population.

• Developing countries account for:

– 84% of global population

– 90% of global disease burden

– 20% of global GDP

– 12% of global health expenditure

• The Bamako Declaration agreed that African governments should spend 2% of health budgets on research. Health research should be seen as INTEGRAL to development and not merely a ‘luxury’.

• Cancer kills more people than HIV/AIDS, TB and Malaria combined.

• HIV/AIDS increases the risk of cancer.

• Breast cancer accounts for the highest cancer incidence in Africa.

• Lack of access to treatment or inadequate treatment results in high case to fatality ratio for cancers.

• Lack of training of health care professionals in cancer control and care contributes to ineffective management of the disease.

 

How do YOU think South Africa is faring with this? Tell us what you think on our Facebook page!

 

 

 

Humanity. Dignity. Equality. Liberty.

Do you know what your rights are as a South African citizen? Furthermore, do you know what your rights are in terms of the healthcare you receive for your breast cancer?

 

Whilst many of us have access to information online and elsewhere — like being able to research our South African Constitution so we can assert our rights effectively — there are even more South Africans with no access to this sort of information at all, leaving them without the knowledge they need to make sure they have fair and effective access to the entire spectrum of breast cancer services, whether it be high quality diagnostic technology or psycho-social support.

We have collected together the key elements of the Constitution into an infogram (below) which we hope you will find useful in ensuring you receive the most effective care possible. It is also undeniably crucial that a breast health policy for South Africa should address each of the rights listed below in order for it to be effective, fair, standardised and equitable across the entire country.

The South African Constitution / Bill of Rights