A positive spin for triple negative breast cancer
The Grace Gawler Institute has assisted many women diagnosed with TNBC and we have had a surprising number of successful outcomes. These patients have taken part in our more intensive services, Survivorship Care Plans.
They have been able to combine in the best of medical care in Australia including minimally invasive treatments.
In addition we have guided and supported them whilst they attended our recommended clinics for treatments overseas, not available in Australia. Long term support, guidance and complementary medicine has been provided to maintain wellbeing and prevent recurrence.
Grace Gawler Institute TNBC Initiative 2024
Alison’s Gift – Creating a better journey for women diagnosed with TNBC
- When Alison spoke of you she would talk of better ways for patients to be treated. A more individualised medicine so that it would be known beforehand if treatments could be effective. Talking of you gave Alison more energy and a more positive view to the future. We know working with you improved her quality of life and gave more time with her family. She would definitely want to see others receive that special kind of support that you were able to provide her with. That is one of the reasons for our passing Alison’s Gift to you. (Alison’s support team, November 12, 2023)
Alison M – A Breast Cancer Legacy
Triple negative Breast cancer (TNBC) 2016-2022
In-house Research: In these circumstances I always action a full case review to be sure that no stone was left unturned for a client. I look at treatment side effects, past and current, access to targeted treatments, roadblocks encountered whilst navigating the maze, etc.
These reports are confidential but powerful, and remain in each patients file serving as reminder of the challenges that cancer brings.
There is a client I would like to honour on the Institute’s Survivor Stories page because her story highlights the many challenges faced by patients who have failed to respond to standard of care treatment, and who then extend their lives by discovering a whole new approach called precision medicine. This includes personalised care and genomic diagnostics.
Alison M was initially diagnosed with TNBC (triple negative breast cancer) in September 2016. Her story appeared on this page as a survivor who was still diligently navigating the survivorship maze. After several surgeries and multiple types of treatments, Alison wrote in her first email in August 2020 when she joined our Survivorship Plan, “As someone who has travelled what I call “the conveyancer belt” of standard surgeries and treatments which are rarely targeted or effective for TNBC, I was enlightened to see your comment that not all TNBC is the same disease”. Also, she often said and wrote, “I am grateful for many things in my life and one of them is definitely you, Grace. I wish I had found you sooner.”
SURVIVOR STORY: Sandra B. NSW. Long Term Survivor – Diagnosed 2014
Triple Negative Breast Cancer (TNBC) locally advanced, both breasts. Still in Remission 2023
I was shocked when diagnosed with triple negative breast cancer, a high grade carcinoma with lymph node involvement.
The doctors said that my cancer was locally advanced with several lumps evident on scans throughout my breast. I had only found one lump which I ignored for several months before seeking help. When further suspicious nodes were found I began to lose hope.
Your life is worth a second opinion
SURVIVOR STORY: Alexa M. Victoria. Long Term TNBC Survivor.
Diagnosed 2015 – locally advanced. Still in Remission 2023
Alexa’s case highlights the need for second opinions.
Alexa – Early in 2015 at 54 years of age I underwent a lumpectomy and chose not to have follow up treatment.
My breast lump was relatively small, and surgeons said they had performed a wide excision and although they recommended, I follow up with either chemotherapy alone or radiotherapy or both to be sure. Under the microscope my small lump was a triple negative breast cancer.
How 3 negatives can become a Positive
ER, PR & HER2 – (the 3 negatives):
BE PROACTIVE: As with any cancer diagnosis, especially TNBC, it is important to understand the nature of your cancer; this is fundamental to making treatment choices & your long-term survival.
TNBCs are a specific subtype of epithelial breast tumours. They are usually diagnosed by biopsy or from tissue removed during surgery; such as lumpectomy or mastectomy.
HER2 is a gene that can play a role in the development of breast cancer. Approximately, 10–14% of breast cancers diagnosed are triple negative.
Advanced TNBC can become HER2 Positive:
When TNBC cells have spread i.e. are in circulation or moved out of breast tissue into organs, biopsies from the new locations (other than from the original biopsy) should be re-tested for hormone receptivity. You may be surprised to learn that cancer cells in order to survive, can change the way they behave.
For example; if you have been intensively treated with chemotherapies, radiation or targeted treatments your cancer can morph and change behaviour. In TNBC this stage is often called – chemo or treatment resistant. LINK – TNBC that progressed as estrogen receptor-positive skin metastases
Genomic diagnostics Essential for targeting TNBC treatment
Genomic diagnostics provide you & your treating practitioners with a unique genetic fingerprint of your cancer type; thus influencing your treatment choices.
TNBC requires a personalised cancer medicine approach and regular monitoring over many years.
Because TNBC harbours substantial genetic variations along with 6 subtypes; fine tuning your diagnostics utilising the latest genomic technology is highly beneficial.
Genomic Diagnostic Tests for patients on Survivorship Care Plans
The health of your gut microbiome can be measured using a faecal sample. This can determine the health of your gut based immune system.
Radiation Sensitivity Assay: Genomic testing for a gene variation can indicate if you will experience radiation induced fibrosis. (RIF) This knowledge may open up other treatment options.
Pharmacogenomics test (PGx): Explores your drug response based on genetic make-up, helping your healthcare provider choose between medical drugs that are problematic and those beneficial.
This analysis provides a personalised report based on the molecular profile of your tumour. The purpose is to provide you and your oncologist options with therapy options including targeted clinical trials.
Tumour Mutational Load (TML):
Based on your DNA; results of this analysis can be classified into a high or low TML. This shows the likelihood or not, of your response to drug based immunotherapy.
Cell free DNA Testing:
Also called a liquid biopsy. These Results can help your oncologist determine treatment success. Cell free DNA can also be used for monitoring your situation when treatments have ceased.
Cancer navigation is essential for those diagnosed with TNBC
*Aims to form a close, trusted & personal therapeutic alliance with you.
*Researches on your behalf & advises you through the important decisions.
*Advocates for you – with doctors, clinics and medical systems.
*Helps bridge gaps in communication between all your practitioners.
*Liaises with oncology & other practitioners on your behalf.
*Encourages you to obtain & keep medical records updated & orderly.
*Manages the whole picture of your health and cancer recovery.
Know your Cancer Navigator!
It is imperative you know about the diverse experience, training and background of any qualified integrative doctor, naturopath or other person who is advising you about Cancer Navigation.
Your life depends upon the experience, skill, integrity, authenticity, information, and quality of guidance provided by your Cancer Navigator.
Dedicated Cancer navigation is a key component of our Survivorship Care Plans. We recommend becoming familiar with your cancer navigator’s background by selecting the following links – Grace’s milestones – About Grace Gawler – Podcast BBC, UK. Grace interview