This week has been a tough one.  Not only because I have had to travel to the East Coast twice (I am the one sitting on the plane with a mask on, Purelling the seat because of my continuing immunosuppression from my transplant) but more importantly, because of three things that have put me over the edge.  I met in Boston with a patient of mine from over 20 years ago who at that time was diagnosed with DCIS.  I operated on her several times trying to get clean margins and ended up doing a mastectomy.  She is doing well for her age but what got me angry is that we have not progressed in 20 years.  Women are still having surgery with dirty margins and mastectomies.  Why don’t we have a way to image DCIS so that we can see its extent prior to surgery?   Why haven’t we figured out who is in the 30% that needs treatment and who isn’t?  Why hasn’t anything changed?

I then got a call from a young woman pregnant with twins whose breast cancer had locally recurred.  What should I do, she asked?  The answer is we don’t know!  She has enough to deal with in terms of the pregnancy but we can’t tell her whether carrying the pregnancy to term will make a difference in the outcome.  In my 32 years of practice we have progressed enough to parse the 5-6 different kinds of breast cancer but not enough to know what to tell this young woman!

The final straw was reading all the questions you submitted on collateral damage. It broke my heart to hear about the women who had not been told that their reconstructed breasts would never have sensation, that chemobrain doesn’t get better, that all these drugs cause significant side effects, most of which don’t go away!

What have we been doing over the past thirty years?  There are a few big wins.  Herceptin means that women with HER-2/neu overexpressing tumors don’t die within three to five years as they used to.  Knowing about and being able to test for the BRCA 1 and 2 gene mutations means we can sometimes actively prevent cancer, although through very crude means; i.e., prophylactic surgery.  And we now have a better handle on who benefits from chemotherapy and who doesn’t, saving some women significant side effects.  But really….in 30 years?  Shouldn’t we have taken care of this by now?

And who is to blame?  I think the answer is all of us.  Sometime during the last thirty years, we allowed ourselves to become complacent, accepting slightly better treatments as triumphs and cosmetic surgery as better than nothing.  We accepted awareness as a goal rather than prevention while “celebrating“ more survivors every year.  THIS IS NOT ACCEPTABLE TO ME OR TO YOU, MUCH LESS TO FUTURE GENERATIONS!

It is time to all join together whether metastatic or not, BRCA+, triple negative, young, old, male or female to say ENOUGH!  We will no longer accept “me too” drugs that are slightly better or chemotherapy that adds a couple of months to someone’s life.

We want the home run and we want it now!  We will not be good girls any longer! 

Get angry, get your friends angry, then do something about it. Be a part of our research through the Army of Women and the [HOW] Study, sign the NBCC’s Deadline 2020 petition, invest in our research by creating a local fundraising event to help us keep pushing the envelope. Or do all of the above. Don’t settle for good enough.

It is time to rekindle the anger that started the breast cancer advocacy movement 20 years ago but this time we will not stop until we have achieved a future without this disease!

 

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38 Responses to It is time to get angry!

  1. Most of us, or at least those of us with Metastatic Breast Cancer, are angry, and have been for a long time. The Breast Cancer community has been content with the status quo for too long and not wanted to bite the hand that feeds it. At last there seem to be some organisations that are prepared to tell these Emperors that actually they are not wearing Pink clothes and not making enough Pink progress. It is time to stop this charade and get some value for donated money in terms of treatment progress to improve the Quality of Life for those with MBC, and ultimately even save some lives. 458,000 will die of breast cancer this year. This is not an acceptable return for the £, $ and Euros etc which have been given to enable progress to be made.

  2. Diane OBrien says:

    Here’s one for you. I went to the pharmacy to renew the lestrezole and noticed that the drug co had changed. Yes, I know generics should be equal but when I questioned why they weren’t using the same co the pharmacist got very pissy. The company was Ranbaxy-I went home and did some research and found out about sanctions on this company and now the story has come out about this company re lipitor due to a whistle blower in the company.
    I went to another pharmacist who told me there was a shortage of this drug. Well gee my oncologist didn’t mention this in fact he sent my lab results without any comment. SO yes I’m made at the complacency by the people that provide care and the copious numbers of organizations including these providers who want are support. Most of the people I know in my family that had chemo adjuvant therapy have trouble with muscles or developed fibromialgia. Im glad i advocated for myself but why didn’t the FDA know about Ranbaxy sooner. If there doing this with drugs there’s bound to be others. SInce my treatment I was hospitalized with sepsis,got another staff when they had to perform an ultrasoound and now a third staff. Makes me wonder if its lying in wait in my body. Every time I have a blood test on the left arm(my infection was in the left breast originally) my arm swells and black and blues. Aren’t our doctors suppose to care or is it just the research they care about. Damn damn damn!

  3. Sharon Gunther says:

    …and they/we know nothing about PERINEURAL INVASION in the breast! It showed on my last months biopsy reporting a BC recurrence. This after chemo, lumpectomy, sentenal node, and radiation 2011 to 2012. Want to hear a quiet doctor? Ask questions about this! I spent 20 hours hunting on smart peoples: scholar.google.com,
    and found only one article that says “perhaps 1 day we will know more about PNI in breast cancer”!!!!!
    It is most common in pancreatic, prostate, and head and neck cancer, and offers a poor prognosis. Gee, why
    would it be any different in BC? Double damn. Had my double mastectomy week ago, will get results this wednesday, and I sure hope they are at least able to say the PNI is gone, and has not gone to the Central Nervous System. Why has this not been figured out yet! They like to talk lymph nodes, as they know more about that. Not this. scared and angry.

  4. Natalie Kase says:

    I was diagnosed 24 years ago with breast cancer, right side. I had a mastectomy, chemotherapy and reconstruction; hormone receptors negative. 1 1/2 years later suspicious cells appeared in my left breast. I was very naive, very, very naive and very angry when I learned that nothing much more had happened in the research of breast cancer! I had another mastectomy and reconstruction. So it is now 24 years, and from my vantage point, not too much has happened! I have been angry for many, many years…and I do not think I will see much more information on the cause and cure of this damn disease in my lifetime!

  5. Robin Keuneke says:

    Very moving and eloquent, Dr. Love. Once again, you have found the words to express what so many of us feel.
    Thank you.

  6. Kathleen Cahill says:

    I have been angry about all of this ever since I was diagnosed in 2006! To be played as a puppet between a Breast Surgeon and an egotistical (I am the chosen doctor to all other doctors wives) I could care less, who the path report said margins not clear, Surgeon saying yes they are, I know they are, to the Oncologist saying go back to Surgeon and demand re-excision or he won’t do anything for me! I am sick of the DAMN PINK PARTIES! My experience is so far to the black side that I am beyond anger! I even had you tell me anger is not good. Well these two doctors created such panic attacks, severe anxiety that I refused to go to anymore doctors! That was April 2006 lumpectomy ER/PR + clear nodes. Finally I went to another Breast surgeon in November 2006 who did the re-excision which was clear but was concerned as I had received no other treatment since original date. I did radiation for 7 weeks with one week boost. Cancer back November 2007 – bi-lateral mastectomy put on Lupron with Aromasin. I have had 3 more recurrences since! You wonder WHY I am angry? The Doctors out there love the term ” Standard of Care”. Not all women or men are the same at all for there to be a “Standard of Care”!

  7. Margaret Andrews says:

    Very well written column…As a 14 year survivor, and one who had to have her first lumpectomy changed to mastectomy because of not clear margins I echo who you write. It would have been better to get it all the first time. As a daughter of someone who died of breast cancer, and one, myself, who also had biopsies on the second breast with magnifications and tests decided to remove the second breast 8 years later when Mom died of recurring cancer after 20 years, I applaud your words. As someone who wonders, after the radiation, chemo, 2.5 years of tamoxifen, and 10 years of Arimidex if her cancer will reappear I too, hope that 30 years of treatment and research will make the difference in my history and I won’t echo what happened to my mother.

  8. Kathleen Cahill says:

    Egotistical Oncologist

  9. Melanie says:

    Lunasin Research Abstracts

    1. Lunasin Peptide Upregulates Thrombospondin 1 (THBS1) Gene Expression in Non-Tumorigenic Prostate Epithelial Cells
    Alfredo F. Galvez, Liping Huang, Mark M.J. Magbanua, Kevin Dawson, Raymond L. Rodriguez, Nutrition and Cancer (2011), In Press.
    There is growing evidence supporting the role of epigenetic modifications in cancer formation as the result of dysregulation of gene expression, especially in the early stages of carcinogenesis. The objective of this study was to investigate the chemopreventive properties of lunasin at the molecular and cellular levels by examining gene expression patterns and the associated epigenetic changes in lunasin treated tumorgenic and non-tumorgenic prostate epithelial cell. The results reported may provide a molecular mechanism to explain the association between higher soy consumption and lower cancer risk.

    2. Lunasin Potentiates the Effect of Oxaliplatin Preventing Outgrowth of Colon Cancer Metastasis, Binds to ?5?1 Integrin and Suppresses FAK/ERK/NF-?B Signaling
    Vermont P. Dia, Elvira Gonzalez de Mejia, Cancer Letters, (2011), 37 (34)
    The effect of lunasin on colon cancer metastasis was studied using three human colon cancer cell lines in vitro and a liver metastasis model of colon cancer in vivo. Lunasin bond with ?5?1 integrin and internalized into the nucleus of KM12L4 human colon cancer cells. Lunasin (10 ?M) inhibited the activation of focal adhesion kinase (FAK) by 28, 39 and 60% in RKO, HCT-116 and KM12L4 human colon cancer cells, respectively. Lunasin caused an increase in the expression of the inhibitor of kappa B alpha (I?B-?), a decrease in nuclear p50 NF-?B and a reduction in the migration of cancer cells. Lunasin (4 mg/kg bw) inhibited metastasis and potentiated the effect of oxaliplatin by reducing the expression of proliferating cell nuclear antigen. Liver metastatic nodules were reduced from 28 (PBS) to 14 (lunasin, P = 0.047) while combination of lunasin and oxaliplatin to 5 (P = 0.004). The tumor burden was reduced from 0.13 (PBS) to 0.10 (lunasin, P = 0.039) to 0.04 (lunasin + oxaliplatin, P < 0.0001). Moreover, lunasin potentiated the effect of oxaliplatin in modifying expression of proteins involved in apoptosis and metastasis including Bax, Bcl-2, IKK-? and p-p65. Lunasin inhibited metastasis of human colon cancer cells by direct binding with ?5?1 integrin suppressing FAK/ERK/NF-?B signaling, and potentiated the effect of oxaliplatin in preventing the outgrowth of metastasis.

    3. Differential Expression of Thrombospondin (THBS1) in Tumorigenic and Nontumorigenic Prostate Epithelial Cells in Response to a Chromatin-Binding Soy Peptide
    Alfredo F. Galvez, Liping Huang, Mark M. J. Magbanua, Kevin Dawson & Raymond L. Rodriguez, Nutrition and Cancer, (2011), 63 (4), 623-636.
    The chemopreventive properties of the chromatin-binding soy peptide, lunasin, are well documented, but its mechanism of action is unclear. To elucidate the mechanism by which lunasin reduces tumor foci formation in cultured mammalian cells, nontumorigenic (RWPE-1) and tumorigenic (RWPE-2) human prostate epithelial cells were treated with lunasin followed by gene expression profiling and characterization of the chromatin acetylation status for certain chemopreventive genes. The genes HIF1A, PRKAR1A, TOB1, and THBS1 were upregulated by lunasin in RWPE-1 but not in RWPE-2 cells. Using histone acetyltransferase (HAT) assays with acid-extracted histones as templates, we showed that lunasin specifically inhibited H4K8 acetylation while enhanced H4K16 acetylation catalyzed by HAT enzymes p300, PCAF, and HAT1A. These results suggest a novel mechanism for lunasin-dependent upregulation of gene expression. Chromatin immunoprecipitation (ChIP) revealed hypoacetylation of H4K16 in RWPE-2 cells, specifically at the 5? end of THBS1 containing a CpG island. Moreover, bisulfite PCR (BSP) and subsequent DNA sequencing indicated that this CpG island was hypomethylated in RWPE-1 but hypermethylated in RWPE-2 cells. Histone hypoacetylation and DNA hypermethylation in the 5? region of THBS1 may explain the inability of lunasin to upregulate this gene in RWPE-2 cells.

    4. Lunasin-Aspirin Combination Against NIH/3T3 Cells Transformation Induced by Chemical Carcinogens
    Chia-Chien Hsieh, Blanca Hernandez-Ledesma, Ben O. de Lumen, Plant Foods for Human Nutrition, (2011), 66 (2), 107-113.
    Carcinogenesis is a multistage process involving a number of molecular pathways sensitive to intervention. Chemoprevention is defined as the use of natural and/or synthetic substances to block, reverse, or retard the process of carcinogenesis. To achieve greater inhibitory effects on cancer cells, combination of two or more chemopreventive agents is commonly considered as a better preventive and/or therapeutic strategy. Lunasin is a promising cancer preventive peptide identified in soybean and other seeds. Its efficacy has been demonstrated by both in vitro and in vivo models. This peptide has been found to inhibit human breast cancer MDA-MB-231 cells proliferation, suppressing cell cycle progress and inducing cell apoptosis. Moreover, lunasin potentiates the effects on these cells of different synthetic and natural compounds, such as aspirin and anacardic acid. This study explored the role of lunasin, alone and in combination with aspirin and anacardic acid on cell proliferation and foci formation of transformed NIH/3T3 cells induced by chemical carcinogens 7,12-dimethylbenz[a]anthracene or 3-methylcholanthrene. The results revealed that lunasin, acting as a single agent, inhibits cell proliferation and foci formation. When combined with aspirin, these effects were significantly increased, indicating that this combination might be a promising strategy to prevent/treat cancer induced by chemical carcinogens.

    5. Relationship between lunasin’s sequence and its inhibitory activity of histones H3 and H4 acetylation
    Blanca Hernandez-Ledesma, Chia-Chien Hsieh, Ben O. de Lumen, Molecular Nutrition & Food Research, (2011) 55 (7), 989-998.
    Scope: Dysfunction of histone acetyltransferases (HATs) or histone deacetylases (HDACs) involved in histones acetylation has been associated with cancer. Inhibitors of these enzymes are becoming potential targets for new therapies. Methods and Results: This study reports by Western-Blot analysis, that peptide lunasin is mainly an in vitro inhibitor of histone H4 acetylation by P300/cAMP-response element-binding protein (CBP)-associated factor (PCAF), with IC(50) values dependent on the lysine position sensitive to be acetylated (0.83 ?M (H4-Lys 8), 1.27 ?M (H4-Lys 12) and 0.40 ?M (H4-Lys 5, 8, 12, 16)). Lunasin is also capable of inhibiting H3 acetylation (IC50 of 5.91 ?M (H3-Lys 9) and 7.81 ?M (H3-Lys 9, 14)). Studies on structure-activity relationship establish that lunasin's sequence are essential for inhibiting H4 acetylation whereas poly-D sequence is the main active sequence responsible for H3 acetylation inhibition. Lunasin also inhibits H3 and H4 acetylation and cell proliferation (IC(50) of 181?M) in breast cancer MDA-MB-231 cells. Moreover, this peptide decreases expression of cyclins and cyclin dependent kinases-4 and -6, implicated in cell cycle pathways. Conclusion: Results from this study demonstrates lunasin's role as modulator of histone acetylation and protein expression that might contribute on its chemopreventive properties against breast cancer.

    6. Lunasin induces apoptosis and modifies the expression of genes associated with extracellular matrix and cell adhesion in human metastatic colon cancer cells
    Vermont P. Dia, Elvira Gonzalez de Mejia, Molecular Nutrition & Food Research, (2011) 55 (4), 623-634.
    SCOPE: Lunasin is an arginine-glycine-aspartic acid (RGD) cancer preventive peptide. The objective was to evaluate the potential of lunasin to induce apoptosis in human colon cancer cells and their oxaliplatin-resistant (OxR) variants, and its effect on the expression of human extracellular matrix and adhesion genes.
    METHODS AND RESULTS: Various human colon cancer cell lines which underwent metastasis were evaluated in vitro using cell flow cytometry and fluorescence microscopy. Lunasin cytotoxicity to different colon cancer cells correlated with the expression of ?(5) b(1) integrin, being most potent to KM12L4 cells (IC(50) =?13??M). Lunasin arrested cell cycle at G2/M phase with concomitant increase in the expression of cyclin-dependent kinase inhibitors p21 and p27. Lunasin (5-25??M) activated the apoptotic mitochondrial pathway as evidenced by changes in the expressions of Bcl-2, Bax, nuclear clusterin, cytochrome c and caspase-3 in KM12L4 and KM12L4-OxR. Lunasin increased the activity of initiator caspase-9 leading to the activation of caspase-3 and also modified the expression of human extracellular matrix and adhesion genes, downregulating integrin ?(5), SELE, MMP10, integrin ?(2) and COL6A1 by 5.01-, 6.53-, 7.71-, 8.19- and 10.10-fold, respectively, while upregulating COL12A1 by 11.61-fold.
    CONCLUSION: Lunasin can be used in cases where resistance to chemotherapy developed.

    7. Complementary Roles in Cancer Prevention: Protease Inhibitor Makes the Cancer Preventive Peptide Lunasin Bioavailable Chia-Chien Hsieh, Blanca Hernandez-Ledesma, Hyun Jin Jeong, Jae Ho Park, Ben O. de Lumen, PLoS ONE, (2010), 5 (1), 1-9.
    Background: The lower incidence of breast cancer among Asian women compared with Western countries has been partly attributed to soy in the Asian diet, leading to efforts to identify the bioactive components that are responsible. Soy Bowman Birk Inhibitor Concentrate (BBIC) is a known cancer preventive agent now in human clinical trials. Methodology/Principal Findings: The objectives of this work are to establish the presence and delineate the in vitro activity of lunasin and BBI found in BBIC, and study their bioavailability after oral administration to mice and rats. We report that lunasin and BBI are the two main bioactive ingredients of BBIC based on inhibition of foci formation, lunasin being more efficacious than BBI on an equimolar basis. BBI and soy Kunitz Trypsin Inhibitor protect lunasin from in vitro digestion with pancreatin. Oral administration of 3H-labeled lunasin with lunasin-enriched soy results in 30% of the peptide reaching target tissues in an intact and bioactive form. In a xenograft model of nude mice transplanted with human breast cancer MDA-MB-231 cells, intraperitoneal injections of lunasin, at 20 mg/kg and 4 mg/kg body weight, decrease tumor incidence by 49% and 33%, respectively, compared with the vehicle-treated group. In contrast, injection with BBI at 20 mg/kg body weight shows no effect on tumor incidence. Tumor generation is significantly reduced with the two doses of lunasin, while BBI is ineffective. Lunasin inhibits cell proliferation and induces cell death in the breast tumor sections. Conclusions/Significance: We conclude that lunasin is actually the bioactive cancer preventive agent in BBIC, and BBI simply protects lunasin from digestion when soybean and other seed foods are eaten by humans.

    8. Lunasin, with an arginine-glycine-aspartic acid motif, causes apoptosis to L1210 leukemia cells by activation of caspase-3
    Elvira Gonzalez de Mejia, W. Wang, Vermont P. Dia, Molecular Nutrition & Food Research, (2010), 54 (3),
    406-414.
    Lunasin is a novel chemopreventive peptide featuring a cell adhesion motif composed of arginine-glycine-aspartate (RGD) which has been associated to cytotoxicity to established cell lines. The objectives of this study were to determine the effect of lunasin on the viability of L1210 leukemia cells and to understand the underlying mechanisms involved. Pure lunasin and lunasin enriched soy flour (LES) caused cytotoxicity to L1210 leukemia cells with IC(50) of 14 and 16 microM (lunasin equivalent), respectively. Simulated gastrointestinal digestion showed that 25% of the original amount of lunasin survived 3 h of pepsin digestion and 3% of lunasin remained after sequential pepsin-pancreatin digestion for a total of 6 h. Cell cycle analysis showed that lunasin caused a dose-dependent G2 cell cycle arrest and apoptosis. Treatment of L1210 leukemia cells with 1 mg/mL of LES for 18 h led to an increase in the amount of apoptotic cells from 2 to 40%. Compared to untreated cells, treatment with 1 mg/mL LES showed a 6-fold increase on the expressions of caspases-8 and -9, and and a 12-fold increase on the expression of caspase-3. These results showed for the first time that lunasin, a naturally occurring peptide containing an RGD motif, caused apoptosis to L1210 leukemia cells through caspase-3 activation.

    9. Lunasin promotes apoptosis in human colon cancer cells by mitochondrial pathway activation and induction of nuclear clusterin expression
    Vermont P. Dia, Elvira Gonzalez de Mejia, The Cancer Letter, (2010), 295 (1), 44-53.
    Lunasin is a naturally occurring peptide with arginine-glycine-aspartic acid motif associated to its reported biological activity. We aimed to determine the potential of lunasin from soybean to stimulate apoptosis in HT-29 colon cancer cells. Lunasin caused cytotoxicity to HT-29 cells and induced G2/M cell cycle arrest with simultaneous increased in p21 expression. Lunasin-induced apoptosis as evidenced by a twofold increase in the percentage of cells undergoing apoptosis, decreased Bcl-2:Bax ratio from 8.5 to 0.4, increased caspase-3 activity by 77% and increased expression of pro-apoptotic nuclear clusterin by five fold when compared to untreated cells. In conclusion, lunasin stimulated apoptosis in HT-29 cells by activating apoptotic mitochondrial pathways and inducing expression of the pro-apoptotic nuclear clusterin.

    10. Recombinant expression of bioactive peptide lunasin in Escherichia coli
    Chin-Feng Liu, Tzu-Ming Pan, Applied Microbiology and Biotechnology, (2010), 88 (1), 177-186.
    Lunasin, a cancer-preventive peptide, was isolated from soybean, barley, and wheat. Previous studies showed that this 43-amino acid peptide has the ability to suppress chemical carcinogen-induced transformation in mammalian cells and skin carcinogenesis in mice. In this study, we attempted to use the Escherichia coli T7 expression system for expression of lunasin. The lunasin gene was synthesized by overlapping extension polymerase chain reaction and expressed in E. coli BL21(DE3) with the use of vector pET29a. The recombinant lunasin containing his-tag at the C-terminus was expressed in soluble form which could be purified by immobilized metal affinity chromatography. After 4 h, the expression level is above 4.73 mg of recombinant his-tagged lunasin/L of Luria-Bertani broth. It does not affect the bacterial growth and expression levels. This is the first study that successfully uses E. coli as a host to produce valuable bioactive lunasin. The result of in vitro bioassay showed that the purified recombinant lunasin can inhibit histone acetylation. Recombinant lunasin also inhibits the release of pro-inflammatory cytokines (tumor necrosis factor-alpha, interleukin-1beta, and nitric oxide production). Compared with other research methods on extraction or chemical synthesis to produce lunasin, our method is very efficient in saving time and cost. In the future, it could be applied in medicine and structure-function determination.

    11. The role of nutraceutical proteins and peptides in apoptosis, angiogenesis, and metastasis of cancer cells
    Elvira Gonzalez de Mejia, Vermont P. Dia, Cancer and Metastasis Reviews, (2010), 29 (3), 511-528.
    The process of carcinogenesis is complex and not easy to eliminate. It includes the initial occurrence of genetic alterations which can lead to the inactivation of tumor-suppressor genes and further accumulation of genetic alterations during tumor progression. Looking for food and food components with biological properties, collectively called nutraceuticals, that can hinder such alterations and prevent the inactivation of tumor-suppressor genes is a very promising area for cancer prevention. Proteins and peptides are one group of nutraceuticals that show potential results in preventing the different stages of cancer including initiation, promotion, and progression. In this review, we summarized current knowledge on the use of nutraceutical proteins and peptides in cancer prevention and treatment. We focused on the role of plant protease inhibitors, lactoferrin and lactoferricin, shark cartilage, plant lectins, and lunasin in the apoptosis, angiogenesis, and metastasis of cancer cells. Also included are studies on bioavailability and clinical trials conducted on these promising proteins and peptides.

    12. Soybean Peptide Lunasin Suppresses in Vitro and In Vivo 7,12-Dimethylbenz [a]anthracene-induced Tumorigenesis
    Chia-Chien Hiseh, Blanca Hernández-Ledesma, Ben O. de Lumen, Journal of Food Science (2010), 75 (9), H311-H316.
    Lunasin is a novel peptide identified in soybean and other seeds. This study evaluated the anti-tumorigenic effects of lunasin on 7,12-dimethylbenz(a)anthracene (DMBA) and 3-methylcholanthrene-treated (MCA) fibroblast NIH/3T3 cells. Lunasin significantly inhibited cell proliferation and cancerous foci formation in these 2 chemical carcinogens-treated cells. An in vivo SENCAR mouse model induced with DMBA was used to study the mammary cancer preventive properties of dietary lunasin contained in soy protein. Tumor incidence was 67% and 50%, and the tumor generation was 1.88 ± 0.48 and 1.17 ± 0.17, respectively, for the mice fed control diet and experimental diet obtained after AIN-93G supplementation with lunasin-enriched soy protein concentrate (containing 0.23% lunasin). However, no effects were observed in mice fed AIN-93G supplemented with soy protein concentrate (containing 0.15% lunasin). The data provided illustrate the anticancer potential of lunasin both in vitro and in vivo and supports the recommendation of soy protein as a dietary component that may aid in the prevention of mammary cancer.

    13. Lunasin, a novel seed peptide, sensitizes human breast cancer MDA-MB-231 cells to aspirin-arrested cell cycle and induced apoptosis
    Chia-Chien Hsieh, Blanca Hernández-Ledesma, Ben O. de Lumen, Chemico-Biological Interactions (2010), 186 (2), 127-134.
    Breast cancer is one of the most common tumors in women of Western countries. The high aggressiveness and therapeutic resistance of estrogen-independent breast tumors have motivated the development of new strategies for prevention and/or treatment. Combinations of two or more chemopreventive agents are currently being used to achieve greater inhibitory effects on breast cancer cells. This study reveals that both aspirin and lunasin inhibit, in a dose-dependent manner, human estrogen-independent breast cancer MDA-MB-231 cell proliferation. These compounds arrest the cell cycle in the S- and G1-phases, respectively, acting synergistically to induce apoptosis. To begin elucidating the mechanism(s) of action of these compounds, different molecular targets involved in cell cycle control, apoptosis and signal transduction have been evaluated by real-time polymerase chain reaction (RT-PCR) array. The cell growth inhibitory effect of a lunasin/aspirin combination is achieved, at least partially, by modulating the expression of genes encoding G1 and S-phase regulatory proteins. Lunasin/aspirin therapy exerts its potent pro-apoptotic effect is at least partially achieved through modulating the extrinsic-apoptosis dependent pathway. Synergistic down-regulatory effects were observed for ERBB2, AKT1, PIK3R1, FOS and JUN signaling genes, whose amplification has been reported as being responsible for breast cancer cell growth and resistance to apoptosis. Therefore, our results suggest that a combination of these two compounds is a promising strategy to prevent/treat breast cancer.

  10. This is the Susan Love I love! The Angry Susan Love who had to bludgeon the staff at UCLA to get them to allow her to start one of the best breast cancer units in California — probably one of the best in the country. Of course, when she left — and you could see it coming, she wanted things run the way she wanted them run, and UCLA is run by the State of California — the whole unit fell apart. They stopped caring. Fortunately for me, UCLA still hires great breast surgeons. Helena Chang made it a point to tell me that she got clean margins, as I knew she would because they don’t come any better. But so long as the people who run hospitals play the tunes medical professionals have to dance to, corners will get cut, good practices will be eliminated, your hospital room won’t get cleaned every day. And worst of all, as far as I’m personally concerned, I’m pretty sure that if Susan hadn’t left UCLA, I’d still be getting treated there. We didn’t always agree, but I loved the fact that she fights the good fight. Her way.

  11. Susie Ellis says:

    Thank you Dr. Love. Fly your angry flag proudly and go kick some butt. We are behind you.

  12. Anne-Marie says:

    Great to find I’m not the only one who feels this frustration! I had to pay for the Oncotype DX test nearly 4 years ago and despite the fact that the preliminary results from the TailorX Trials in May 2012 showed that 38% of the BC patients given this test would not benefit from chemo (which costs $15,000) the test is still not being covered here in British Columbia – even though it’s been covered in Ontario since 2010 (when I had mine) and currently in 6 other (poorer) provinces. Since the results of this research have not yet trickled down to the front line, one must assume that 38% of women are still being prescribed chemo which will be of little or no benefit to them. There’s also a simple $300 cheek swab) test available to determine whether you have the enzyme necessary to metabolize Tamoxifen (CYP2D6) which most oncologists are not even aware of so they continue to prescribe the “one size fits all” standard dose of when some women may need more (poor metabolizers) and some less (rapid metabolizers). I paid for mine and found I’m a normal metabolizer – which is a good thing if you’re taking a drug for at least 5 years! It really makes you wonder who all these people are working for…..

  13. this message is for Diane Obrien and others. I had lumpectomy and radiation 17 years ago, and at that time my Doctor said “Do not have your blood pressure, blood work, or anything else done on your left arm”. . (it was my left breast). I’m amazed that all Doctors dont’ give this information.

  14. Mary says:

    Good to know that I am not the only one who is angry and have been since being mutilated back in 06. I had reconstruction and the PA was very condescending regarding my concerns. Asked if I planned to visit a nude beach! My plastic surgeon had the nerve to refer to my breast mound as a “boob” in front of a colleague who was shadowing him. He did not appreciate my correcting him. Needless to say I have not seen him since. I refused adjuvant therapy after surgery including Herceptin as all carried too great a risk of heart issues. Basically, you are damned if you do and damned if you don’t, where treatment is concerned and after 30 years that is NOT acceptable. Well, I am still here, despite mastectomy, lumpectomy in the contralateral breast, two years later and a lot of rage over the state of treatment of this definitely over pinked disease. Thank you Dr. Love for so eloquently expressing your discontent. Unfortunately it extends to care for other cancers as well. Treatment has been and continues to be barbaric.

  15. Cate says:

    I can’t get angry about breast cancer when all I feel is numb and depression. Hope is all that’s left of my emotions. Anger at lack of progress is understandable and encouraged,but anger directed at other breast cancer patients who don’t (or can’t) agree on anything about how to proceed is something I can’t personally tolerate. It only causes stress and anxiety. Metastatic breast cancer itself provides more than I can handle. If that’s complacency, then put the blame on people like me who just want to experience what little joy there is left in life. and leave the outrage to those who have the energy and the means to fight the war, (or whatever it is), against cancer. I deeply respect all of you and your efforts, but anger only drains me and then begins to eat away at whatever is left.

  16. Anne-Marie says:

    Further to comments made by Diane O’Brien & Peggy Rackelmann, I was also told that anyone who has had lymphs removed should never allow IV, BP or injections of any kind to be done on the affected arm because any one of these can trigger lymphodema – the only exception being patients who’ve had lymphs removed on both sides who have no alternative. I immediately ordered myself a gold Medicalert bracelet engraved with the message “No IV-BP to left arm – lymphadenectomy” which I’ve worn on that wrist ever since so even if I’m lying unconscious on the side of the road, I can still get the message across!! It’s even more important if your left arm is affected because most nurses & paramedics have been trained to do these things on the left arm.

  17. Gwen O'Brien says:

    I’m too sad to be angry. Breast cancer ruined my life. I’ll never be the same. I have zero estrogen so I have zero sex drive and my husband hates me for it. Why didn’t I just die?

  18. Susan Zager says:

    Thank you for saying everything we are thinking. The “collateral damage” from breast cancer never goes away and we still have too many dying from this disease. We need unity, hope and action.

  19. Bertha Holt says:

    YOU GO DR. LOVE, WE NEED A PERSON WHO REALLY CARE ABOUT OTHERS. THAT WHY I JOIN AMRY OF WOMEN. WHATEVER I CAN DO TO HELP THIS CAUSE I WILL. ANGRY, ANGRY

    GOD BLESS

  20. Marilyn says:

    Here is the answer to your questions Dr Love. Yes, why has there been so little progress!!??? You bet we should be angry!!! Unfortunately, most of us don’t pay attention until we are touched very closely by the ‘thing’! We haven’t progressed, as you should know Dr Love, because the big pharmaceuticals run the medical industry. They’re the ones who have their dirty little hands in everything, and they benefit from our suffering. Why not concentrate on funding for some of the many successful ‘alternative’ treatments for breast cancers, and better yet, what about more focus on education on preventing these maladies (changes in eating habits, lifestyle, etc.), which in turn could result in people banding together and absolutely no longer supporting the big business and industries that continue to feed us chemicals and toxins that poison our bodies and result in such diseases! I was diagnosed with breast cancer last year and am appalled at the treatment that patients are offered. In the medical system there are no options given, just cut, poison and burn. It’s a big business!!

  21. Carolyn Vallieres says:

    I had a “biopsy” and the surgeon never told me there was a possibility of a mastectomy procedure. When I came out of surgery, I had a truncated and disfigured breast, and found on the written OR report that it was a mastectomy procedure. When I confronted the surgeon, he became angry and dismissed me as his patient.
    I documented everything, including the fact that they found LCIS, which I understood from Dr. Love’s book that
    you should not excise. I wrote to the hospital president, went to Dr. DeFusco (I was in the Star study), and
    the plastic surgeon. I finally had a complete reconstruction and reduction of the other breast. In between these surguries, I was diagnosed with clinical depression caused by the whole experience. I assume that because
    this mastectomy procedure was so badly handled, I was given the reconstruction at no charge.
    (I also previously avoided a hysterectomy after being told by two physicians that I was “old and didn’t need it
    anymore”.) When are these surgeons going to be listeners?

  22. Vera says:

    I guarantee if men’s testicles were being lopped off at the rate that we are losing our breasts, and their sexual performance adversely affected, we’d be very close to a cure. It’s all an issue of priority. The only thing that’s changed between my initial dx in 2002 and my metastasis in 2011 was giving chemo every 2 weeks instead of 3 and giving tamoxifen 10 years instead of 5. Big whoop.

  23. Susan Love says:

    Wow! I see I am not the only one that is angry! Now we have to take this angry and put it into action and change things! If you haven’t join the HOW study (www.healthofwomenstudy.org), send us your collateral damage (www.questionthecure.org), and keep complaining. Being good little girls never got us anywhere!

    @ Sharon Gunther Perineural invasion does not have anything to do with spread to the central nervous system. It is a local finding which indicates a more aggressive tumor and has been studied. If you send me your email I will give you some articles.
    @ Melanie Lunasin is like many other compounds that have shown benefit in animal models and petri dishes (curcumin comes to mind) but have not been tested yet in people. Lets hope it lives up to its promise.

  24. Lisa says:

    Thank you Dr. Love!

    Thank you for everything you do and for making this point so clearly. I am angry too. Having lost my aunt to breast cancer in 1994 and seeing that truly very little has changed, is a hard pill to swallow and damn it I don’t want to swallow it anymore. I personally think that SGK has had a bit to do with this lack of change. I know, I am stepping in it a bit here, but I really do believe they have been a huge part of the problem. Millions of dollars have been raised over the years, but most of it has NOT gone to research (in 2010 Komen raised – in just one year – 389 million dollars – BUT only 14% of that 389 million went to research!!!!!!)

    If we looked at every year that millions were raised – all in the name of a cure – where the majority of that money did NOT go to research – well, it kind of makes me sick and yes, it makes me really ANGRY.

    I realize going forward, that blame is not going to help – unless exposing historical problems is the catalyst for much needed change. I am very angry that all those millions were squandered. We have been way past awareness for so long now. And the kind of awareness that Komen preached (pink ribbons, get your mammograms, “early detection saves lives” was misplaced anyway – we all know that detecting cancer doesn’t prevent death from cancer, it just gives us the opportunity to be treated). Sigh.

    I am so grateful for you. And, I hope that your voice, supported by all of us, will lead to the real change that we all so desperately need. Funding needs to go to research – plain and simple. I am very angry that Komen did not act responsibly (in my opinion) with there funding choices in the past – spending only 14% (according to Reuters) in 2010 of nearly 400 million dollars on research makes my heart sick. To think that even half of that money, from just ONE year of fund raising, could have lead to something beyond pink balloons, portapotties and golf carts and pink rose ceremonies . . . well we will never know what could have been, will we?

    All we know is that what has happened has NOT been enough. I am so grateful that you are here to take things in a new direction. And I hope, truly, truly hope, that you rub off on Nancy Brinker. We need big changes. Thank you for being the awesome leader you are!

    I was diagnosed Her2+/ER+/PR+ in 2009 – so I am one of those women who would have been dead by now without for advance of Herceptin (and the fact that it became available in time for me). I am so grateful, can’t even express how grateful I am. But, we need more, so much more.

    I am tired of seeing my friends dying, tired of seeing new friends diagnosed, tired of worrying about the risk of recurrence and the constant fear that visits on my life and the lives of so many.

    You give me so much hope. Thank you. Thank you for being angry, thank you for being brilliant.

    Much love,

    Lisa
    aka: http://www.cancerfree2b.com

  25. I am glad we are expressing our anger and discontent with the insane status quo. Every time there is a ‘new’ chemo, it gets added on. Results to survival: NOT MUCH. Results for toxicity: A LOT!
    I have been championing the use of Integrative Oncology as a way to reduce those toxicities and in some cases ENHANCE treatments.
    I support the use of alternative medicine (which will not receive level one studies a la pharmaceuticals because many cannot be patented). Sometimes they do get studied and some move to accepted practice but are all-too-often still ignored as BIG PHARMA didn’t patent it. Why does the pharmaceutical industry get to decide so much?

    Let’s get acupuncture covered by insurance as a start. Traditional Chinese Medicine is a 6000+ year system. After 18,000 generations, don’t you think they would have noticed if it wasn’t working? This can balance the body, keep up blood counts, reduce fatigue and nausea and MORE.

    When I founded Annie Appleseed Project it was to share the amazing amount of information on everything else – stuff your doctor (no offense Sue) didn’t tell you. Eat more fruits/veggies, walk around, relax and enjoy any aspect of life you can. Live longer/better just from that.

  26. Gagik Melikyan says:

    Dear Susan,
    Thank you for your post. There is every reason to be angry for all of us. My personal experience with BC community is nothing but positive. Over the last ten years, I kept applying to NIH and CBCRP to develop a new generation of therapeutics for BC treatment and was not able to get a single penny out of them. My design has NO analogy on the market, it is inherently non-toxic, and no one in the BC community seem to be interested (I am sorry for not ever applying to your foundation for support but $$ needed is much more than your foundation could provide). If 10 years ago I could get $400K from NIH, the new treatment could have been already on the way to the market. Well, I saw no interest from either NIH, or CBCRP, so I concentrated on the fundamental research. It is tragic that billions of taxpayers dollars are spent every year, and there are no tangible results.
    With warmest regards,
    Gagik Melikyan
    Department of Chemistry and Biochemistry
    California State University Northridge
    Northridge, CA

  27. Jane says:

    I just found this website through a friend and am angry at the experiences so many women have gone through with treatment, and the lack of progress in treatment. I was diagnosed with stage 4 BC in April, HER2+ and ER+ and am nearing the end of chemo. I have developed neuropathy as a result of chemo; it is being monitored and one chemo was slightly reduced, but I am concerned it won’t go away after treatment. I too am angry at the lack of progress with alternative or other promising research, most of which seems is being done outside of pharmaceutical companies by a single researcher and therefore does not get funding for research or trials. There may well be less toxic treatment that could be available sooner, if it weren’t for the money being made by big pharma, which seems to control much of gov’t funding through lobbying, etc. (at least that is what I’m learning, I hope my sources are accurate – it is so hard to know what info is truthful or not). I also heard about the small percentage of money that the Komen foundation gave to research, an outrage, and I have not supported that organization since. I am trying to stay positive about my prognosis, which varies, depending on who I talk to. I will need to be on herceptin indefinitely if I can tolerate it, and I walk, meditate, eat well ( I did all these things before and got cancer anyway, so who knows?), and try and focus on the present – it’s all any of has anyway. Does anyone have info on the ESSIAC report and legitimate sources of obtaining it?

  28. Michele Pattison says:

    I’m angry because I lost my 44 year old daughter two weeks ago to stage 4 breast cancer. I’ve learned to hate October. She was diagnosed in October 2009 and died in October 2013. With all the fund raising and pink ribbons flying, one would think research would have come further by now. I can only hope that it progresses enough to save my 8 and 4 year old granddaughters from the same fate as their mom.

  29. TONI BARCA says:

    For a very long time I thought I was the only one who thought that this big C research had gone on too long. That there were too many egos and not enough teamwork and sharing of data, that the medical establishment would never find a cure because that would mean the end of their jobs.

    I just recently met two women who were left permanently bald because their oncologist never told them that this was a major side affect. So now though they are in remission they are ashamed to go out in public and feel completely destroyed not just by the ravages of cancer, changed breasts, chemo brain but by the outward physically change that can never be undone.

    I was at this year’s USC breast cancer symposium and loved your talk on the history of breast cancer! Your compassion and passion shone through- I want to thank you for being the light!~

  30. Lynn DaCosse says:

    Wow, it is so overwhelming. My Mom was diagnosed with BC in 1979 at age 52 and I was diagnosed in 2006, at age 42. Not much has changed except that my Mom died in 1981, only “surviving” 2 years after a radical mastectomy that completely disfigured her. She saved her hair with ice packs during experimental chemo only to have her head shaved a year later for an unnecessary surgery to place a shunt in her head for experimental chemo that they never used, robbing her of any chance for a dignified death. Today she would have had other, less-invasive options and most likely palliative care. She would probably have gone to see the doctor earlier rather than waiting almost a year after discovering her lump, she waited so as not to distract from my older sister’s college graduation. There was so much fear, shame and stigma that kept her away, and while I am nauseated by today’s pink exploitation of October, I remember the pink-less days where there wasn’t any awareness and much more isolation. The group Y-Me was the only support group around and had just formed a year earlier and a representative came into her hospital room the day after her surgery with a hand-sewn gingham drawstring bag with a squeeze-ball and instructions for “crawling up the wall” arm exercises. Betty Ford had shared her mastectomy story prior to my Mom’s surgery, but other than that, there was not much in the news and the word “breast” wasn’t used often. 25 years later my cancer was found during a routine mammogram, I opted for a lumpectomy, my surgeon was a female breast specialist who’s entire practice is dedicated to the health of the breast, she is so adept at the use of ultrasound that she detected a malignant lymph node prior to biopsy and biopsied both sites. I knew going into surgery that I had lymph node metastasis and she put in a port for chemo and with her in-surgery use of ultrasound I got very clean margins. I believe her expertise and specialization saved me at least two if not three or more surgeries. I had TAC, chemo but the nausea drugs were helpful and an oncology nurse advised me to use tea tree oil to save my finger nails. I had Susan Love’s Breast Book to read and have always known not to have IV’s or BP’s or blood work done on my left arm. I chose not to take Tamoxifen having read about the potential side effects, knowing my body metabolizes drugs very quickly and I am very sensitive to pharmaceuticals so for my body I know it was not the right treatment. I have a friend who is responding well to Herceptin and I too think that is the latest and greatest improvement and would like to see more results like that. As I laid on my back getting my 32 daily radiation treatments I was angry that we were still slashing and burning but tried very hard to focus on the positive changes. I know I carry the BRCA-II gene but I do not have a significant family history other than my Mom, with older sister’s, Aunts, Grandparents etc. never being diagnosed. I believe there are a complex set of causes of BC, some within my control, many beyond me. I have to believe there is a contributing environmental cause that is causing endocrine disruption feeding the fire. My collateral damage has been diverticulitis, Hashimoto’s disease, very fine, thin hair with male-patterned balding and some autonomic nerve damage that we are still sorting out. However, I am here seven years later and have had seven years with no evidence of disease so far. My kids were 9, 7 and 4 year old twins when I was diagnosed and they are now 16, 14 and 11. My seven year survival so far has been exponential when you take a 9 year old daughter to 16, a 7 yr. old daughter to 14 a 4 yr old daughter to 11 and a four year old son to 11. I am so happy to have been here for those seven years of development and milestones. I of course am angry that I may not be here as long as I would like but I have to balance that with trying to make the best of today. I performed my comedy show two months after my treatment ended to raise money for the Susan Love Foundation, Raising close to $13,000 over the years. That was almost 7 years ago and I thought maybe we would have a blood test by now, but I know how slowly the wheels of research turn. I can only hope we make some progress before my daughters are 32 and may be diagnosed 10 years earlier than I was.

  31. 65chevy says:

    Yes… It is a big fail. You did the same old thing twenty years ago that they are doing today..

    And everybody is still dieing..

    Do you not realize that surgery isn’t curing anybody? Surgery and chemotherapy is not curing anybody? And add to that radiation? How about those hormonals…

    All you have been doing is insulting the immune system of the people with cancer. People like me..
    I am appalled… THERE HAS BEEN NO PROGRESS at all..

    Surgery has never been a cure.. You put that woman through hell, and you made her pay you for it and here you are.. NO SOLUTIONS…

    DO you sleep at night? I think you do… Well.. Work on the immune system first… Leave off all of this slash poison and burn.

  32. Lynn says:

    A lot of us have been angry for a long time. Patients, caregivers, and health care providers are urged to be cheerful, not angry. We need to develop an environment around cancer that is accepting of the power of anger!
    Especially since, unlike we often hear, research shows that sadness and anger do not promote cancer in any way.
    Let’s use our anger to demand research in environmental contributors to cancer! We will never get below 1970′s incidence rates otherwise.

  33. Yvonne Salo says:

    I’ve been living with my Metatstatic disease for many years but have just started adjuvant therapy. I just read in the comments above I can now look forward to Fibromyalgia being part of my life. I’m already feeling those effects. When I’ve mentioned it to my Oncologist he sort of shrugs his shoulders. I guess they don’t want to tell you that you are now stuck with these symptoms. I’m grateful that there are drugs that are helping me, but I wish that there a better way than filling your body with chemicals that destroy your immune system and create other problems. I hope one day that there will be better ways to deal with this. My problem is I don’t feel unwell enough that I want my life to end, but living with the disease is distressing every day and you don’t have much quality of life. It’s awful for family members, especially when your husband becomes your Carer. It’s not nice for your friends either. There are many things to look forward to and I hope I live longer, but there will come a stage where I’ll think that enough is enough. One day there will be a cure. I’m sure of it. I truly hope that other women in the future won’t fear the disease if, God forbid, they are diagnosed in the future.

  34. More importantly, it is catastrophic, which means it can’t be avoided or protected against.
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  35. Jane says:

    Darlin’ this lady hasn’t been “complacent.” Not ever. Especially not for the last 14 years, so please don’t foist responsibility on “all of us.” Why add blame at all, except, perhaps, to those in power who many of us are mighty certain had the power to do a heck of a lot more, but preferred to spend the money on trinkets.

    Those of us who dare to present rational arguments to physicians often end up being burned at the medical stake. Just like ‘ol times. There does come a time, dear, when one needs to decide to live until we’re not, and without medical intervention, whether we have an illness or not. I haven’t reached that point as yet, but I’ll not take an iota of responsibility, nor should the rest of us, for not doing more than we already have. We’ve given out nerves, pieces, or all of, our breasts, our money….enough.

    In fact, reading your anger, I will respond with some of my own. What changed the way you approach all this
    Dr. Love? Maybe you’re just tired, too. Who wouldn’t be. Disband the “army” – which I’ve detested since its inception, and go back to square one.

  36. Jane says:

    PS “Square One” would be to give yourself every opportunity to heal. You know what a mess all the breast cancer stuff is. That morass can make a gal sick. We do what we can and are able to do at any time.

  37. Jane says:

    Here’s a plan: Demand that the American College of Radiology insist that medical facilities that state they are “ACR Accredited,” state exactly the extent of the accreditation; whether breast imaging is done by ACR accredited technologists; whether radiologists are ACR accredited. The ACR has majorly contributed to a false sense of security by not requiring full accreditation information.

    Demand that facilities that do imaging publish quarterly public reports of statistics on the number of false positives and false negatives. Let’s see those numbers.

    Let’s see a medical specialty, “Breast Specialist.” Not surgeons, not ob/gyns. And let’s see a dramatic increase in the number of endocrinologists who would work in tandem with them.

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