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Survive and Thrive Newsletter - Spring 2014




Dear Friends,

This edition of Survive and Thrive examines a concern many survivors face, the risk of developing second cancers after treatment.

Research is an essential part of our work to improve the lives of cancer survivors. So we want to let you know about research that might interest you or make a difference in your life.

Recent studies have shown that female survivors who receive radiation therapy to the chest wall, armpit area, or whole body before the age of 40 have an increased risk of developing breast cancer. In response, Seattle Cancer Care Alliance (SCCA) is conducting research into developing a preventive treatment option for these women. While this study is specific to breast cancer, researchers at SCCA regularly investigate improved methods of preventing, treating, and diagnosing many different cancers, leading to improved health and lives saved.

Wishing you well,

K. Scott Baker, M.D.
Director, Survivorship Program

Karen Syrjala, Ph.D.
Co-Director, Survivorship Program

Risk of Developing Second Cancers After Treatment

Research shows that women who have received radiation therapy to the chest wall, axilla (armpit area), or whole body before the age of 40 as treatment for childhood, adolescent, or young adulthood cancers have an increased chance of developing breast cancer, with some studies indicating that these women have 20 times the risk of getting breast cancer in their lifetime as a woman without radiation therapy.

The research, conducted by several research organizations and published in the Journal of Clinical Oncology and Journal of the National Cancer Institute, highlights a clear need for strategies to reduce this risk for these women.

Recognizing a need for a preventive treatment for these women, SCCA, in collaboration with the City of Hope National Medical Center, is conducting a research study to see if a low dose of tamoxifen can reduce the risk of breast cancer. Tamoxifen works by blocking the estrogen receptor on abnormal cells and preventing their growth. While tamoxifen has been shown to reduce the incidence of breast cancer in other high-risk women, it has not been studied in women who have received radiation to the chest wall, axilla, or whole body.

“This study allows us to offer a potential preventive option to women with a higher risk of developing breast cancer,” says Larissa Korde, MD, MPH, breast cancer medical oncologist and the lead SCCA researcher for the study. “We are hopeful that the results of this study will allow us to expand this research to a much larger population, potentially saving many lives.”

The trial focuses on the drug tamoxifen in lower doses than given to women with breast cancer. According to a large study published in the Journal of the National Cancer Institute in 1998, tamoxifen can reduce breast cancer risk by 50 percent in other high-risk women. Recent data from the Journal of Clinical Oncology suggests that a lower tamoxifen dose may be just as effective as a higher dose but with substantially lower side effects. While common side effects from the standard dose of tamoxifen have been reported to include hot flashes and vaginal discharge, these symptoms have not been described by patients treated with the lower dose of tamoxifen used in this study.

Dr. Korde will examine the effects of low dose tamoxifen on markers associated with increased breast cancer risk, including breast density and markers in the blood, urine, and breast. The study is currently open for enrollment for eligible participants including women at least 25-years old who were diagnosed with childhood, adolescent, or young adulthood cancers two or more years ago. Women must have received radiation treatment to the chest wall, axilla, or whole body prior to the age of 40 and remained free of disease recurrence for at least two years.

For those interested in participating in this study, or who would like more information, please contact:

Donielle O’Connor
Clinical Research Coordinator
Low-Dose Tamoxifen for Risk Reduction of Radiation-Induced Breast Cancer
(206) 288-7427
doconnor@seattlecca.org

Patient Profile: James Grizzard

An avid outdoor enthusiast, James Grizzard has always lived a very athletic lifestyle. Living in Tampa, James enjoyed golf year-round. After moving from Florida four years ago for a job in Kirkland, James traded golf for more Northwest outdoor activities, including fishing, hiking, and camping. Coinciding with his move was an unexpected diagnosis of colon cancer. James jokes that he moved to the Seattle area “just in time to be treated at Seattle Cancer Care Alliance.”

James struggled for years with mysterious stomach issues. Doctors repeatedly told him it was just gas. The results of his routine colonoscopies always came back normal. It wasn’t until he doubled-over in pain during a meeting that a trip to the emergency room changed his life. After undergoing routine testing that came back normal and led to another diagnosis of gas, James demanded an MRI. The results of the MRI indicated a growth on his colon. James was diagnosed with colon cancer and found himself prepping for surgery three days later. James then faced a year of chemotherapy at SCCA.

It was during one of his cycles of treatment that James discovered SCCA’s Survivorship Clinic, after a member of the Survivorship Clinic team introduced herself and mentioned the Clinic’s services. Upon completion of his treatment last spring, James visited the Survivorship Clinic. Unsure what to expect post-treatment, James had many questions. How do you maintain proper health after treatment? How do you balance work, stress, exercise, and healthy eating? Would his cancer come back?

James now returns to SCCA every three months for check-ups and makes a point of stopping by the Survivorship Clinic during each visit. He feels it is important to refresh himself on the guidance provided by the Survivorship team.

“When I first visited the Survivorship Clinic I was in a fog about what to expect from life as a survivor,” James said. “I’m thankful for the valuable guidance, comforting care and outstanding level of service I’ve received.”

James feels that participating in the Survivorship Program has been an essential part of his cancer treatment plan and encourages others to participate. He also believes that the tools gained from the Survivorship Clinic have helped him reevaluate what is important in his life. While he recognizes that everyone is different, for James finding a balance has been key.

“My cancer journey has helped me realize what is really important in life,” he said. “My advice to others, don’t wait to make life-changing decisions to eat healthier, spend more time with those who are important to you, or to be a better person. Make those decisions and act on them today.”

Spring Newsletter Events and Community Education

Save the Date – June 7, 2014 - Moving Beyond Cancer to Wellness

Moving Beyond Cancer to Wellness, an annual event designed for cancer patients, survivors, caregivers, friends, family, and health care professionals, provides general education on a variety of the late- and long-term effects faced by cancer survivors after treatment is completed. This free conference will take place on Saturday, June 7 from 8:30 a.m. to 3 p.m. at Fred Hutchinson Cancer Research Center. Full event details and registration.

Survivorship Program Facebook Page and Blog

We are expanding our communications efforts to increase awareness of our program and connect with survivors through our new Facebook page and blog. If you have not done so already, stay connected by liking us on Facebook and following our blog.