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The Treatment Resistance Problem

Posted 1/1/2014

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  First, wishing you all a Healthy and Happy New Year. "Healthy" comes before "Happy" here as we all know that without the health part, happiness is much harder to find. We all also have learned to notice and really appreciate our times of good health. New Year's Day is also our wedding anniversary, and it has been wonderful to celebrate this marker each year on January 1st. We always have a holiday and people usually remember it. Perfect.

  Today's entry is about the complex and perplexing and important issue of treatment resistance. Women with metastatic breast cancer, actually people with metastatic any kind of cancer, live with "forever" treatment. The basic plan is one treatment as long as it works and then a change to another when the disease progresses--as it inevitably does. The cancer cells figure out how to resist any particular treatment and then a change is needed.

  Cancer cells are really smart and mutate in ways to outwit whatever we throw at them. The hope is always that it will take a while for this to happen, so that the value of a treatment is long-lasting. I know one woman with metastatic/Stage IV breast cancer who has been on the very same treatment, Taxol and herceptin, for fourteen years--and her cancer has been completely stable all this time. That is the record in my acquaintance.

  From Cure Today comes this article about this problem. Don't be misled by the overly sunny title, but we are making progress.

  Solving the Treatment Resistance Riddle

Celeste Mills lived with metastatic breast cancer for 14 years before her unexpected death in August. Between 1999 and 2013, she underwent a succession of treatments involving various chemotherapy agents, targeted drugs and combinations. “Whenever we started to lose some ground, my doctor added different medicines,” Mills said. “One would kick it back for awhile, then it would stop working, and we’d try something else.”

Mills, who lived outside Los Angeles, said she wasn’t surprised that dealing with her cancer turned into such a complicated affair. “These cancer cells have been living here a long time,” she said. “They know my body better than I do.”

In many ways, she was right, says Michael Gottesman, head of the multidrug resistance section at the National Cancer Institute in Bethesda, Md. “The cell will do anything it can to survive,” Gottesman says. “Biology is trying to outwit us.”


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