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Tag: advanced breast cancer

  • Advanced Breast Cancer: How It Affects You at Work

    Advanced Breast Cancer: How It Affects You at Work

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    A diagnosis of metastatic breast cancer doesn’t mean you have to quit working. But you might find it easier to manage everything that comes with your condition when you’re not also concerned with work. 

    There’s no right or wrong answer. It’s a personal choice that depends on many factors. Here’s what to consider when making the decision, and how to make it work if you decide to stay at your job.

    To Work or Not to Work

    “Many with advanced breast cancer still work and maintain their family life with amazing ease, even with regular appointments and sometimes ongoing outpatient intravenous therapies,” says Rebecca Crane-Okada, PhD, director of Cancer Navigation & Willow Sage Wellness Programs at the Margie Petersen Breast Center at Providence Saint John’s Health Center in Santa Monica, CA.

    Working may help you feel grounded and productive. It may be a good distraction and give you a sense of power when other parts of your life feel beyond your control. But if your job feels like too much to manage on top of your treatments and symptoms, you may decide to take a break or not return to work.

    To Share or Not to Share

    Who you tell and how much you share is up to you.

    It may be helpful to tell your boss. If your manager knows what’s going on, they may be able help by extending deadlines, changing meeting times, or letting you work from home. You can come up with a plan together.

    If you need work accommodations like regular breaks or a flexible schedule, you’ll have to share some information with your human resources department. Your human resources department and supervisor are legally required to keep your medical information private. But they may have to tell their managers.

    There may be benefits to sharing with your colleagues. They could be a source of emotional support and help you manage your work better.

    Marlena Murphy, 45, who has metastatic breast cancer and is an advocate for TurningPoint Breast Cancer Rehabilitation in Atlanta, GA, decided to share her cancer diagnosis at work so she could balance her work with her treatments. 

    “The main thing for me was to communicate with people I work directly with, regarding treatment and medical appointment dates,” Murphy says.

    Sharing with co-workers can have drawbacks. They may pepper you with questions about your health and treatment. You may get unwanted medical advice or opinions. And they’re not required to keep whatever you share to themselves. 

    How to Find Balance

    How you feel and how you manage at work may change on a day-to-day basis.

    On some days you may feel energetic, like you can handle anything. On other days, you may feel tired or struggle with symptoms like fatigue, nausea, constipation, diarrhea, and muscle or bone pain. Try to let your body be your guide.

    When you feel tired, take a break. If your job is physically demanding or you’re on your feet a lot, you may need regular rest breaks. Modifications like moving your desk closer to a restroom or working from home can help you find balance.

    Getting Help at Work

    There’s a lot you can do to make it easier to work while managing advanced breast cancer.

    For example, if you’re in the middle of treatment, ask your boss if you can set your own hours. It may help to shift your working hours to times in the day when you have more energy and will be more productive.

    Consider adjustments like:

    • Compressed work weeks
    • Flexible hours
    • Regular breaks throughout the day
    • Remote work
    • Shorter schedule

    If you need extended time off, you may want to use sick leave.

    If you’re going back to work after being out for a while, ask your boss if you can ease back into work with shorter or fewer days. Ask your co-workers to bring you up to speed on anything you missed, like new systems or procedures that started when you were out.

    Know Your Rights

    You may be entitled to several types of support while managing advanced breast cancer. Here are a few to look into:

    Americans with Disabilities Act (ADA). This requires your employer to make adjustments like shorter work hours, a modified work schedule, or reassignment to an open position. It also protects you from discrimination, so you get the same consideration you’d have without cancer.

    Family and Medical Leave Act (FMLA). This requires your employer to give you up to 12 work weeks of unpaid leave during a 12-month period. You can also use it if you’re a caregiver for your spouse, child, or a parent with a serious health condition.

    Employee Assistance Programs. These programs offer help with personal issues that may affect your ability to do your job. For example, they may help you with financial and emotional concerns. 

    Disability policies. If advanced breast cancer prevents you from being able to work, you may qualify for short-term or long-term disability insurance. These policies may give you 40%-70% of your base salary. Short-term disability may be about 3-6 months. Long-term disability starts after short-term disability ends.

    Talk to your human resources representative about what you qualify for and how to start the process.

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  • Antibody Drug Boosts Survival for Type of Advanced Breast Cancer

    Antibody Drug Boosts Survival for Type of Advanced Breast Cancer

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    By Dennis Thompson 

    HealthDay Reporter

    THURSDAY, Dec. 8, 2022 (HealthDay News) — A relatively new drug is boosting survival rates for women with a specific type of advanced breast cancer who haven’t responded to other treatments, according to a pair of clinical trials.
     

    The targeted antibody drug — trastuzumab deruxtecan (T-DXd, sold under the brand name Enhertu) — dramatically outperformed an older antibody drug in one trial, quadrupling the number of months women survived without their cancer progressing.

    T-DXd also outperformed standard chemotherapy in another clinical trial, more than doubling the number of months of progression-free survival and reducing the risk of death by 34%.

    T-DXd is aimed at helping patients who have HER2-positive breast cancers.

    HER2 is a protein that promotes growth of breast cancer cells. About 20% of patients have tumors with higher levels of HER2.

    Results from both clinical trials were reported Wednesday at the San Antonio Breast Cancer Symposium.

    “We have a drug that is very effective and seems to be working, at least in good part, by a targeting mechanism against HER2,” said Dr. Carlos Arteaga, chair of comprehensive oncology for the Simmons Comprehensive Cancer Center at UT Southwestern Medical Center, in Dallas.

    Arteaga, co-director of the symposium, led a news briefing announcing the results of the two trials.

    T-DXd delivers a one-two punch to breast cancer cells by combining an antibody called trastuzumab with a chemotherapy drug called deruxtecan.

    The antibody part of T-DXd binds with HER2 receptors on the breast cancer tumor, blocking the ability of the protein to promote cancer growth. This binding also serves to steer cancer-killing deruxtecan directly into tumor cells.

    The U.S. Food and Drug Administration approved T-DXd in 2019 as a follow-up therapy for patients whose breast cancer had continued to spread despite prior treatments with other cancer drugs.

    Ongoing clinical trials have been aimed at figuring out how effective T-DXd is compared to other drugs, and when it should be implemented in treating advanced HER2-positive breast cancers.

    One clinical trial compared T-DXd as a follow-up treatment against trastuzumab emtansine (T-DM1), an earlier antibody drug that combined trastuzumab with a different chemo agent.

    The 524 patients in that trial randomly were treated with one of the two drugs, after they had stopped responding to initial therapies.

    About one in five patients (21%) wound up cancer-free following treatment with T-DXd, compared with nearly 10% of those receiving T-DM1, the researchers reported.

    Further, more than 78% had some clinical response to T-DXd, compared with 35% responding to T-DM1.

    Patients treated with T-DXd had nearly 29 months of progression-free survival on average, about four times the 7 months seen in patients receiving T-DM1, which is sold under the brand name Kadcyla.

    Patients who received T-DXd also had a 36% lower overall risk of death than patients treated with T-DM1, said clinical trial researcher Dr. Sara Hurvitz, a professor with the University of California, Los Angeles, Geffen School of Medicine and Jonsson Comprehensive Cancer Center.

    “These updated results do demonstrate remarkable (overall survival) and (progression-free survival) benefits, solidly placing T-DXd as the standard of care,” Hurvitz said in a news briefing.

    The other clinical trial compared T-DXd to standard chemotherapy as a follow-up treatment.

    The trial involved more than 600 patients whose breast cancers had continued to grow following T-DM1 treatment. About two-thirds received T-DXd, and the rest received chemo.

    Breast cancer patients were 64% less likely to die or have their cancer continue to spread following treatment with T-DXd compared to chemotherapy, the researchers found

    Average progression-free survival was nearly 18 months with T-DXd, more than twice the 7 months achieved with chemotherapy.

    Overall survival also was significantly longer, 39 months on average for T-DXd patients compared to 26 months with chemo.

    About 14% of patients wound up cancer-free following T-DXd treatment in this trial, compared to 5% for chemo.

    The trial “confirms the favorable benefit/risk ratio of T-DXd in patients with advanced HER2 positive breast cancer,” said clinical trial researcher Dr. Ian Krop, chief clinical research officer at the Yale Cancer Center in New Haven, Conn.

    In both trials, the most concerning side effect of T-DXd was damage to the lung, either through inflammation or scarring of lung tissue.

    About 6% suffered lung inflammation and 3% lung scarring in Krop’s trial, while about 15% suffered lung inflammation or scarring in Hurvitz’s trial.

    It’s not yet clear why the drug would cause these side effects in the lungs, Hurvitz said, noting that it doesn’t seem to be driven by the cancer spreading into the lungs.

    “We should, as clinicians, continue to follow CT scans of the lungs closely in our patients being treated with T-DXd, because this is an event that can occur even up to a year or longer of a patient being on therapy,” Hurvitz said.

    Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

    More information

    The American Cancer Society has more about HER2-positive breast cancer.

     

    SOURCES: Carlos Arteaga, MD, chair, comprehensive oncology, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas; Sara Hurvitz, MD, professor, University of California, Los Angeles, David Geffen School of Medicine and Jonsson Comprehensive Cancer Center; Ian Krop, MD, PhD, chief clinical research officer, Yale Cancer Center, New Haven, Conn.; presentation, San Antonio Breast Cancer Symposium, Dec. 6 to 10, 2022

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