The Breast Cancer Society of Canada

Research saves lives!
Breast Cancer Ribbon

Posts Tagged ‘Natalia Mukhina’

I know firsthand how important research is – Ruth Ackerman

posted by:

Ruth Ackerman’s story inspires the kind of work the Breast Cancer Society is funding. We hope you will also find inspiration in her story and take part in Giving Tuesday on this November 28th, by giving to life-saving breast cancer research, because Research Matters

Ruth Ackerman became a pharmacist because she always was good at chemistry and math and the curriculum looked interesting. “I have never dreamt of inventing any magical pill,” she says smiling. “But my education helped me enormously in my cancer journey. As both a pharmacist and cancer survivor, I know firsthand how important research is.”

“We need research to gain evidence that something works. Yet, it is equally important to make sure that something does not work in the way we hoped it had to.” Let’s listen to the voice of Ruth, a 17+ year survivor of triple-negative breast cancer, and take part in Giving Tuesday. Because research matters.

Ruth Ackerman - BCSC Giving Tuesday 2017

It all began in 1999, when I asked my family physician if I could go on birth control pills. “You are in your 40s now, and I want you to have a mammogram before you start taking the pills,” she answered. The mammogram was fine. After just a month, however, I found a lump in my breast. “That’s weird,” I thought, but I was not worried much as I had just had a clear mammogram. But when I found a lump in my armpit a couple of months later, I was quickly in the surgeon’s office to have a biopsy.

He did a fine needle aspiration biopsy, showing cancer cells. Because the tumor was large – 4.5 cm –  I underwent a full mastectomy. I had 20 lymph nodes removed as well, and 17 of them had cancer cells. Shortly after that, I was given a diagnosis of invasive ductal carcinoma, stage III. The pathology report showed that the tumor was estrogen-receptor-negative, so I had no hopes for hormonal therapy. My treatment plan included 6 months of chemotherapy and then 7 weeks of radiation. My breast cancer was very aggressive, and they treated it aggressively.

Then and now Ruth had triple-negative breast cancer (TNBC) – one of the most dangerous types of the disease, which is negative for estrogen, progesterone, and HER2 receptors. But at that time Ruth did not know yet that her disease is called TNBC. The HER2 testing was not used as routinely then as it is currently. Ruth’s test for HER2 was performed in 2004, and result came back negative. Patients now in the same situation often start their treatment with chemo before having surgery. It has been proven that such a regime shows better results in treating TNBC. Research matters. 

Because my tumor was so aggressive, I was referred to a researcher who explored high-dose chemotherapy with stem cells transplant in breast cancer. At the time, this regimen was showing good results in treating high-risk breast cancer; however, it was a controversial and undeniably toxic treatment modality.

While I was eligible to have the treatment, I was very worried about it. From a pharmacist standpoint, it seemed right, but I did a lot of research and realized that I could die from the treatment itself. And frankly, after 2 rounds of chemotherapy, I didn’t know how I would continue to work at my job if I went through with even more toxic treatment. After much thought, I said, “No, I want to do regular chemo.” Researchers later concluded that stem cell methods work well for blood tumors, but not for solid tumors like breast cancer. The high-dose approach to treating breast cancer was debunked.

Obviously, any chemotherapy may cause various side effects. I remember my physician telling me that he was going to drop my chemo dose to 75% as I had experienced protracted febrile neutropenia and had been hospitalized. After he saw the look on my face, he said, “I don’t want to kill you, Ruth. What I am trying to do here is to cure you.” I think that was the first time he said “cure”. It sounded extremely encouraging.

Ruth Ackerman - BCSC Giving Tuesday 2017

I am aware of how insidious cancer is. When I was diagnosed with cancer a second time, part of me was like “I know this.” It occurred in the same area which had been irradiated in 2000 and getting a proper biopsy proved difficult. After 4 months and 2 biopsies, I was told my new tumor was malignant on Christmas Eve. It was hard. My reaction was, “Ok, so then get it the hell out of me!” The tumour was completely excised 3.5 long months later in 2016, and I hope to never have to face cancer again.

Then and now Breast cancer patients benefit today from more accurate strategies that have been put into clinical practice in recent years. One of them is new radiation regimens that use improved equipment. They cause fewer complications. A lot has been done as well to introduce such methods as trucut biopsy, MRI, PET-CT scan, HER2 routine testing, personalized targeted treatment, etc. Research matters.

What is one of the worst things about having breast cancer in your early 40s, which is when my cancer story happened? You feel pretty strong. You rely on your body and you feel perfectly fine. Breast cancer is tricky because there are no symptoms in the early stages. When you have been told you have “that thing” in your breast it is scary. It shakes your self-confidence. It changes a lot around you.

I like helping people and also value the help of others. I used the support of breast cancer support groups throughout treatment and beyond.  There was a diverse group of many women. Some of them had been 20 years cancer-free. Some had been newly diagnosed or were currently in treatment. But they all were so warmly inviting and supportive. They inspired me to fight and gave me strength and support.

Later, as a Peer Support Volunteer with the Canadian Cancer Society, I provided telephone support to those who had breast cancer. During our conversations I was someone who had “been there” and gone through what they were facing. It is such a wonderful feeling to talk to somebody who is so scared and give them some hope! We would chat about everything. Strikingly, the number one thing we always started with was their question “What did I do to cause this?”  The women said, “I had children, I breastfed them, I don’t smoke, I exercise, and here I have breast cancer. Why?”

Ruth Ackerman - BCSC Giving Tuesday 2017

Researchers know a lot about what may cause breast cancer; however, there is still much that is unknown. I have a history of breast cancer in my family. My two aunts and grand-aunt had breast cancer, and one of my aunts was diagnosed at 42 (the same age I was at diagnosis) and died at 43. It happened very quickly. My grandfather had male breast cancer, which is very rare! My genetic tests showed a negative result though. Subsequently, due to the most recent cancer I had in 2016, I was again referred to do genetic testing and once again it came back negative. Whatever I had, it is not genetic. Although my second cancer was likely caused by the radiation treatments I received in 2000, my first one seemed to be just random. This is what we know now. I believe we are always learning more about the cause of breast cancer since research is constantly evolving.

Then and now In the 1990s, achievements in genetics opened up the prospect for genetic testing to recognize mutations in BRAC genes associated with breast cancer. Ruth underwent her first BRAC test in the early 2000s. In 2016, her geneticist suggested that Ruth redo it because the BRAC test used in 2000 gave many false negatives. Since then, the technology has rapidly improved, and patients can now do more precise genetic testing. Because research matters.

As a pharmacist, I truly believe in research. Research is expensive because researchers must make sure that their research is accurate and always have to check and double-check the data. They need to have a significant cohort of patients to make sure that what they are researching they are getting right. I’ve been disease-free for more than 17 years. Research is a key for cancer patients because it gives them hope.

“Research matters because life is priceless.”
– Ruth Ackerman

Your donation to The Breast Cancer Society of Canada will help fund breast cancer research. Give today, help save lives by supporting life-saving breast cancer research because, Research Matters. Prefer to give using your phone? Text GIVE to 41010 to donate $5 

Ruth’s story was transcribed from interviews conducted by BCSC volunteer
Natalia Mukhina – Health journalist, reporter and cancer research advocate

Natalia Mukhina - Health Journalist

Natalia Mukhina, MA in Health Studies, is a health journalist, reporter and cancer research advocate with a special focus on breast cancer. She is blogging on the up-to-date diagnostic and treatment opportunities, pharmaceutical developments, clinical trials, research methods, and medical advancements in breast cancer. Natalia participated in numerous breast cancer conferences including 18th Patient Advocate Program at 38th San Antonio Breast Cancer Symposium. She is a member of The Association of Health Care Journalists (AHCJ).


Finding a Novel Strategy to Prevent Metastasis

posted by:

“What my patients with early stage breast cancer really fear is to hear the word ‘metastasis’.” Most oncologists would agree with this statement, which I once heard from a presenter at the San Antonio Breast Cancer Symposium.  There is no doubt that being told you have metastatic breast cancer is a lot to take in, as it means that breast cancer has spread beyond the breast to other parts in the body. The disease becomes more advanced the farther it spreads. And, unfortunately, it also becomes incurable.

How can the appearance of metastases be prevented? One of the ways to address this issue – and probably the most promising – originates from the field of molecular biology and biochemistry.

Dr. Jean-François Côté, Director of the Cancer and Genetic Diseases Division in MontrealDr. Jean-François Côté Clinical Research Institute (IRCM), explores the molecular signals that allow cancer cells to seed and grow new tumors, and how to stop this spread. Along with his research team, he looks at signalling pathways that control cell migration. One of the team’s current projects focuses on breast cancer. Recently, Dr. Côté visited the Cancer Research Institute at Queen’s University and shared details of this research during a seminar titled “Unravelling the complexity of metastasis: Characterizing the roles of the receptor tyrosine kinase AXL in metastatic progression.”

What is the research agenda of Dr. Côté’s team? Statistics indicate that the majority of breast cancer deaths occur because of the manifestation of metastases. The metastatic process is complex: cancer cells detach from a primary tumour, enter nearby blood vessels, and migrate in the vascular system. Throughout this process, cancer cells exchange signals, and such signaling pathways drive tumor progression and metastasis after cancer cells reach and survive at secondary sites.

In a nutshell, AXL is a cell surface receptor. As Dr. Côté explains, the expression of AXL correlates with the appearance of metastases in several types of cancers, including breast cancer. AXL stimulates cell proliferation promoting cell survival, resistance, invasion, and metastasis. In other words, signals from AXL help malignant cells grow and spread to distant areas in the body.

A snapshot of AXL cooperating with HER2 in human breast cancer samples

A snapshot of AXL cooperating with HER2 in human breast cancer samples

The mechanism AXL uses to perform its pro-metastatic role is still not completely clear. To identify signaling networks controlled by AXL, Dr. Côté borrowed proteomics approaches – protein-based analysis methods that help estimate the relative and absolute amounts of thousands of proteins across diverse biological systems. Proteomic technologies are in high demand in cancer studies as they have the potential to lead to the discovery of new therapeutic targets and improve the precision of anti-cancer treatments.

What unites researchers in the cancer field all over the world is the understanding that a “one-size-fits-all” strategy for treating cancer no longer works. We live in the era of a tailor-made individualised approach. Searching for ways to personalize breast cancer treatment is considered the most promising way forward for leading cancer researchers. As researchers such as Dr. Côté and his team learn more about the molecular mechanisms controlling signaling by the receptor tyrosine kinase AXL, they are better able to move forward and identify some pharmacologic targets for treating breast cancer. The next major step will be designing novel anti-cancer therapies that will work better than conventional untargeted chemotherapy. “Old-school” chemotherapy kills without distinction. Targeted drugs attack breast cancer without harming benign cells.

Dr. Côté also employs in vivo approaches. In vivo (Latin for “within the living”) means that an investigator uses a whole, living organism in research. Regarding cancer studies, in vivo testing involves mouse models and human patient-derived xenografts. In the case of xenografts, human tumor cells are transplanted into a mouse. This allows the design of a model with the same biological parameters as an actual cancer patient. Obviously, this is a perfect way to observe the overall effect of an experiment using a living subject, while not harming people.

Much has been achieved in research and much more remains to be done, as Dr. Côté says. To date, findings indicate that the receptor tyrosine kinase AXL is a promising therapeutic target for breast cancer therapy. “Our results suggest that inhibition of AXL would be beneficial in limiting the spread of breast cancer,” argues Dr. Côté.

Natalia Mukhina –
Health journalist, reporter and cancer research advocate


Natalia Mukhina - Health Journalist

Natalia Mukhina, MA in Health Studies, is a health journalist, reporter and cancer research advocate with a special focus on breast cancer. She is blogging on the up-to-date diagnostic and treatment opportunities, pharmaceutical developments, clinical trials, research methods, and medical advancements in breast cancer. Natalia participated in numerous breast cancer conferences including 18th Patient Advocate Program at 38th San Antonio Breast Cancer Symposium. She is a member of The Association of Health Care Journalists (AHCJ).