New Cancer Center Clinic Targets High-Risk Women

Wanted:

Any woman who faces a high risk for the most feared female cancers – breast and ovarian – or who wants to know if she does.

A new clinic targeting high-risk women is now up and running at the Arizona Cancer Center. It offers the latest methods and technologies for early screening and prevention of these cancers, in addition to treatments, clinical trials, and nutritional and psychological counseling.

“I have seen so many patients come down with breast cancer in their 30s, then get ovarian cancer in their 40s, and I don’t want to see that anymore,” said Dr. Molly Brewer, a University of Arizona ovarian-cancer specialist who played a key role in opening the clinic.

“You take a look at their family history, and you say, omigosh, this could have been caught so much earlier – maybe even prevented. That’s why we opened this clinic.”

Until now, cancer medicine has focused mostly on treatment after diagnosis. But with ovarian cancer, that is dangerous, because symptoms rarely occur until it is in advanced, often fatal, stages.

Although regular screening for breast cancer is encouraged, even that is sometimes “too little, too late,” said Dr. Christina Kim, a breast surgeon with the Arizona Cancer Center who also is a founding member of the clinic team.

Mammograms typically find cancers that are 5 millimeters or larger, and it can take up to 10 years for a lesion to reach that size, Kim said.

“The emerging techniques we use allow much earlier diagnosis. We want to focus on finding cancer very early, even in the precancerous stage, by screening women at a young age,” she said. “Our target is those in their 30s or early 40s, but we can evaluate and work with any at-risk woman older than 18.”

After losing her mother, two sisters and an aunt to breast or ovarian cancer, Tucsonan Mary Dimercurio, 58, wishes this clinic had been open years ago – before both cancers struck her as well.

“I would have loved a clinic like this. With the kind of family history I have, I’m about as high-risk as you can get. This has been a huge issue for so long for my entire family,” said Dimercurio. She lost one breast to cancer in 1980, has been in treatment for ovarian cancer since 2002, and had her other breast removed in June to end further threat from that cancer.

Now a patient at the high-risk clinic, she’ll continue her treatment there – and may have access to an experimental drug for her cancer because of it.

“Dr. Brewer is trying to get a drug that’s not yet approved for ovarian cancer. My insurance is balking at it, but she’s working on it. That’s part of what happens here,” Dimercurio said.

The clinic team includes a breast surgeon, a gynecologic oncologist, medical oncologists, a genetic counselor, a nutritionist and nurse coordinators.

What many women may not realize is that breast and ovarian cancers pose dual threats to high-risk women, which is why the clinic focuses on both.

“These two cancers run together – there is a certain subset of women at high risk for both,” said Brewer. “If you have a genetic risk for breast cancer, you very likely are at risk for ovarian as well.”

Breast cancer is expected to kill more than 40,400 women in the United States this year while ovarian cancer will kill more than 16,000. In Arizona, 720 women are expected to die of breast cancer this year and 290 of ovarian cancer.

Dimercurio carries what is known as the “breast cancer gene” – the BRCA-1 mutation that is a marker for familial breast cancer and for hereditary breast-ovarian cancer syndrome.

In doing evaluations of patient risk, the clinic’s genetic counselor tests for this and other cancer markers, and explores the complete family history. High-technology screening methods also are used.

One technique, breast endoscopy, uses a tiny probe to explore the breast milk ducts, where most cancers start years before a mammogram would find them.

“We just want women – even women who aren’t sure if they are at risk – to know we’re here,” Brewer said. “We want to get the word out.”

FOR MORE INFORMATION:

To contact the High-Risk Breast and Ovarian Cancer Clinic, call 326-5290 Monday through Friday, 8 a.m.-noon.

ARE YOU AT RISK?

* To determine your risk for breast or ovarian cancer, answer the following questions:

* Do you have nipple discharge?

* Have you had breast or ovarian cancer?

* Did/does your mother, sister or daughter have breast or ovarian cancer?

* Are there two or more aunts or cousins with breast or ovarian cancer on either side of your family?

* Do you have any male relatives who have/had breast cancer?

* Were you or any of your relatives diagnosed with breast or ovarian cancer before the age of 50?

* Is there a known genetic mutation, such as BRCA-1 or BRCA-2, in your family?

* If you answered “yes” to any of the questions, you are a candidate for the High-Risk Breast and Ovarian Cancer Clinic at the Arizona Cancer Center.

* Contact reporter Carla McClain at 806-7754 or at cmcclain@azstarnet.com.