The Telegraph
Since 1st March, 1999
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New therapy hope for breast cancer
- Disease on upswing in city; medicos laud US study

More than 100,000 Indian women are detected with breast cancer every year, and the incidence is alarmingly on the rise, particularly among urban females. The dreaded disease is the second most common malignancy in women in India after cervical carcinoma, and the scenario in Calcutta is no different.

According to the population-based cancer registry of the city at Chittaranjan National Cancer Institute’s department of epidemiology and bio-statistics, breast cancer accounts for around 22.5 per cent of all female cancer patients in Calcutta.

However, a new combination therapy developed in the US holds out new hope for metastatic breast cancer (which means the disease has spread via the blood to other organs) patients, say city-based oncologists. Gemcite (pharmaceuticals major Eli Lilly’s brand for gemcitabine hydrochloride), which was so far being used for lung, pancreatic and bladder cancer, has been found to be effective in management of breast cancer, too, according to a recent study.

The study presented at The American Society of Clinical Oncology (ASCO) by the drug company this summer showed Gemcite with Taxol (paclitaxel) can be used in metastatic breast cancer with “good results”.

ASCO is the world’s leading professional organisation representing physicians who treat people with cancer. The study, conducted on 529 metastatic breast-cancer patients, comprising a fair sprinkling of Indians, showed that the combination could not only be tolerated well, but also actually slowed the disease in these patients and improved their quality of life.

“This could mean that patients with metastatic breast cancer have a new treatment option, going by early indications. However, this is only an interim result and more authentic data should be available next year,” observes clinical oncologist Chanchal Goswami.

About 40 per cent of breast cancer patients develop metastatic disease after primary treatment and the average survival time for patients after diagnosis of metastatic disease is 18 to 30 months.

Goswami, however, is enthused by the median time to disease progression of 5.4 months for patients given the combination cycle, compared to 3.5 months for those receiving only the paclitaxel cycle.

Time to disease progression is a measure of time after cancer is treated until the disease starts to get worse. More than 50 per cent of the women studied were progression-free at six months on the combination therapy, according to data released by the company.

The combination is one of the few to surpass the single-agent efficacy of paclitaxel in the treatment of metastatic breast cancer, the study maintains. The global trial showed that the combination “more effectively shrunk the tumour”, it adds.

The four primary treatment options for patients with breast cancer are surgery, radiation, chemotherapy and hormonal therapy. Successful management, however, usually requires a multi-modal approach involving surgery, radiation and systemic therapy.

According to Goswami, associated with AMRI-Apollo Hospitals, Apollo Gleneagles Hospitals and Ruby General Hospital, all possible management tools are available in Calcutta. What is lacking still is awareness, he feels.

“In a thriving metropolis like Calcutta, the incidence of breast cancer can only go up. Unfortunately, there is no organised screening programme which can detect the disease early so that metastasis can be prevented, giving the patient a better chance. The need of the hour is spreading awareness through NGOs and social workers on breast self-examination, which can be a beginning, at least,” says Goswami.

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