I couldn’t be more excited to share this news with you today. Because it could very well save you or someone you know from some very dangerous and misguided treatment recommendations.
According to results from a recent study, genomic testing may allow as many as half of all breast cancer patients to avoid chemotherapy.
Now that’s a breakthrough.
Unlike genetic testing, which assesses your cancer risk, genomic testing uses tumor tissue analysis to help guide treatment decisions. It can help assess the aggressiveness of your cancer, and also tell you how responsive it is likely to be to drug therapy.
And yet somehow, I don’t see anyone shouting these latest findings from the rooftops…despite the fact that they were featured in the prestigious New England Journal of Medicine. If that’s not evidence that medical oncology is nothing but a big business that needs to be attacked head on, I don’t know what is.
But I digress. Let’s take a closer look at this new research.
Find out whether you truly need chemo
The large European study looked at nearly 6,700 women with early-stage breast cancer. And it focused primarily on a sub-group identified as “high-risk” based on typical clinical diagnostic procedures, but low-risk according to results of a genomic test called MammaPrint. (In other words, genomic testing indicated they had a less aggressive, slower moving cancer. Something typical diagnostic procedures can’t really effectively determine.)
Results showed that—in this genomically low-risk group—the five-year, metastasis-free survival rate was just 1.5% higher for women who received chemotherapy versus those who didn’t. That’s a pretty measly “benefit” when you stop to consider the personal cost.
Chemotherapy is powerful stuff that ravages your body. And yet, it offers little in the way of increased survival for a significant percentage of women with breast cancer. Again, only half of these women stand to gain anything from treatment beyond surgery and oral medications. But without genomic testing, they would very likely ALL be subjected to chemotherapy—because it’s simply the mainstream’s go-to cancer treatment (and a very big cash cow indeed).
There’s also a similar test, called Oncotype Dx, which I use in my own practice. And trials have shown that more than 99% of women deemed low-risk by this test survived five years without metastasis.
Translation: There would be literally NO benefit from chemotherapy for this group of women. And yet, again, without genomic testing to guide their treatment decisions, they likely would have received it anyway.
For the record, this is why I always say prognosis is the true end point, and all we really need to look at when making treatment decisions. Because when faced with a disease like cancer, what you can do and what you should do are often two different things.
The question always boils down to what treatment is going to allow you to live well, for the longest time. And as this research shows, for as many as half of all breast cancer patients, chemotherapy isn’t necessarily the answer.
The more patients that know this, the fewer will be subjected to grueling, expensive treatments without any tangible reward.
This kind of testing is as good as it gets at this point in time.
And the good news is, MammaPrint and Oncotype Dx are both widely used in clinical practice. (As I mentioned, I use the latter in my own office.) But there are other tests out there too—including the Breast Cancer Index (7-gene signature), EndoPredict (12-gene signature), and Mammostrat (5-gene signature). And as time goes on, I imagine we can expect even more to hit the market.
Of course, these tests aren’t cheap. But if you or anyone you know is facing tough decisions about whether to undergo chemo or not, they’re definitely worth saving up for.