Gene tests tailor care to kill cancer, cut side effects

PHILADELPHIA, PA.; October 15, 2013

Marjorie Anderson of Strawberry Mansion isn't sitting back in her retirement.

She's too busy raising her adopted teenage daughters.

"They were good for me, and I was good for them. So we make the perfect match," Marjorie chuckles.

When Marjorie learned she had DCIS - a non-invasive form of breast cancer, she & her daughters worried she'd need radiation or surgery.

"Cancer, I don't think that's a word that anyone wants to hear."

That's used to be standard for DCIS, because doctors couldn't tell which cases would become invasive cancer.

"They said 'Mommy - if something happens to you, what's going to happen to us?'" she recalls.

Daughter Alyaha adds, "I was worried a little bit. she means a lot to me."

But Dr. Lawrence Solin, the chairman of radiation oncology at Einstein Healthcare, told Marjorie she DIDN'T need radiation, because of her score on the Oncotype gene test.

Oncotype analyzes genes in cancer cells, then gives a score based the aggressiveness of the cancer.

"The goal of this particular test is to spare women radiation treatment if possible," says Dr. Solin.

Marjorie's 10-year chance of having the cancer become invasive was in single digits.

Dr. Solin says it's rewarding to reliably offer patients LESS treatment and LESS side effects, not more.

"The best strategy is for many patients just to use the hormone therapy," Dr. Solin told us. "It's really great to be able to help a patient through that decision-making process.

For Marjorie, taking a daily tamoxifen pill helps her fight cancer, while putting her family's mind at ease.

"I know i'm going to be fine," she says.

Cari Grundman's treatment was guided by a different type of genetic test.

She and Dr. Beth Dupree of Holy Redeemer Hospital thought a lumpectomy alone would be fine for her small tumor.

"Two weeks later, I had the surgery, there was no node involvement, and I was declared cancer-free. And I thought great - we're done!" remembers Cari, of New Hope, Pa.

But to be certain, Dr. Dupree had a Mammaprint test run on Cari's tumor cells.

Mammaprint also looks at the aggressiveness of tumor cells, and whether chemotherapy will kill them.

Sometimes you have a tiny tumor that needs chemotherapy, and other times, you have a large tumor that's not going to benefit.

"I was almost leaning against getting the chemotherapy," recallsCari.

Although she thought she could skip chemo and its side effects, the MammaPrint test showed her cells were aggressive, and if there were any left, they could spread.

Dr. Dupree notes, "Chemotherapy was like an insurance policy."

And Cari adds, "I was actually relieved that the decision was taken out of my hands."

"It gave me that peace of mind that I'll never look back and say - you know what, i really should have gone ahead and done that," she says.

Dr. Dupree say the genetic tests are another sign of the current revolution in cancer care.

"Breast cancer treatment has changed completely since my residency," she says, smiling.

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