Many readers may not be aware that the Waikato is an active centre for breast cancer research and we have our own dedicated research team, the Breast Cancer Research Trust (BCRT) working alongside Waikato Hospital breast cancer multidisciplinary staff.
The BCRT was established in 2000 to ensure breast cancer patients access to clinical trials and a breast cancer register. Clinical trials are an essential part of our health system and are necessary to find out if new treatments are more effective than those currently accepted as the best available standard of care. All new breast cancer treatments or prevention strategies must be rigorously tested through the clinical trials process before they are made widely available to the community. Breast cancer is the most common cancer in New Zealand (NZ) women. The incidence of diagnosis is one in nine women. Over 3000 NZ women and 20-30 men are diagnosed annually. Each year over 400 Waikato women and 2-3 men are diagnosed with breast cancer. That’s more than one woman diagnosed every working day! Sadly each year we lose 600-700 of our loved ones to this disease, a greater loss than the annual road toll.
For the women who lose their battle with this disease there is a ripple effect of their loss on their families/whanau and communities.
Jenni Scarlet (Research Nurse & Trust Co-founder) lost her mother to breast cancer and experienced the ripple effect this had on her family, particularly on her teenage sisters. It was out of her experience that the Trust’s logo, a yellow button, came. Originating from the words “mothers are like buttons, they hold everything together” and from a research perspective the button represents “holding lives together” through evidence based research.
Supporting women participating in clinical trials
There are a number of advantages for women to consider participating in a clinical trial. They may be able to access a new treatment before it is routinely available as standard treatment for all breast cancer patients. Trial participants are often monitored more closely than patients who receive standard treatment outside of a clinical trial. Overall patients have better outcomes because of close monitoring.
Doctors and nurses who are involved in clinical trials keep up-to-date with latest developments in treatment. Research improves staff skills, experience, education, helps professional development and maintains a beneficial culture of enquiry.
The most common reason given by women for deciding to participate in a clinical trial, is that they want to help provide more information for future generations of their family. Women diagnosed with breast cancer today, “stand on the shoulders” of women who have participated in clinical trials in the past.
Meryl is one such woman who has benefited from past research.
Since her initial diagnosis and treatment 20 years ago, she has overcome two serious recurrences requiring more radical treatment. She has recently celebrated her first grandchild and her 70th birthday milestone and says:
“I’m so grateful for all the science and knowledge that has helped me to survive as well as the dedicated doctors and nurses who worked so hard to get me to this point”.
All the major milestones in treating breast cancer have been the result of research. These advancements include better drug treatments; both chemotherapy and hormonal therapies; improvements in radiotherapy, breast conserving surgery instead of mastectomy, the development of sentinel node surgical techniques instead of axillary (armpit) dissection, and reducing treatment side effects and improving quality of life. Research ensures evidence based best practice and Waikato researchers want the best for those in our region diagnosed with breast cancer.
Breast cancer is not just one disease, there are multiple different types of breast cancer. Ian Campbell (Waikato Breast Surgeon & Trust Founder) explains, “As we progress beyond 2021, the BCRT is enabling clinical trials which are individualising treatments more to the specific features of each different type of breast cancer. For example, drug treatments are becoming more targeted to specific growth factors of a tumour. As technology develops there are specialised laboratory tests which can examine multiple aspects of a tumour.
The results of these tests will help guide oncology doctors to select future patients who will or won’t benefit from treatments such as chemotherapy and radiotherapy.” With early detection and better treatments more and more women are surviving breast cancer. See www.
If you are diagnosed with breast cancer, you can ask your Surgeon or Oncologist if there is a clinical trial available for you.
New Zealand has a national breast cancer register
The Breast Cancer Research Trust (BCRT) runs the Waikato / Midlands regional division of the Breast Cancer Foundation National Register (‘the register’).
This is a Ministry of Health secured web-based database built with the intention of creating a population based picture of breast cancer care in New Zealand.
The register records detailed information about diagnosis, treatment and outcomes of patients with breast cancer, which allows the medical community to monitor standards of care in the Waikato and Midlands and benchmarks against national and international treatment standards.
This confidential database also allows multidisciplinary research into the many aspects of the breast cancer position in the Waikato and New Zealand.
Waikato based research staff collaborate with the Auckland, Wellington and Christchurch regions of the register with observational studies and projects.
The information stored on the register is completely confidential and can only be released through strict governance control. Both public and private sector breast cancer patients, as well as patients with invasive breast cancer and DCIS (ductal carcinoma in situ – a pre-invasive cancer) are eligible to participate in the registers; participation is voluntary.
Examples of research from the register
A project to investigate the management of women with breast cancer in addition to other medical problems, and their long term outcomes. This group of women often have complex medical needs and her research showed how important it is for doctors to determine where there may be opportunities to improve their care (this research was carried out by Dr Melissa Edwards, Surgical Trainee & Research Fellow).
A study investigating the variations in the management and outcomes for women diagnosed with advanced breast cancer. 1600 cases of Waikato and Auckland women with advanced or metastatic disease at diagnosis (called de novo metastatic breast cancer) and 4000 women with recurrent disease (i.e. recurrence following early breast cancer diagnosis) was analysed. Overall, the study results showed that survival for patients with advanced breast cancer in New Zealand is very similar to other developed countries. There are two different types (triple negative or non-luminal HER2 positive) of advanced breast cancer that had the worst prognosis. The site of metastases is also an important indicator, with evidence that those who did not have metastases to internal organs of the body (e.g. liver, lungs) will on average, survive for longer periods of time.
Information from this project helps guide Oncology doctors in their discussion with patients about their prognosis and treatment (this research was carried out by Drs Chunhuan Lao, Research Fellow and Marion Kuper-Hommel, Medical Oncologist, Waikato Hospital).
Examples of current studies;
1) study investigating electronic self-reporting of symptoms in patients with advanced breast cancer
International research has shown that more attention to patient reported outcome measures (PROMs) improves not just quality of life but survival. This work has led to Dr Marion Kuper-Hommel (Medical Oncologist and BCRT Trustee) in developing a local study supported by the Breast Cancer Foundation NZ.
In February Waikato researchers commenced recruiting to what is called the “ABCpro study”. This study is introducing electronic self-reporting of symptoms and treatment side effects for women living with advanced breast cancer (also known as metastatic, incurable or stage four breast cancer). In addition to usual care, the new service will involve women completing weekly online surveys about common symptoms of advanced breast cancer and side effects associated with treatments. The survey responses are then sent to an advanced breast cancer (ABC) nurse who will use the responses to assist patients to better manage symptoms and side effects from home in between regular clinic visits. The survey responses will also help the Oncology team to decide on further tests or treatments.
The aim of this new service is to improve the quality of life of women with ABC by better symptom and side effect control. Waikato Hospital is a centre for this pilot study which will introduce and evaluate this new service. To date we have 32 patients enrolled aged from 32 to 82 years, with the 82-year-old being one of our most IT savvy! Some feedback from participating women so far: “Empowering to learn about self-management, advocating for myself and grow my confidence in living with ABC”;
“Great project and will be great for people who are newly diagnosed with ABC. The guidance, support and encouragement is enormously helpful and especially about what I can do to help myself”;
“It’s amazing to know there is someone to ask for help when I’m not sure how to manage things. I wouldn’t have dreamt of a service like this before or known who to contact and have the trust that they will always get back to you”.
Dr Marion Kuper (Medical Oncologist Waikato Hospital & BCRT Trustee) is Principal Researcher and Jenni Scarlet (BCRT Research Nurse) is study coordinator. Donna Alexander (Waikato Hospital) is our wonderful ABC nurse!
2) A clinical trial of giredestrant (GDC-9545) for advanced breast cancer
The Waikato is a centre for an international drug trial for women and men with a certain type of advanced breast cancer. Advanced breast cancer (ABC) is when cancer has spread to other parts of the body. This trial is enrolling people with breast cancer that has many oestrogen receptors (referred to as oestrogen receptor positive cancer). Oestrogen can make breast cancers grow and treatment for these cancers is to either block the hormone getting to the cancer cells or to lower the amount of hormone in the body. Oncology doctors recommend these people (mostly women) receive treatment with hormone therapy. Giredestrant is a new hormone therapy that blocks oestrogen getting to the breast cancer cells. Researchers think that by adding giredestrant to another standard therapy (palbociclib) for ABC, that this combination may work well in treating oestrogen receptor positive breast cancer.
This clinical trial will also find out more about side effects of giredestrant and how this treatment affects quality of life. The name of this clinical trial is the “persevERA trial”.
Dr Marion Kuper-Hommel (Medical Oncologist & BCRT Trustee) is leading this clinical trial, and Jenni Scarlet (BCRT Research Nurse) is trial coordinator.
Pink Walk & Button Run Thursday 28th October 5.30 pm Hamilton Lake
Get your workmates together (and your boss) and enter a team, dress up in pink for breast cancer awareness, and yellow for breast cancer research, and see if your business or organisation can win an amazing prize for being in the team draw, or win a prize for biggest team! Be into win spot prizes for other best dressed categories including best decorated bra, best dressed adult, teen, child and under five and also best dressed dog. There are vouchers from Body Café and Hot Gossip Bra Shop and other wonderful prizes donated by local businesses up for grabs for everyone that registers online. Join us at the Pink Walk and Button Run for breast cancer to be held Thursday 28th October at Hamilton Lake.
The Pink Walk is a 3.8 km fun walk around Hamilton Lake and the Button Run is approx. a 5 km fun run around the lake and Innes Common. This Pink Walk was first organised in 2006 by a group of health promoters and breast cancer survivors who wanted to raise breast cancer awareness in the Waikato community. The BCRT have been recipients of funds raised each year. Braemar Hospital have always had a large contingent of walkers/runners enter and in 2011 became Gold Sponsor of the event. Sponsorship ensures that all funds raised go to, and are invested in breast cancer research. A massive thanks to Braemar Hospital for their ongoing support!
So dress up and come along on the 28th. The first 100 registrants will receive a free t-shirt (size dependent on availability and will need to be collected at event). There is a free sausage sizzle for all registered children under 16 years and free fresh fruit for everyone donated by Vege King. Be entertained by performers from Enchanted Entertainment and the Free Lunch Street Theatre Company and more. Go to https://pinkwalk.co.nz/ to ENTER NOW with your family or friends, a work team of other group!
Thanks for supporting women participating in clinical trials by attending this FUNdraising event!
Note for any potential event changes due to COVID-19 please visit the Pink Walk website.
October is breast cancer awareness month
Breast cancer awareness month is a time to raise awareness of breast health. If you are a woman and you are getting older, you have the two main risk factors for breast cancer.
One of the best things we can do to improve outcomes from breast cancer is early detection. This is important for all women, but especially so for Māori women who are at even higher risk of developing breast cancer than non-Māori, and have double the death rate compared to NZ European women.
Research work supported by the Breast Cancer Research Trust has shown that Māori women with cancers detected through screening do just as well as non-Māori. Breast cancer cure in these women is high with 94% breast cancer survival at 10 years.
Early detection saves lives Regular mammograms
- A screening mammogram is the best method for the early detection of breast cancer in women with no symptoms.
- We recommend women start having annual screening mammograms between 40-49 and then once every two years from 50 years (and up to age 80 – as long as women remain in good health).
BreastScreen Aotearoa is New Zealand’s free breast cancer screening programme. It checks women for signs of early breast cancer using mammograms.
You can have a free mammogram every two years through BreastScreen Aotearoa if you are between 45-69 years. Please phone 0800 270 200 to enrol in this programme. You can also enrol for on line at www.nsu.govt.nz
Mammograms;
- Can show changes in the breast before anything can be seen or felt. In most cases the changes will not be cancer.
- Can detect breast cancer early, which means a very good chance of cure.
- Can detect about 75 percent of unsuspected cancer in women under 50 and 85 percent in women over 50.
- Cannot prevent you getting breast cancer and cannot always prevent death from breast cancer.
- Are safe because only very small amounts of radiation are used in two-yearly screening.
Be breast aware:
- You can examine your breast by looking at yourself in the mirror with your hands on your head.
- Changes in the breast to look out for and report to your doctor;
- A new lump or thickening
- Skin dimpling or puckering
- Any change in one nipple, such as discharge that occurs without squeezing or a turned-in nipple
- Or a rash or reddening or scalyness of the nipple
While most lumps and other symptoms are not due to cancer, proper assessment is needed to determine this. If you see something different, see your GP for a check-up and get referred for appropriate further workup.
More and more women than ever before are surviving a diagnosis of breast cancer thanks to early detection and more effective, safe and tailored treatments developed through research.
What can you do to reduce breast cancer risk?
All women are at risk of breast cancer, and risk increases with age. Understanding breast cancer risks – those you can control and those you can’t – may help you to improve your breast health;
- Regular exercise – at least four hours per week; coming along to the annual Pink Walk and Button Run is a good start!
- Eating a healthy diet including low fat and sugar, and lots of fresh
fruit and vegetables, - Maintaining a healthy weight, especially after the menopause,
- Keep alcohol intake to less than 10 drinks per week. Ensure you have alcohol
free days, - Breast-feed if possible. Breastfeeding for 12 months or more is associated with a reduction in breast cancer risk,
- Know your family history. Most women who are diagnosed with breast cancer have no family history. A small proportion get breast cancer because of a heritable cancer gene mutation. If you have a number of relatives affected by breast cancer on the same side of the family (mothers or fathers) your risk may be increased. Talk to your doctor about your family history, you may need to start breast surveillance at a younger age.
