Breast cancer awareness—know your options


Sometimes people just get the genetic short end of the stick, but you’d never know Tammy Coleman was one of those people.

Her upbeat personality and contagious enthusiasm belie two heart attacks, a stroke, congestive heart failure and complications related to high blood pressure. And that was all before she was diagnosed with breast cancer—something that ran in her family.

Genetic testing revealed her as the recipient of a genetic mutation that made it highly probable she would develop ovarian cancer too, so within one day Coleman received a double mastectomy and complete hysterectomy.

She had to do chemo, and doctors recommended radiation as well. Because of her existing health problems, particularly related to her heart condition, specialists recommended proton therapy. The targeted nature of protons allow for the benefit of radiation therapy without the collateral damage to surrounding healthy tissue in heart and lungs.

Initially, she was apprehensive about proton therapy.

“When I first walked into Provision I was a nervous wreck,” she says. “I was so scared. I knew protons are still radiation. I thought, ‘That looks like the weirdest machine I’ve seen in my entire life, and you want me to lay on that table?’”

Her fears were unfounded, however, and she discovered a second home at Provision.

“When you’re sitting in a regular medical facility, nobody talks to anybody,” Coleman says. “At Provision, everybody’s so friendly. All the guys, they became my brothers and dads and cousins. I feel like I gained a whole new family by being here.”

Breast cancer: Making the diagnosis

More than a quarter of a million women are expected to be diagnosed with invasive breast cancer this year. Breast cancer is the second most common cancer among women (next to skin cancer). Breast cancer also has the second highest rate of cancer-related death (next to lung cancer).

More than 40,000 women in the U.S. are expected to die from breast cancer in 2017.

Among younger women, under age 45, African Americans are most likely to be diagnosed with breast cancer, and African Americans are most likely to die from the disease. White women are the next largest group, with Asian, Hispanic and Native-American women less impacted by breast cancer.

Those at highest risk of breast cancer have a mother, sister or daughter who has been diagnosed. However, less than 15 percent of those who get breast cancer have a first-degree relative survivor. An even smaller number of cancer cases are linked to specific genetic mutations of the BRCA1 and BRCA2 genes, which significantly boosts the likelihood of developing breast cancer.

The largest group of women to be diagnosed with breast cancer are those in their 70s.

Current recommendations call for women ages 40-44 to have a choice for annual mammograms with a recommendation of regular, yearly screening among those age 45 to 54. Women over age 55 can switch to every two years for annual mammograms.

Proton therapy a treatment of choice

In recent years, science has proven that women who receive conventional radiation treatment for breast cancer are also receiving unhealthy doses of that radiation in their hearts and lungs.

In the New England Journal of Medicine, an article published in 2013 declared women’s risk of a “major coronary event” went up by 7.4 percent for every gray of radiation exposure to the heart. Radiation dose for a typical breast cancer regimen is 50 gray.

The article concluded: There is no safe level of radiation exposure to the heart.

Likewise, research has shown that patients can contract pneumonitis from even low doses of radiation.

What is the solution? Proton therapy.

A recent pilot study shows that using proton therapy for breast cancer instead of conventional radiation resulted in less than ½ gray radiation dose to the heart and .6 gray radiation dose to the lungs. In addition, patients did not experience pneumonitis or the fatigue typically associated with conventional radiation therapy.

Choosing proton therapy over conventional radiation also reduces the risk of succumbing to secondary cancer, essentially cutting the risk in half of more, depending on the type of radiation technology used.

“Proton therapy completely transforms the outlook for women with breast cancer facing the long-term impacts of conventional radiation therapy,” said Dr. Allen Meek, radiation oncologist and medical director for Provision Medical Group. “With proton therapy the heart receives just .2 Gy of radiation exposure compared to 10 Gy with conventional photons. It’s a life-saving treatment in more ways than one.”

Proton therapy patient becomes advocate

Since her cancer diagnosis, Coleman has become quite the spokeswoman for breast cancer awareness, participating in local events and signing up for cancer runs and spreading the word on a Facebook page she has set up for that purpose.

She’s also become an advocate for Provision CARES Center for Proton Therapy and Provision.

“This is my passion now,” she says.