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How To Prevent Metastatic Breast Cancer

Honing In On A Treatment

Can we prevent brain metastases in breast cancer?

The discovery could be the key to preventing breast cancer from spreading to bone. If doctors can identify LOX in breast cancer patients, they may be able to block the enzymes action. That could prevent bone damage and make it harder for tumor cells to grow in bones.

The research also showed that treatment with an existing drug class can prevent those bone changes in mice. The drug, bisphosphonate, is primarily used to stop bone loss due to osteoporosis.

If the medication can help protect the bones of breast cancer patients, it could result in fewer cases of bone metastases.

Study authors say the next step is to determine how LOX interacts with bone cells. That will help in the development of new drugs to stop bone lesions from forming.

The study was co-led by Alison Gartland, Ph.D., and Janine T. Erler, Ph.D. Details were published in the journal

Tumour Dormancy And Reawakening

Tumour dormancy is generally defined as a prolonged state of asymptomatic micrometastatic disease. In cancer of the breast or prostate, cancer cells can remain dormant for years and even decades before recurring as metastatic disease. During this latent period, patients are considered to be disease-free due to the lack of any symptoms of illness and because they have no detectable neoplasms by clinical imaging. Often described as one of the most wicked cancer cell misbehaviours, tumour dormancy shares many features in common with chronic diseases. Yet, its nature appears to be reversible, as myriad mechanisms have been shown to induce a switch to reawaken indolent DTCs . Furthermore, tumour dormancy is not exclusively a phenomenon of end-stage tumorigenesis, as it can apply to the presence of occult neoplasms until clinical diagnosis , and/or to MRD left behind after treatment . Attention, however, must be paid to the molecular underpinnings of these two scenarios as mechanistic differences between primary and metastatic dormancy might exist.

Obstacles In The Current Metastatic Drug Development Space

Several reasons underlie the paucity of effective treatments in the prevention of metastatic disease in the clinical setting. The complexity of the disease process plays a major role in this therapeutic gap. In addition, systematic obstacles are recognized as serious impediments towards more successful translational efforts.

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Why Does My Provider Need To Test The Metastatic Tumor

Your care team will test the metastases to figure out the biology of the tumor, which can help guide your treatment plan. Providers may test tumors for:

  • Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy may be your first treatment.
  • HER2 status: Human epidermal growth factor receptor 2 is a protein that is overexpressed on some breast cancer cells. HER2-positive cancer responds to specific HER2-targeted therapies.
  • PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider may test for this gene mutation. Specific targeted therapies can be used to treat tumors with this mutation.
  • PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1 status. If the PD-L1 test is positive, you may be recommended to receive a combination of immunotherapy and chemotherapy.

How Will Hospice Help

Schematic representation of a breast cancer undergoing a ...

Many people are amazed at the help available when hospice is instituted. In addition to care from the team, hospice most often provides a hospital bed, oxygen, and any equipment or medications needed. This can save a lot of running around for your family and make you as comfortable as possible.

Many people want to spend their last days at home, surrounded by loved ones. With hospice care, the police do not need to be called, as they typically do with any “unattended death.” Your family can spend time with you until they wish to call the funeral home.

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Summary Of Treatment Options For Metastatic Breast Cancer

Hormone receptor-positive, HER2-negative breast cancer

Hormonal therapy is considered the standard initial treatment for HER2-negative metastatic breast cancer that is also hormone receptor-positive, and is often given in combination with targeted therapy. However, chemotherapy may also be given. A clinical trial may also be an option for treatment at any stage.

Hormone receptor-negative, HER2-negative breast cancer

In general, chemotherapy or targeted therapy is given for treatment of triple-negative breast cancer. A clinical trial may also be an option for treatment at any stage.

HER2-positive breast cancer that has spread to parts of the body other than the brain

In general, HER2-targeted therapy is regularly added to treatment for HER2-positive breast cancer that has spread. The drugs used depend on the treatments already given and whether the cancer is hormone receptor-positive. The treatment recommendations for first-line, second-line, and third-line or higher treatment are listed below. A clinical trial may also be an option for treatment at any stage.

First-line treatment

Second-line treatment

  • Second-line treatment is used for people with early-stage breast cancer who had the cancer either spread during initial treatment with trastuzumab or return within 12 months after stopping treatment with trastuzumab. It is also used for people whose cancer worsens while receiving first-line treatment.

  • The preferred second-line treatment is the drug T-DM1.

Targeting Arrest And Adhesion

Studies revealing the interaction between tumor hetero-aggregates and the endothelium have suggested that the disruption of this binding could prevent the next steps in the cascade. The inhibition of the interaction between P-, E- and L-selectins has been successfully exploited in experimental models of metastasis and in mice . Other approaches proposed include hyaluronic acid and its receptor CD44 for instance, suppressing the hyaluronan synthase with 4-methylumbelliferone suppressed liver metastases of melanoma cells in mice .

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Potential Gatekeepers That We May Consider Inhibiting Based On Current Studies Are Stat3 And Reinstating Nr2f1 Expression

A potential multifaceted target that has been demonstrated to be a molecular hub in mediating tumor escape from immune surveillance and regulate the outgrowth of dormant DTCs is STAT3. Expansion and immunosuppression of MDSCs is mediated by activation of STAT3 . Anti-inflammatory M2-like macrophages which also play an important role in metastasis at distant organs are polarized to the M2 phenotype by STAT3 activation . Furthermore, in addition to STAT3s role in immune suppression, STAT3 activation was recently shown to also directly mediate dormant DTC outgrowth. DDR1 interaction with Col-I at the permissive niche induced non-canonical signaling converging on activation of STAT3 in dormant breast DTCs, which culminated in their outgrowth at multiple organ sites . Notably, in paraffin-embedded tissue microarray sections of human breast cancers there was a significant increase in the expression of phosphorylated STAT3 in lung metastases compared to their matched primary tumors and the highest levels of pSTAT3 were present in those that had recurred after a short disease-free interval . These results suggest a role of activated STAT3 in metastatic outgrowth of dormant breast DTCs in the lungs. Therefore, targeting STAT3 may prevent both dormant breast DTCs outgrowth at the permissive site in the lungs and the formation of an immune suppressive niche.

Overall, these studies may open up novel avenues to maintain DTCs dormancy.

Keep Your Mood Happy:

Metastatic Breast Cancer – How We Treat Metastatic Disease

Depression is closely related to cancer recurrence. Low mood can lead to low immune function, which is not conducive to regulating the bodys immune function and killing residual tumor cells. If necessary, the intervention of a psychologist is required. But more importantly, the patient maintains a normal mentality and faces it positively.

Tips for keeping a good mood:

Release emotions: find a way that suits you to vent, such as singing, taking a walk, meeting with friends on a regular basis, and so on.

Divert attention: pick up the things you love again, such as painting, calligraphy, riding, etc., to enrich yourself.

Change the environment: such as traveling, vacationing, leaving a place familiar to you, changing a place will change your mood.

Self-suggestion: Tell yourself that it is a day to be happy, and a day to be unhappy, and that a bad mood brings a lot of harm. There is no benefit to all harms. It is better to keep a good mood and face optimistically.

Reading: Reading inspirational, light-hearted and humorous books will not only take us away from the real world, but also let us experience the joys, sorrows, sorrows and joys that happen to other people. It can gain the strength to fight against difficulties. Everyones life is accompanied Frustrated, some peoples stories are wonderful, and some are plain. The difference lies in whether you have courage and how to deal with the wind in life.

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Green Tea And Metastasis Of Pancreatic Cancer

It is difficult to detect pancreatic cancer in the early stage despite the development of more sophisticated diagnostic techniques and surgical resection provides the only option. Treatment with EGCG inhibited viability, capillary tube formation, and migration of human umbilical vein endothelial cells . There was reduction in Ki-67, PCNA, Von Willebrand factor, VEGF, CD31, VEGFR-2, ERK1/2, JNK1/2, p38, MMP-2, MMP-7, MMP-9, and MMP-12 and induction of apoptosis, caspase-3 activity, and p21/WAF1 in tumors of athymic nude mice implanted with human pancreatic cancer AsPC-1 cells suggesting that EGCG inhibited pancreatic cancer growth, invasion, metastasis, and angiogenesis . In pancreatic cancer cell line MIA PaCa-2, nutrient mixture containing green tea exhibited a dose-dependent antiproliferative effect, decreased expression of MMP-9, and inhibition of invasion through Matrigel .

Can Metastatic Breast Cancer Be Cured

There is no cure for metastatic breast cancer. Once the cancer cells have spread to another distant area of the body, its impossible to get rid of them all. However, the right treatment plan can help extend your life and improve its quality.

Metastatic breast cancer treatment aims to shrink tumors, slow their growth and improve your symptoms.

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How Is Breast Cancer Diagnosed

Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:

  • A physical exam, including a clinical breast exam . This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
  • A medical history
  • Breast biopsy
  • Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose , and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel , a comprehensive metabolic panel , and an electrolyte panel.

If these tests show that you have breast cancer, you will have tests which study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include

  • Genetic tests for genetic changes such as BRCA and TP53
  • HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
  • An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.

Green Tea And Metastasis Of Prostate Cancer

Cancers Spread to Bone

The effects of a diet containing lysine, proline, arginine, ascorbic acid, and green tea extract on the growth of tumors induced by implanting human PCa PC-3 cells in athymic nude mice and on the expression of MMPs, VEGF, Ki-67, and fibronectin in these tumors, as well as the production of mucin, were investigated. It was found that there was inhibition of tumor growth and inhibition of MMP-9 and VEGF secretion and mitosis in tissues of group treated with the nutrient mixture of the diet . The expression of metastasis-promoting Mts1 gene was assessed in GTP-treated transgenic adenocarcinoma of the mouse prostate model. Freshly prepared 0.1% GTP solution in tap water was supplied thrice a week to experimental animals as the sole source of drinking fluid for 24 weeks, while the control group of animals received the same tap water throughout the study. The animals were sacrificed at 0, 8, 16, and 24 weeks of GTP feeding and were analyzed for S100A4 and E-cadherin. An increase in the expression of S100A4 at mRNA and protein level in dorsolateral prostate, but not in nontransgenic mice, was found with the progression of age and PCa growth in TRAMP mice. There was inhibition of PCa progression in mice fed with GTP which was associated with reduction of S100A4 and restoration of E-cadherin .

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Preventing The Reawakening Of Dormant Dtcs By Targeting Their Crosstalk With Their Supportive Niche

The microenvironment of the metastatic niche and its remodeling plays a fundamental role in dictating the fate of residing dormant DTCs by inducing cell-intrinsic mechanisms culminating in the escape from tumor dormancy .

Notably, several studies highlighted the potential role of Int1 activation in regulating the dormant to proliferative switch . Previous work reported how the cross talk between Int1 and the urokinase receptor can dictate the fate of dormant breast and head and neck cancer cells . Int1 partners with subunits to form 12 potential integrin receptors, which bind to extracellular matrix molecules such as collagens, laminin, and fibronectin .

Indeed, surgical trauma induces local and systemic inflammatory responses that can also contribute to the accelerated growth of residual and micrometastatic disease . Hence, intervention with inhibitors for 51 integrin should be pre-operative and immediately after surgery .

Overall, the studies presented here emphasize the important role of inflammation and/or fibrosis in dormant DTCs outgrowth and also reinforce the notion that intervention in the perioperative stage and immediately after re-section may be critical to prevent local and/or distant recurrences.

What Is Breast Cancer

Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.

Sometimes the cancer does not spread any further. This is called “in situ.” If the cancer spreads outside the breast, the cancer is called “invasive.” It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize through the lymph system or the blood.

Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.

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Treatment Options For Metastatic Breast Cancer

  • Surgery: If breast cancer has spread to another part of your body, surgery many not be recommended because its unlikely to remove all the cancer cells. Still, if you have painful lesions in your bones or blockages in your liver, your doctor may recommend surgery. If your first diagnosis of breast cancer was metastatic, called de novo by doctors, your doctor may recommend surgery to remove the tumor in the breast.
  • Chemotherapy: If the cancer is growing quickly or is growing even though youre on other treatments, your doctor will likely recommend chemotherapy. Chemotherapy is a systemic treatment because the medicines affect the entire body. Chemotherapy works by destroying or damaging cancer cells as much as possible.
  • Radiation Therapy: For metastatic disease, radiation is used to:
  • ease pain
  • improve breathing by opening a blocked airway
  • reduce pressure on a pinched nerve
  • Hormonal Therapy: Hormonal therapy is used to shrink or slow the growth of hormone-receptor-positive disease. Hormonal therapy will not work on hormone-receptor-negative breast cancer.
  • Targeted Therapies: Targeted therapies, as the name suggests, target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow rapidly. Targeted therapies are generally less likely than chemotherapy to harm healthy cells.
  • In some cases, a treatment may stop working and the cancer may start growing. If this happens, you and your doctor will talk about other treatment options.

    Turmeric Inhibits Cancer Bone Metastasis

    Metastatic Breast Cancer Research Initiative

    Many forms of tumours like lung cancer or breast cancer tumours secrete Parathyroid hormone-related protein , a condition that causes hypercalcaemia.

    Hypercalcaemia is a condition characterized by increased calcium levels in blood.

    Bones are sites of metastasis for many forms of cancer such as breast cancer , renal cell carcinoma, etc.

    Research has shown that hypercalcemia is one of the important drives of cancer bone metastases.

    Studies have shown that curcuminoids present in turmeric can inhibit the secretion of Parathyroid hormone-related protein , hence reduce chances of cancer bone metastases.

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    Eradicating Dormant Dtcs Before They Awaken

    Once DTCs anchor in their new and non-permissive niche adaptive cell-intrinsic mechanisms ensure their long-term survival and escape from immune surveillance . These hibernating cells resist most traditional and newer targeted agents given their quiescent state and/or their induced senescencelike state or as recently suggested due to the BM perivascular niche . Hence, unraveling cell-intrinsic mechanisms responsible for long-term survival of DTCs along with the mechanisms that enable their chemoresistance and immune evasion may open up new approaches to eradicate these dormant DTCs.

    Blood Tests For Tumor Markers

    In some cases, blood tests for tumor markers may be used to help monitor metastatic breast cancer.

    For example, you may have blood tests every few months for cancer antigen 15-3 or cancer antigen 27.29 . These tests are similar. Health care providers usually check one, but not both of these blood tests.

    Whether the tumor marker test score rises or falls over time may give some information on tumor response to a drug or tumor spread.

    Tumor marker tests are not helpful in every case. Some people with rising tumor marker levels dont have tumor growth, and some people with tumor growth have normal or unchanged tumor marker levels.

    Health care providers dont make treatment decisions based on serum tumor marker testing alone. They may combine findings from a tumor marker test with information on symptoms and findings from imaging tests . This combined information can help your health care providers understand if a treatment is working well for your cancer.

    Talk with your health care provider about whether tumor marker testing is right for you.

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