Looking for Answers to Breast Cancer
01/25/2010
Richard Love on the need for global breast cancer research
The fight against breast cancer goes on in the United States every day of every month. The fight also goes on worldwide. As an American scientist looking for ways to beat breast cancer, I know that looking at the problem globally is where we will find the answers for here at home.
Breast cancer is no longer a problem only of middle- and upper-class women in high-income countries like the U.S. In 2010, there will be 1.5 million new individuals diagnosed worldwide. One million will be poor women; over half of all new diagnoses will be among women in Asian countries, and half of women diagnosed will be younger than 50 years of age.
In the foreseeable future, these numbers will only increase, as will the gap between who will live and who will die. In high-income countries like Italy, roughly 75 percent of women with breast cancer are now cured; in low-income countries, the figures are the opposite - at least 75 percent die. While there certainly has been progress, for the majority of affected women globally, breast cancer is an ugly, tortuous death sentence.
In the U.S., we talk of regular breast exams, mammography, MRI imaging, multi-visit chemotherapy treatments, and financial costs. Low-income countries don't have these options, leaving women with few if any choices for care and treatment. Most often, by the time women in low-income countries are seen by a health professional, they have large tumors and die in short course.
So why is it important for us to connect through research to our sisters in the developing world? Because it is our differences as human beings that open a window into the full spectrum of this disease.
Here is what we know: A large majority of women in the U.S. are of European descent, and as such are at risk of different types of breast cancer and different side effects from treatments than African-American or Asian-American women. We are only beginning to understand the how factors like genetics, environment and hormones affect breast cancer risk, so there is a great deal that we can learn by studying these factors in different populations. Global health research can give us important lessons to use for treatment of breast cancer among women with all ethnic and genetic backgrounds in the United States.
For many years, I have been working with colleagues in Asia, and increasingly in the United States, to develop research activities that have the potential to help all women. Right now, researchers, including myself, are following three promising avenues in Bangladesh to learn more about defeating breast cancer. The first study focuses on cultural barriers that make it difficult to detect breast cancer, and it also involves a long-term study that will give us a rare look on the best methods of care based over a period of years. A second example involves primary health workers in rural areas using cell-phone software to record and send information about the breast problems they are finding in the women they examine. And a third example is research that now looks at how breast cancer spreads, and whether large tumors "self seed." Some researchers are proposing that pathologic cell mobility may contribute to the growth of a primary tumor. In other words, escapee cancer cells may constantly re-seed a primary tumor making that mass a dense collection of contiguous small growths
These research efforts will help women everywhere - from the wealthiest countries to the poorest ones. That's why we need to dedicate funding for new and ongoing global health research. It is an investment that could save the lives of women around the world.
Dr. Richard Love is a professor of internal medicine and public health at the Ohio State University and scientific director of the International Breast Cancer Research Foundation. He is currently an ambassador for the Paul G. Rogers Society for Global Health Research Program.
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