Priority Areas Illustrate Expertise

With a breadth that addresses all types of breast
and gynecologic cancers – from the common to the
obscure, the early-stage to the advanced – the Susan F.
Smith Center for Women’s Cancers at Dana-Farber is
propelling the science and fine-tuning patient care for
women (and in a few cases, men) of all ages.
The center’s research and care expertise is growing
in four major areas where patients find themselves in
particular need of assistance: breast surgery, metastatic
breast cancer, breast cancer in young women, and
recurrent ovarian cancer.
Breast Surgery
Colleen Sullivan was prepared to follow a typical plan
for her breast cancer: a lumpectomy followed by radia-
tion. When she learned a genetic defect was causing her
cancer, however, she opted for a mastectomy to decrease
the odds of developing a second breast cancer.
Many breast cancer patients face such decisions,
and the Susan F. Smith Center is well-prepared to
guide them. Surgeons offer minimal and maximum
approaches, aiming for the best outcome while
adjusting for each woman’s type of tumor, unique
situation, and preferences.
From shrinking tumors with drugs before surgery,
to combining mastectomy and reconstruction pro-
cedures to give women the best cosmetic outcomes,
surgeons continually hone their skills and work within
the full picture of a patient’s life, using advanced tech-
niques such as testing lymph nodes during surgery and
viewing real-time images as surgery progresses.
Metastatic Breast Cancer
It is hard enough for a woman of any age to learn
she has breast cancer. But when she finds out her
cancer has spread beyond the breast, the challenges
and worries multiply.
Today, women with metastatic breast cancer can
live well for many years. In fact, Susan F. Smith Center
scientists conduct such a wealth of research in these
types of advanced cancers that some women transfer
their care here when their cancer reaches this stage.
Susan F. Smith Center oncologists work closely with
oncologists at other centers to provide optimal care,
even for women who do not live near Boston. Dana-
Farber is currently conducting more than 30 clinical
trials to study the effects of new, targeted drugs on
metastatic breast cancer. Much of this research has
resulted in treatment breakthroughs and new standards
of care for these patients.
These are special circumstances, where the best that
science has to offer is very important. Physician-scien-
tists not only study targeted therapies and test various
combinations, but also offer resources and support to
this unique group of women.
Pat Hastings continues to live a full life with meta-
static cancer, caring for purebred horses on a farm in
Vermont and traveling to Dana-Farber every three
weeks for experimental treatment
Young Women with Breast Cancer
Although a cancer diagnosis occurs less frequently
in women in their early 40s or younger, sometimes the
ripple effect on a patient and her family and friends
can be greater. A young woman may be raising chil-
dren, starting a career, or dating. She might be con-
cerned about fertility, or have extra anxiety about both
the cosmetic and medical challenges she faces. Feeling
“young and strong” becomes very important to her.
Young and Strong: A Program for Young Women
with Breast Cancer helps patients and providers
address concerns about fertility and reproductive
options, genetics, psychosocial matters, and other
treatment and survivorship issues facing young
women. The program’s physician-scientists are
focused on improving surgical decision-making,
studying the way genetics in young women might
differ from that of older women, and exploring
options for preserving fertility.
Established in 2005, the program is the first of its kind
in New England and one of the only such programs in
the U.S. Since its inception, the program has shepherded
more than a thousand young women on their journey
through and beyond cancer. A recent grant will expand
the program to include women at Dana-Farber’s satellite
centers and community network locations, in Massachu-
setts, New Hampshire, and Connecticut.
Recurrent Ovarian Cancer
Ovarian cancer differs from breast cancer in one
obvious way: it cannot be easily detected at the early
stages. Therefore, it is often diagnosed after it reaches
an advanced stage, and even after successful treatment,
it often returns. Donna Gregory (see page 14) found
herself in just this situation.
While chemotherapy drugs that contain platinum
are often very effective for ovarian cancer patients, in
some cases, the cancer begins to reject the platinum.
Today, several clinical trials testing drugs known as
PARP inhibitors, which work by blocking one of the
pathways by which tumor cells repair their damaged
DNA (see page 4), are under way for patients whose
tumors initially responded to platinum-based chemo-
therapy agents but then began to grow again.
Increasingly, Susan F. Smith Center investigators
are testing drugs and drug combinations that are
not chemotherapy at all. In one study, cediranib,
an antiogenesis inhibitor that hampers cancer cells’
growth by interfering with their blood supply, com-
bined with olaparib, a PARP inhibitor, improved out-
comes in a recent study (see page 12). Olaparib has
recently become the first PARP inhibitor approved by
the U.S. Food and Drug Administration.
Investigators are testing other types of combina-
tion therapies for recurrent ovarian cancer as well as
the effectiveness of immunotherapies (such as ipilim-
umab) to unleash the body’s own immune response
against cancer.

 

Courtesy of Dana-Farber Cancer Institute

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