Mobilization to Survive Breast Cancer

By Mike Halliwell

Since Betty Halliwell's diagnosis with a very aggressive form of bilateral breast cancer (detected in time to be treated effectively by mammograms at age 47 and 48), Mike Halliwell has been a pioneer in improving breast cancer therapy. (See http://www.csulb.edu/~halliwel/). This is discussed in excerpts from Halliwell's October 28, 2004 speech at the Petaluma campus of Santa Rosa Junior College.

Marin County has the highest rate of breast cancer in the nation. However, recent data have shown that San Francisco may be catching up and Sonoma County is not far behind. If an effective political defense against creeping toward a single payer system and away from more diversified health care cannot be mounted in this highly educated area, where can women expect to improve their chances of survival from this disease? .... Betty Halliwell's fight against breast cancer has been thirteen years of trying to make her one advantage, the early detection and removal of her tumors, stand up against a tumor growth rate, that has about the greatest potential for recurrence found anywhere in the medical literature. (The March 1992 of the Journal of Clinical Oncology reports a 22% five-year recurrence rate for a category of tumors with a slightly higher upper size limit than Betty's primary cancer, the same estrogen-receptor status, and which like hers, had not spread to the lymph nodes; according to the relationships found between tumor growth rate and recurrence risk, a breast cancer with the same growth rate as Betty's had the worst prognosis of the 247 tumors examined.) Fortunately, this warning that Betty was at the 99.6 percentile in terms of her risk of recurrence, was published almost exactly when she reached the six-month point where it is recommended that post-operative chemotherapy stop. After an extensive search I was able to find a cancer specialist who was willing to continue chemotherapy and hormonal therapy far beyond their recommended maximum durations.

Since I teach statistics, I expected that all we could do was "go down fighting," because I didn't expect that simply extending the use of the standard therapies would be sufficient to hold in check the most aggressive of breast cancers. However, it eventually became apparent tht hormonal therapy was slowing down the breast cancer growth rate to the point where chemotherapy could be spread out enough for normal tissues to fully recover between doses, and that four cycles of chemotherapy per year were sufficient to "harvest" the minority of breast cancer cells which seem to be stimulated by long-term hormonal therapy. There is no apparent reason that a continuing therapy which can hold the most aggressive breast cancer in check for thirteen [now fifteen] years, would not work for any breast cancer if it is caught at a sufficiently early stage. Accordingly, at long last, I can see an advantage to fighting a frequently lethal disease from the very worst position on the battlefield -- IF WE CAN HOLD THIS POSITION WE CAN WIN THE WAR.

[In the two years since 2004, exciting designer drugs like Herceptin have been validated by clinical trials for use in the prevention of recurrences. Everyone who is following breast cancer research knows that due to advances made possible by our new knowledge of the human genome HELP IS ON THE WAY. The "poster child" for Herceptin therapy, mentioned by its developer Dr. Dennis Slamon at numerous breast cancer conferences, was "so close to death's door" when she was one of the first to receive this drug, that doctors chose her because she seemed to have "little to lose" from takiing a therapy not previously tested on humans. That lady survives today, a decade later, with no sign of cancer. Part of the credit for this miracle belongs to her doctors who fought "tooth and nail" with every combination of the available therapies they thought might work, to keep her alive as long as possible BEFORE they had any reason to think something like Herceptin might be coming their way. Today women fighting breast cancer should heed the command given to the 82nd airborne division who were assigned a key bridge near St. Mere Eglise, to prevent a Nazi counterattack against American troops landing on Omaha Beach on June 6, 1944: "HOLD UNTIL RELIEVED, HOLD UNTIL RELIEVED." Sixty-two years later on June 6, 2006, I hope you will help me to fulfill this same command.]