In the last few years, cancer care has become more personalized, with targeted treatments that can be tailored to your specific needs. With these new treatments, we are seeing better responses and longer survival. Oncologists and surgeons can use biomarkers — genes in tumor cells — to help patients choose precise treatments that are best for their needs, values, and goals. Personalized treatments also reduce the risk of overtreatment or undertreatment, meaning fewer side effects and a higher chance of clearing the cancer.
In cancers that primarily affect women, these innovations have been life-changing. Even for women with advanced cancers, and high-risk patients who may be diagnosed with cancer in the future, this technology leads to better response rates and survival.
Tumor Genomics in Texas
Breast cancer, endometrial cancer (cancer of the lining of the uterus), and ovarian cancer are some of the most common seen among women. Recently, endometrial cancer incidence surpassed ovarian cancer as the deadliest cancer for women. However, 85% of endometrial cancer can be treated if caught and diagnosed early. And tumor genomics, or the study of the genes that cause specific cancers, is one of the best ways to treat these cancers.
Built on tumor genomics, immunotherapy is a treatment that enables the body’s own immune system to eliminate cancer cells. Patients on immunotherapy show strong responses, especially patients whose cancer has returned. Newer medications combine antibodies (which help the immune system recognize cancer cells) and drugs together to directly target cancer cells.
Genes also play a prominent role in leading-edge treatment for breast cancer. Texas Oncology is one of the highest enrollers to the FLEX Registry, a database that helps researchers link gene data with cancer treatment outcomes. This data helps to improve personalized treatment for early-stage breast cancer patients. Our team is also working hard to improve the data available for minorities, including men with breast cancer (Gold, et al.).
Through genomics, we can better compare treatment options—like chemotherapy, immunotherapy, surgery, or radiation—alone or in combinations for any stage of cancer. By using genomics alongside surgery and new drug combinations, we can improve outcomes and survival rates for many cancer patients.
Screening and Referrals
Patients have the highest chance of clearing cancer when it is caught early. Unfortunately, the medical system has a history of ignoring or overlooking women’s health symptoms. This means cancers that primarily affect women are diagnosed less often than they should be.
Women should work with their primary care provider to advocate for their own symptoms to be taken seriously. Nearly 1.3 million lives could be saved worldwide if clinicians address the top risk factors with female patients like tobacco, alcohol, infections, and obesity. If you think you are at risk, ask for a screening.
For breast cancer, a mammogram every year beginning at age 40 is the gold standard. But if a first-degree relative (mother, sister, etc.) was diagnosed with breast cancer, then you should start screening ten years younger (e.g., 32 if mother diagnosed at 42). If the mammogram is unclear, an oncologist can use a standard screening tool to better calculate you risk of developing cancer or if you need more screening, like an MRI.
We can also consider genetic testing with significant family history, such as direct family relatives with breast, ovarian, or pancreatic cancer or two family members on the same side with prostate cancer.
For endometrial cancer, one of the key indicators is post-menopausal bleeding. Especially for non-Hispanic white women, endometrial cancer is more likely be in advanced stages when it is caught, making it harder to successful treat.
It takes a strong team of genetic counselors, advance practice providers, and research staff to provide personalized treatment options for your specific cancer. And many promising clinical trials are currently underway that could become the standard of care for even more specific treatment in the future. We look forward to a future where targeted therapy based on genomics is available for every patient and every type of disease.
Joshua E. Kilgore, M.D., is a board‑certified gynecologic oncologist with clinical and research expertise in genetics and novel chemotherapeutic therapies. He completed his fellowship at the University of North Carolina at Chapel Hill, residency at the University of Washington, and medical degree at New York Medical College. Dr. Kilgore practices at BSA Hospital and Northwest Texas Healthcare System in Amarillo and is a member of the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology.
This article originally appeared on Amarillo Globe-News: Personalized approaches in women’s cancer care | OPINION
Reporting by By Joshua E. Kilgore, M.D., Texas Oncology Amarillo, Special to the Amarillo Globe-News / Amarillo Globe-News
USA TODAY Network via Reuters Connect
By Joshua E. Kilgore, M.D., Texas Oncology Amarillo, Special to the Amarillo Globe-News | USA TODAY Network
