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(NewsUSA) - For patients with breast cancer, knowing whether the diagnosis is early stage or advanced is needed to help treat the disease.
Vice-President and Chief Medical Officer for Georgia Cancer Specialists, Cheryl Jones, MD, has experience in treating patients with advanced breast cancer, an incurable but treatable disease, which comprises metastatic (stage IV) and locally advanced (stage III) breast cancer.
Metastatic breast cancer occurs when the cancer spreads to other parts of the body and is treated differently than earlier stages of the disease. Dr. Jones explains the importance of understanding tumor subtypes to help patients become more involved in treatment discussions.
Here she addresses questions about the different subtypes, which include human epidermal growth factor receptor-2 positive (HER2+) and hormone receptor-positive (HR+).
Q: How do HR and HER2 status help determine a treatment plan?
Dr. Jones: Each tumor's genetic makeup helps oncologists identify the best approach to the treatment of advanced breast cancer.
HR+ tumors, which occur in approximately 70 percent of cases, are fueled by hormones like estrogen and progesterone. Therefore, postmenopausal patients may benefit from hormonal therapy, such as an aromatase inhibitor, which blocks the production of estrogen from helping the cancer grow.
If the breast cancer is HR-, accounting for about 15-20 percent of cases in the US, then we treat with drugs other than hormonal therapy, such as chemotherapy.
If the tumor overexpresses the HER2 gene it is known as HER2+ and requires aggressive treatment such as with drugs that target the HER2 protein. This occurs in about one in five breast cancers.
Q: What are the biggest considerations when treating advanced breast cancer subtypes?
Dr. Jones: For advanced HR+/HER2- breast cancer, we consider how this type can outsmart hormonal therapy over time and become resistant, resulting in tumor progression.
Treatments exist that may extend the benefits of hormonal therapy. For example, Afinitor (everolimus) is a prescription medicine used to treat advanced HR+/HER2- breast cancer, along with the medicine exemestane (an aromatase inhibitor), in postmenopausal women who have already received certain other medicines for their cancer. Afinitor can cause serious side effects, including lung or breathing problems, infections and kidney failure which can lead to death.
Even though HER2+ tumors tend to be more aggressive, HER2 targeted treatments also exist.
Tumors that are both HER2- and HR-, known as triple negative breast cancer, cannot be treated with HER2 targeted or hormonal therapies, so we will commonly use a combination of surgery, radiation and chemotherapy.
Visit www.Afinitor.com to learn more about advanced HR+/HER2- breast cancer.
Afinitor is a prescription medicine used to treat advanced hormone receptor-positive, HER2-negative breast cancer, along with the medicine exemestane, in postmenopausal women who have already received certain other medicines for their cancer
Important Safety Information
Patients should not take Afinitor if they are allergic to Afinitor or to any of its ingredients. Patients should tell their health care provider before taking Afinitor if they are allergic to sirolimus (Rapamune®) or temsirolimus (Torisel®).
Afinitor can cause serious side effects, including lung or breathing problems, infections, and kidney failure, which can even lead to death. If patients experience these side effects, they may need to stop taking Afinitor for a while or use a lower dose. Patients should follow their health care provider's instructions.
In some patients, lung or breathing problems may be severe and can even lead to death. Patients should tell their health care provider right away if they have any of these symptoms: new or worsening cough, shortness of breath, chest pain, difficulty breathing, or wheezing.
Afinitor may make patients more likely to develop an infection, such as pneumonia, or a bacterial, fungal, or viral infection. Viral infections may include reactivation of hepatitis B in people who have had hepatitis B in the past. In some people these infections may be severe and can even lead to death. Patients may need to be treated as soon as possible. Patients should tell their health care provider right away if they have a temperature of 100.5?F or above, chills, or do not feel well. Symptoms of hepatitis B or infection may include the following: fever, chills, skin rash, joint pain and inflammation, tiredness, loss of appetite, nausea, pale stools or dark urine, yellowing of the skin, or pain in the upper right side of the stomach.
Afinitor may cause kidney failure. In some people this may be severe and can even lead to death. Patients should have tests to check their kidney function before and during their treatment with Afinitor.
Afinitor can cause incisions to heal slowly or not heal well. Patients should tell their health care provider if their incision is red, warm, or painful; if they have blood, fluid, or pus in their incision; or if their incision opens up or is swollen.
Common side effects include mouth ulcers. Afinitor can cause mouth ulcers and sores. Other common side effects include infections, feeling weak or tired, nausea and vomiting, skin problems, headache, weight loss, loss of appetite, cough, diarrhea, fever, swelling of the hands, arms, legs, feet, face, or other parts of the body, joint pain, abnormal taste, stomach-area (abdomen) pain, nose bleeds, increased blood cholesterol and sugar levels, decreased blood phosphate levels, low red and white blood cells, and the absence of menstrual periods (menstruation).
Please see full Prescribing Information for Afinitor available at Afinitor.com.
Rapamune® (sirolimus) and Torisel® (temsirolimus) are registered trademarks of Wyeth Pharmaceuticals Inc.
GARDEN CITY, Kan. â€“ Michelle Gilles is a horse trainer and a competitor.
She also is a wife and mother, and no matter where she goes, she does so with her family involved. Whether itâ€™s working her business at their home near Lubbock, Texas, or on the road at competitions, itâ€™s certainly family time.
â€śA family that works together, plays together and stays together,â€ť said Gilles, owner of Michelle Gilles Horsemanship. â€śEverywhere I go, itâ€™s me, my husband and kids.â€ť
That works just fine. By combining family, work and competition, the native Californian is living her perfect life. That includes her ventures for Extreme Mustang Makeover events, reining contests and competing in the Colt Starting Challenge USA, the latter of which showcases trainersâ€™ work with young horses.
In fact, Gilles will be part of the next challenge, set for 6-9 p.m. Friday, Sept. 5, and 5-9:30 p.m. Saturday, Sept. 6, inside the Bronc Buster Horse Palace at the Finney County Fairgrounds in Garden City.
â€śThe Colt Starting Challenge is a really great way to further your education with horses,â€ť Gilles said. â€śIt makes you have to learn who you truly are, because you are putting a lot of training in such a short period of time. You have to know your stuff.â€ť
While she utilizes the challenges for self-training, Gillesâ€™ true competitive nature comes out in full force when itâ€™s time to enter the arena.
â€śThe Colt Starting pen shows you where your holes are and where you have to go back and fix,â€ť she said. â€śI do it to better myself and hopefully educate the public that thereâ€™s a new way of doing things.â€ť
The Colt Starting Challenge focuses on natural horsemanship, which better utilizes a horseâ€™s natural instincts. The techniques used are a far cry from what was done a generation ago and what many have seen regarding breaking horses on TV and in the movies.
The competitions are the brain child of trainer and horseman Russell Beatty. In the two-day challenges, trainers are matched via random draw to horses that have had limited handling; there has been no saddle nor bridle ever on the animal. To close out the challenge, trainers take their hoses through a variety of obstacles in order to show how far their animals have come in a short amount of time.
â€śIâ€™ve been watching different competitions, and this was interesting because I am really good at getting these young ones going, and I enjoy getting the colts started,â€ť Gilles said. â€śI got started by watching them, and Iâ€™ve already been to four. I watched Russell, and I really liked the sportsmanship and that with his competitions, itâ€™s all about the horse.
â€śIf you get in a bind in your pen and need help, another competitor can come in and help you. Thatâ€™s an awesome part of the competition.â€ť
As a trainer, she has taken a lot from the Colt Starting Challenges. In fact, some of the lessons learned have enabled Gilles to upgrade the techniques she utilizes in her home practice.
â€śIâ€™m much quicker and more aggressive,â€ť she said. â€śWhen I would get a green horse before, I would go slower and be methodical in the process. Now I have the tools to speed up the process of my training. Ideally the public wants a horst thatâ€™s past green broke in less than 30 days.
â€śNow Iâ€™m able to give a much better product to the horse community in a short amount of time.â€ť
While trainers in the Colt Starting Challenge utilize the same philosophy, they go about their work using a variety of methods. For Gilles, adapting along the way is outstanding for her business.
â€śI was raised around horses my whole life,â€ť Gilles said, noting that she began focusing on training while in college. â€śI started taking equine science classes. Thatâ€™s where I started learning about starting colts.
â€śI fell in love with it. Horses are honest and pure, and they get out of it what you put into it. Horses have no bad intentions. What you give that horse, they give right back to you. The horse is really a reflection of who you are.â€ť
Gillesâ€™ passion is evident in everything she does, and sheâ€™s excited to share it through the Colt Starting Challenge USA.