UAB Comprehensive Cancer Center Magazine - Spring 2016 - Page 6

survivor profile Breast cancer is the most common cancer for women age 15 to 39, and women ages 15 to 34 die more frequently from breast cancer than any other cancer. 8 U A B about the options in preserving their fertility.” Indeed, with her treatment options potentially jeopardizing her ability to have a family, Jessica met the next day with G. Wright Bates, M.D., professor of reproductive endocrinology, and his team. “Many available therapies, while very successful in treating cancer, can impact the egg quality and number or a woman’s ability for future fertility,” Dr. Bates says. “For this reason, the initial consult with the oncology team is absolutely crucial to the patient.” As with her cancer treatment, Jessica had options on how to preserve her fertility. But just like other women in her situation, what she did not have was a lot of time. Treatment for breast cancer typically does not have to start immediately, but she did not have months to wait either. After consulting with Dr. Bates’ team, she decided to have her eggs harvested and frozen. She had a three-week period to accomplish that before she started chemotherapy. “It takes at least two weeks to prep the ovary with hormonal stimulation and harvest the eggs,” Dr. Bates says. “It’s a fairly simple procedure; there are no incisions. It’s an ultrasound-guided needle biopsy of the ovary with anesthesia, so the patients are very comfortable. We’re actually now freezing both eggs and embryos or fertilized eggs, very successfully, and Jessica’s case is a prime example.” Cancer treatment A woman who is diagnosed with breast cancer at UAB meets with an oncologist, surgeon and radiation oncologist as quickly as possible after diagnosis to discuss treatment options. In Jessica’s case, she met with oncologist Andres Forero, M.D., radiation oncologist Jennifer de los Santos, M.D., and Dr. Krontiras. A breast cancer diagnosis in young women like Jessica is rare; estimates from the Young Survival Coalition are that 13,110 cases of breast cancer are diagnosed in women under the age of 40 each year. However, breast cancer is the most common cancer for women age 15 to 39, and women ages 15 to 34 die more frequently from breast cancer than any other cancer. “Patients as young as Jessica usually don’t have as good a prognosis as patients who develop cancer in older ages, because often those cancers in younger patients tend to be more aggressive,” says Dr. Forero, a Cancer Center senior scientist. “Unfortunately, we are seeing more and more younger patients being diagnosed with breast cancer.” UAB’s team of physicians came up with a plan for Jessica that included three different types of therapy, including local therapy of the breast cancer with surgery and radiation therapy. They also treated Jessica systemically with chemotherapy. C O M P R E H E N S I V E C A N C E R C E N T E R The physicians gave Jessica all of her treatment options on that visit. She ultimately chose to take part in a clinical trial, a research study that for her consisted of 12 chemotherapy treatments for 14 weeks. When that was completed, she had four treatments of Adriamycin and cytoxan every other week. She then had her lumpectomy on March 7, 2012, six months after her diagnosis. “I discussed in detail whether I should have a lumpectomy or a mastectomy, and if I had a mastectomy, should it be one side or two,” Jessica recalls. “Dr. Krontiras was pretty emphatic that the research has shown that there really wasn’t much difference — at least in my case — so we did the lumpectomy. It’s an easier procedure with a shorter recovery time, and if the outcome is going to be the same, then that made more sense to me.” Freezing embryos of frozen eggs Two years later, gFW"W766BvB'&VBBfvr7V66W76gV66W"G&VFVBFR6WRFV6FVBFW'7VRf֖ǒG"&FW>( FVFvVBW766( 2Vvw2fW'FƗV@FVvFv( 27W&BVBFFV''G&6fW"'WBf"vFWfW"&V6W766( 0VFWG&VFBB&W7BFvW&RG"&FW2fV@6f'F&RVVvFG&6fW"FRV''2( vRfR6WfW&&W'2FBvRW6Rf &V6WFfGvFFRvbW"vfrFRFVG0FRFV66Rf"&Vv7( G"&FW262( 666ǒFRVFWG&V2B&VG@FN( 2vBVVBvFW766( ХvW2VFG2B66VFf2F&V7F"`767FVB&W&GV7FfRFV6vW2vfW'6VW2FPW&FbT.( 2fG&fW'FƗF&&F'&W&VBW766( 2Vvw22FVvW"&GvVB&P&VGvVFRVvr6V2vW&RfW'FƗVBFWw&WpFR"f"fWrF2VFFW&V6RV''2@v2BFBBG"&FW2FV6FVBBv2BFVFG&6fW"FVFW766( 2WFW'W26FRFVFVBFg&VWRFRV''2BG'vfWrF2FW"गB2BV6Fg&VWRV''2F066V&'WBB2WG&VVǒ&&RFg&VWRV''0FBvW&Rg&V27FW2"Vvr6V2G"VFG062FB&W6V&6( BB&WfW27V66W76W2vFF2WFBBT"( BvfRW766Bvv@66RF&VƗR&Vv7( vF&V6VBGf6VVG27'&W6W'fFFV6vW2v^( &R6VVr&RB&RbFW6P7V66W727F&W2( G"VFG262( W"W"G&6fW &Vv7&FW2f"7'&W6W'fVBV''2&P7W'&VFǒWVF"WfV6ƖvFǒ&WGFW"FF6PvR6VRvFg&W66R76RV''G&6fW'2v@F2V22FBW"7'&W6W'fFFV6VW2&Pfr֖bVvFfR7BFRVƗGbFRV''2f'GVFVǒvRvW&R&RF6WfPF27V66W72f"W766Fv6&VǒvfW2W2w&V@W'66F6f7FFRVFvRfVVvVF027V66W76gV2fbFR6'G2&V6W6RvRrv^( &PVrW"FVG26WfRFV"v2b&V6֖p&VG2N( 2W6WFǒ&Wv&Fr( ХvFFRV''2&Vg&VFR&W&GV7FfRFVЦvfRW766( 2WFW'W2Gv&RF2F&W7BFG&VFVBBBF6R&W'2f"&V6WFfG&Vf&P&6VVFrvFFRV''G&6fW"खfV&W"#BGvF2gFW"FRf'7@GFVBFG&6fW"FRV''2v2WBBGvV''2vW&RG&6fW'&VBFW766( 2WFW'W2BPbFV( F( fǒBv2ff6W766v0&VvBBGVRFvfR&'FVǒ#RगBv2r&BfVvBW&WFvWBF&Vv7'WBW766626Rv2WfW"6WF6F@FRfW'FƗG&W6W'fF&6W72v2vrFv&( ĒfRFRWF7BfFG"&FW2B2VF&PFVBFV"&ƗFW2( W76662( FB6BvB7FWrFW&Rv266RBvVF( Bv&Fr2WfW"W&6VBBbBFF( Bv&( @BvRǒBGvV''26F2v2CF2v0W"R6B( BvVBfR&VV6B&WBB'W@FW&R&RFW"v2FfRf֖ǒR6F@V''2R6FB&&W2vVBfR&VVF6FVB'WBBvVF( BfR&VVFRVBbFPv&BBBFBV7BG'( РFR&Vv7W766( 2&Vv7v2&WB26F26P6VBfRVB6RWfW"BW6V6P7F'FVBFvWBF&VBV6ǒFv&BFRVBv62&&Vv6W2BvV^( &P6''r&r&'FR&7VW"VB@W2BWfVV6W"FVFW'7FB'WBFR&W7VBVǒ##Rv2WfW'FpW766Bv6VBfRVBgFW"fW&6֖p6'7F6W3vƖ6W"7&2v2&&খT.( 2vVBfG26VFW"2VBBV6RVF&'( ėBv267W'&V( W76662( ĖbRBF@R&6vVv2Fv6VBFBRF( B&RF( BFvVN( fR&VƖWfVBR'WBFPvRWW&V6Rv2W7Br&Vr&RF@גƗGFR&2FR&W7BfVVƖrFRv&B( ФW7662V6FFW"662@6&VvfW'2f"FV"WW'F6RVBwVF6RFRvF&VvW"G&VFVBF6W.( 2&'F@&WB6R6FVW2F&V6VfRw&2WfW'6F2B6Rv&R&R&V6WF &6W"f"V'226FV6RbG&VFVBf FR'&V7B66W"vR6R626R2f&WfW"w&FVgVf"rW 662vW&R&RFG&VBFR66W"6^( 26FgVFBFWV6W&vVBW"F&WBW VFFRFv6W2fW"V'2vB66FW"v@W"ƖfR֖vBƖRFvFR&B( 'fW6ǒFWvBF6fRW"ƖfR'WBPFfRFF&WBvBV2gFW"^( &PG&VFVB( W76662( ėN( 2vVBvBFƗfR'W@vB&WBFRSV'2bƖfR"&RRfP6RW"G&VFVB26WFVCFN( 26WFpFWFF( Bv&R( fW'vBFBBFBf'7@FVBG"f&W&6B( bRvBFfR&'RVVBFFƲFG"&FW2( ( Фf"FR662FW6VF( B&RW"f W766( 27V66W76gV66W"G&VFVBBW&WFFW&BgFW"6R6WFVBG&VFVBG"f&W&vBFrW76626VwVRvV6Rv&VB2&Vv7FW&VBW'6RT.( 2gW6FW&6Ɩ72( ĆVrW"vF&VvF0Fff7VB&6W72BFVvF`FW6R77VW22fW'&Wv&Fr( G"f&W&62( f6rFRFW&@vrvRvfRW"66R&6V@&W6V&6FB6R6&R7W&VBBFR7B&Wv&Fr'B6VVpW"&RFW"BVrW"vF&VvFR&6W72BvWBFF@BvWGFr7BFR熖WG`7FrW"VF6FB6VVpW"fRvFW&gVfVǒ&'गN( 2&Wv&FrN( 2r@vVBFV6FRV'Bb&G( Ю( ĦW766( 266R2&PWRbv( 2W'67FV6PBFW6&RF&R( G"&FW2FG2( vRvW&Rf'GVFPF&fFRW"6RRFRvRb'&V7B66W Fv62BN( 2W7V6ǐ6F6grf"גFVBPF6VRFRVB&W7VG2BW2W2WfV&P6 ֗GFVBFfW'FƗG&W6W'fFBWfV&PFgVFBvR&R'Bbw&VB7FGWFƖPT"FB2BFRf&Vg&BbFV6wWBFW0FRFRF6&Rf"FRFfGVBG&VBFRvPW'6( ФW766v2&VV7GVFVBT.( 266`W'6rBFVBT"7V6FW2B0rW'6R&7FFW"BT"W2W"7F'7&RFW'2FW&RFV"F2( FRRFrRF27F'vfW2FW'20R( 6R62( ėN( 2r7F'7&VF&PRFBBbVRBBw&FrFW6P&RrVRvVVBvfRRRג7BFW7W&FRFRRF27F'2&RFFFR6Rf"FW'2( Т2rR"220( R"RBR22R