The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
Oct. 19--One day, doctors might be able to stop breast cancer cells from spreading to other parts of the body.
Breast cancer survivors may have better information about what exercises are and are not safe for them.
And women could have a new resource to help them choose whether to undergo genetic testing that can determine their risk of developing the disease.
Three researchers at local universities are working on those projects -- just a small part in the nation's multi-million dollar endeavor to find better treatments for breast cancer and help the women and men affected by it.
The National Institutes of Health alone directed $800 million to breast cancer research nationwide in 2012, including about $13 million for projects at universities in Ohio. Since 2009, the NIH has awarded more than $64 million to support 221 grants in Ohio. Private organizations also dedicate money, including $86 million from the American Cancer Society that is currently funding 220 breast cancer research and training grants nationwide.
"We don't know where the next breakthrough is going to come from, so that is why we have to invest," said Julian Cambronero, a breast cancer researcher at the Wright State University Boonshoft School of Medicine.
Researchers pursue every avenue
This year, nearly 40,000 women will die from breast cancer and another 300,000 will develop it in some form, according to the American Cancer Society.
Some will experience the most aggressive type -- called triple-negative by doctors -- that is currently being studied in one of 20 laboratories dedicated to breast cancer at Ohio State University, according to Dr. Charles Shapiro, director of breast medical oncology at The Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
Some will become resistant to common treatments, a problem being studied in one of 20 breast cancer research labs at the University of Cincinnati, according to Susan Waltz, professor in the department of cancer biology at the University of Cincinnati College of Medicine Vontz Center for Molecular Studies.
And some will develop tumors that spread into their lungs, which has been the target of Cambronero's research at Wright State. With $6 million from the NIH and other groups to fund his work during his 17 years at WSU, Cambronero found a gene that, when altered, can result in breast cancer and the spread of tumors into the lungs. He's experimenting with two new inhibitors to stop it.
Cambronero said if breast cancer cannot be eradicated completely, at least he hopes his research will be able to ensure it does not spread, so it can be treated like a chronic disease, such as diabetes.
"The long-term is to try to prevent metastasis," which he said is what kills patients. "The very long-term is to try and see if we can contain the disease," he said.
'More information... is critical'
Mary Fisher has focused her research at the University of Dayton on helping breast cancer survivors who develop lymphedema -- swelling in the body that occurs (and never fully goes away) after lymph nodes are taken during surgery.
There is no cure for lymphedema and no standard way to screen for it or diagnose it, according to Susan G. Komen for the Cure, the country's leading breast cancer advocacy group.
"It becomes a chronic disease," Fisher said.
With funding from the University of Dayton, Fisher is working to identify yoga exercises that could be safe and beneficial for women with lymphedema. She is also involved in a NIH project that aims to identify risk factors of the disease. And, Fisher recently completed a study of how arm function is affected for women who have been through breast cancer treatment.
Fisher's work to develop better information for women who have had breast cancer is critical, said Terri Baldasare, who hopes to participate in the yoga study.
Baldasare of Beavercreek developed lymphedema a year and a half after having surgery to remove a tumor from her breast. "With this, your life completely changes," she said.
"The more information you can have on what you do is critical," she said.
Miami University researcher Christopher Wolfe is also working to bring more information to women.
During the last three years and with a $360,000 grant from the National Cancer Institute, he has developed an interactive tutorial that will help women learn about genetic testing for breast cancer so they can make an informed decision about whether it is right for them.
Women can ask questions and interact with an avatar through the web-based program to learn about the "ups and downs" of genetic testing, said Wolfe, who is working with Cornell University professor Valerie Reyna on the project. He said the "Intelligent Tutoring System" -- the first of its kind in patient decision making -- is important because there is a shortage of genetic counselors in the United States.
"The tutor appears to help women better understand the issues," he said. "And also make better decisions around genetic testing."
'On the cusp'
Breast cancer survivor Amy Linaberry of Kettering said she is confident that researchers, such as those in Ohio, will one day discover the cure for breast cancer.
"For me, I think research is very important in understanding and curing breast cancer. How my cancer was treated is different than someone else years ago," she said.
Discoveries in labs and clinical trials have already changed the way doctors detect, treat and predict breast cancer.
In the 1970s, there was just one accepted surgical option: mastectomy. Only one randomized trial had tested mammograms as an early way to detect breast cancer; combination chemotherapy was in its early stages of research; and no one had identified the genes that put a person at greater risk of breast cancer, according to the National Cancer Institute.
Today, doctors prefer to do a lumpectomy followed by radiation; mammograms are routine; combination chemotherapy is standard; and several genes associated with breast cancer have been identified, according to the institute.
And the future promises "more effective and less toxic" treatments for breast cancer, the organization says.
Shapiro says the progress comes in "incremental" stages. "It's not like one day we don't have a cure and one day we're curing the disease," he said.
But, after more than 23 years of work in the field, Shapiro said he is more hopeful than ever that researchers are making progress.
"I think the future is very bright," he said. "I think that we're on the cusp of something great. More effective treatments. More cures. The next 25 years will be even more fantastic in terms of what we can actually do for people who have this disease."
-- Breast cancer facts
-- 2.9 million women living in the United States have a history of breast cancer
-- A woman has a 1 in 8 chance of being diagnosed with breast cancer during her lifetime
-- 88 percent of deaths from breast cancer are women age 50 and older
-- The median age for breast cancer diagnosis was 61 years old in recent years
-- Women should begin annual mammograms at age 40
-- 2,240 men will be diagnosed with breast cancer this year and 410 will die from the disease
Source: American Cancer Society
Terri Baldasare runs a fundraiser called "Living with Lymphedema." It raises money to provide the compression sleeves that women need to control swelling in their arms from lymphedema that occurs after their breast cancer treatment. The sleeves, which are not paid for by insurance, cost more than $100 and can only be used for up to six months. Women also need at least two at a time because they must be worn at nearly all times. The program is run out of Miami Valley Hospital.
"Meet Your Breast Cancer Researcher" event at the University of Cincinnati
What: Learn about new advances in breast cancer research with interactive discussions
Where: Vontz Center for Molecular Studies, 3125 Eden Ave., Cincinnati. Park in the Eden Avenue garage
When: 10 a.m. to noon, Saturday, Nov. 9
Register: Online at uchealth.com/events/breast-cancer-researcher or call 513-584-3810
Explore more information about the $13 million of research projects happening at Ohio universities online at MyDaytonDailyNews.com
SPECIAL COVERAGE: BREAST CANCER AWARENESS
Today's newspaper is dedicated to those whose lives have been touched by breast cancer.
Inside this special edition, you will learn about the important cancer research happening here locally.
In today's Life section, readers share the lessons they have learned through the cancer journey. You also will find a guide to local cancer care options, local resources and important information about prevention and detection.
For five years, we have printed an annual Pink Paper edition to promote awareness of this disease that impacts so many lives.
Thank you readers, for joining us in the fight.
You will find information about the American Cancer Society's Making Strides Against Breast Cancer walk taking place today at Dayton's Fifth Third Field, and photos from today's event online at MyDaytonDailyNews.com.
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