STAR-BULLETIN /2002
Radiologist Bryan Gushiken examined mammograms in March to detect abnormalities at Kapiolani Women's Health Center. A noted cancer researcher says fewer women will develop breast cancer because of the drug tamoxifen.
Fewer women will develop breast cancer in the future because of the anti-estrogen drug tamoxifen, which blocks growth of cancer cells, says a noted cancer researcher. Drug reduces breast
cancer incidenceThe finding is among developments that
were discussed at a recent cancer forumBy Helen Altonn
haltonn@starbulletin.comTamoxifen can reduce incidence of cancer in high-risk women and, after cancer is diagnosed, reduce the likelihood of a recurrence, said Dr. Patricia Ganz, professor at the University of California Los Angeles Schools of Medicine and Public Health.
Doctors in five years also will be able to read different genes to identify a fast-growing tumor for aggressive therapy, she said at a recent Asian & Pacific Islander Breast Cancer Survivorship Conference.
Looking at information encoded in a gene (gene expression) will provide "a specific fingerprint for every tumor so we can characterize who needs treatment and who doesn't," she told about 200 participants at the conference, sponsored by the Cancer Research Center of Hawaii at the Luana Hills Country Club.
Dr. Carolyn Gotay, cancer center professor and researcher, coordinated the event with a $20,000 award she received as the 2001 Susan G. Komen Foundation Professor of Survivorship.
She said she thought bringing people together from hospitals, the state Department of Health, University of Hawaii and nonprofit organizations would help to advance research and achieve "the biggest kind of outcome."
Breast cancer affects about 180,000 women annually, including 1,000 women in Hawaii, according to the cancer center.
Ganz cited a 30 percent decrease in breast cancer deaths because of mammograms and early detection of tumors. Women are surviving longer and studies show they're doing very well, she said.
Among cancer survivors at the conference was former state Rep. Jackie Young, who now works for the American Cancer Society. She said she chose to speak out about the disease to help overcome fear and ignorance.
After initial shock, emotional and physical distress, survivors Patti Isaacs, 46, Emma Mader, 64, and Shirley Streck, 66, said breast cancer has taught them to focus on important things.
"I can basically say I'm a better person for having cancer," said Isaacs, a UH doctoral student in clinical psychology. "I savor every moment with family and friends."
"It changed my lifestyle for the good, but I still like chocolate," Mader said.
Streck said she thinks she got cancer to make herself slow down. "I used to think I was superwoman."
Isaacs said no one in her family had cancer when she was diagnosed at age 39. Mader, diagnosed at age 17, and Streck, a one-year survivor, said they have relatives with cancer.
But the cause of breast cancer is "something else besides who your parents are," said Dr. Gertraud Maskarinec of the Cancer Research Center.
The disease is low risk in many countries, but the rate goes up when people migrate to the United States, she said. With Japanese migrants, she said, it takes two to three generations for the risk to go up, which suggests environmental factors, particularly diet, are involved.
Gotay said about 98 to 99 percent of the women in a study of 634 Hawaii breast cancer patients said increasing survival was the major factor affecting treatment decisions. "Keeping their breast (38 percent) was not as important as I expected."
Dr. Clayton Chong, Hawaii's only native Hawaiian oncologist and the principal investigator for 'Imi Hale, Native Hawaiian Cancer Awareness Research and Training Network, drew a dire picture of Hawaiian women and breast cancer.
They have the highest rate of advanced disease and the lowest five-year survival rate, he said, listing cultural factors, lack of accessibility to health care and acceptance of conventional care among major problems.
Asians and Pacific Islanders have had a "three-digit increase" in cancer since 1995, said Marjorie Kagawa-Singer, associate professor at the University of California Los Angeles School of Public Health and Asian American Studies Center.
She said genetics seems to account for less than 5 percent of all cancers, with the rest caused by lifestyle and/or environmental factors. Since culture influences lifestyles, she said attention to cultural differences could make a big difference in reducing the disease and increasing survivorship.
Native Hawaiian cancer survivors are helping 'Imi Hale identify cultural problems and solutions to the Hawaiian cancer plight, said Dr. Kathryn Braun, director of the UH medical school's Center on Aging and research director of 'Imi Hale, and JoAnn Tsark, Papa Ola Lokahi research director. They stressed the importance of "cultural protocol, native Hawaiian healing traditions and beliefs about the body parts."
People shouldn't be treated as "cultural characterizations," said UH religion professor George Tanabe, pointing out, "Culture changes by age, time and generations. I'm not Japanese the way my grandfather is."
His son's fourth-generation Chinese American wife from Los Angeles also isn't like her Chinese ancestors, he said, noting when the family took her to a Chinese dinner here, she asked for a fork.
