Twenty to thirty percent of breast cancers over express a protein referred to as the human epidermal growth factor receptor, better known as HER2 over expression.

Herceptin is an agent that is targeted against the HER2 receptor and helps to slow or stop the spread of cancer cells that over express this protein. Unfortunately, some women that do have the over expression of HER2 on their breast cancer cells do not respond to treatment with Herceptin.

The Journal of the National Cancer Institute has published a report that says among breast cancer patients with HER2 over expressing cancer cells, those whose cells also express a receptor called p95HER2 have a poor anti-cancer response rate with Herceptin.

The study included forty seven women with metastatic breast cancer. All were treated with Herceptin. Nine of these patients also expressed the receptor p95HER2.

The results showed that only 11 percent of the women with the p95HER2 expression showed an anti-cancer response to Herceptin. Of the patients who did not express p95HER2 demonstrated a response of 51 percent. The report also showed that laboratory testing of cancer cells that do express p95HER2 demonstrated anti-cancer activity with a drug called Tykerb.

The researchers concluded that patients with HER2-over expressing breast cancer who also express p95HER2 appear to be more resistant to treatment with Herceptin and "may require alternative or additional anti-HER2–targeting strategies." Patients with HER2-over expressing breast cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating biologic markers that may help predict responses to certain therapies.

Researchers at Johns Hopkins discovered that a drug commonly used to treat toenail fungus could block angiogenesis, blood vessels that feed a tumor.

The drug, itraconazole, is FDA approved for human use, which may fast-track its availability as an anti-cancer drug.

If you are interested in reading more about Angiogenesis and cancer growth you can read my post back in July.

The researchers at this point have yet to determine exactly how itraconazole works to stop vessel growth.

My friend -- who has a friend newly diagnosed with brain cancer -- greeted me at the door the other day and asked with a sense of urgency, "How can I help?"

"Help your friend?" I asked.

"Yes, she said, unsure of what she might say or do in this time of great difficulty for everyone involved.

I told her a few things. And then I thought of some more. It wasn't terribly easy to come up with these ideas. Because even though I myself was on the receiving end of help during my cancer journey, it's still hard to imagine what an individual wants or needs -- or doesn't want or need. But here's what I've got to offer.

I hope this helps my friend.

I hope it helps you too.

• Allow your loved one to take the lead. If you sense this person wants to talk, then talk. If you sense talk is not welcomed, then don't talk. To determine whether or not your friend or family member wants to discuss cancer, approach the topic and judge the response you get. I know I can usually tell if someone is willing to open up -- typically the conversation just flows -- and when someone is putting the brakes on chit-chat -- typically the conversation falls flat.

• If talk is not in the cards, then consider an offer of food. Sometimes actions speak much louder than words. So think about calling a restaurant in your friend's town and ordering a meal to be delivered right to the door. Most eating establishments accept credit card numbers over the phone so location should be a non-issue. Even those deep in despair need to eat, and taking away the chore of cooking and cleaning up can be quite a gift.

• If the gift of food is not up your alley, how about sending a small gift, like a candle, a pair of cozy socks, a grocery store gift card, a music CD, a gift certificate for a spa. You name it, your special something might brighten the day.

• If you live near your loved one and have some free time, offer to drive to appointments, visit during treatments, pick up kids and entertain them for the day, clean house, cook, and clean up dinner. Try to be very specific with your offers. Say, "I'd like to pick up your kids tomorrow at lunch so you can take a nap" or "I'm coming over on Sunday to rake leaves." These offers are easier to accept than the "call me if you need anything" kind.
  

• If a quick stop at your loved one's house is possible, drop off a book on the front porch or set some pretty potted flowers by the door. Or do both. Then walk away without saying a word. Let your help take your friend by surprise.

• When you do have the chance to talk, avoid guiding the conversation with your own thoughts and advice, unless requested. Saying, "Everything will be OK," for example, may not be true. Assuring your friend she will sail right through chemotherapy may backfire if nausea and fatigue are just down the road. Stating, "it's OK, your hair will grow back," doesn't really help those living with the horror of hair loss. So stay away from promises and predictions and stick to the present. Ask questions, listen, and paraphrase back what your friend has shared. These are basic counseling techniques. The premise is that allowing the person to work through the issues is more important than what we can do to directly help.
  

• Don't forget about the good old greeting card or short note that lets your loved know how much you care. Let the card say it if you wish to avoid writing and then add an address, a stamp, and send your support on its way.
  

• This makes eight -- so much for sticking to my Sunday plan -- but I must share this too: Don't forget about your loved one after months and even years pass by. Initial diagnoses are tough and treatments are tough too. But as your friend survives each day, remember to check in. Cancer is a life-long battle for many. Support and assistance may be just as valuable a year down the road as it is on day one.

I guess I've just assumed that breast cancer organizations happily accept every donation they receive and joyfully funnel all charitable gifts into their noble endeavors. I mean, without money and research and programs and services and education, where would we be? We'd be uninformed and lagging behind the force of this disease instead of gaining momentum on its trail. That's where we'd be.

Now, I've never assumed these organizations accept money obtained through illegal measures. But I've also never assumed they'd turn away money just because it came from a group of women whose profession and means of fundraising might be considered unacceptable. I suppose I shouldn't make assumptions. Because I seem to be wrong on all accounts.

The Breast Cancer Society of Canada has officially rejected a donation from a group of Vancouver strippers because of the controversial nature of their fundraisers. Exotic Dancers For Cancer these women call themselves, and for four years they have been raising money in honor of another dancer who lost her battle with terminal cancer.

Trina Ricketts, founder of the exotic dancer website nakedtruth.ca and recipient of the letter rejecting the donation, is shocked that people consider this contribution dirty money. And she is so bothered by this unfair judgment that she has been contacting the media and outting the Breast Cancer Society of Canada's discrimination practices. Her protests are working.

In a supportive turn of events, Ricketts has been met with an overwhelmingly positive response -- and she now has several organizations willing to accept all donations she wishes to offer.

This story is not nearly as simple as presented here. It's so much more detailed and touching and moving when told by Ricketts herself -- who happens to share her inspiring journey right here.

CORRECTION: Trina Ricketts reports that she did not seek out the media to out the Breast Cancer Society of Canada.

"The decision to go public was not in the interests of outing the Breast Cancer Society of Canada, but rather to seek out charities that would be willing to accept our donations," she said.

The standard dose of some medications are too high and dangerous for the patients, where some patients respond the exact opposite and show that the standard dose is too low to produce beneficial effects. It would seem to be a simple case of age, gender, or genetic differences to explain the individual variability in response to the drugs.

A study at the University of Kansas is reporting that variations in the body's production of hydrogen peroxide, which is believed to serve as a signaling molecule at low levels, can affect the accumulation of drugs inside our cells.

Oxidative stress, an increase in hydrogen peroxide levels, may have an increased response to a given dosage of a drug. This seems to show that it is in our best interest for physicians to provide more individualized dosing of drugs.

Hydrogen peroxide effects could be especially important in therapeutic drugs such as aminophylline, carbamazepine, lithium, carbonate, phenytoin, theophylline and warfarin. The researchers think that small changes in the doses of these drugs could cause either subtherapeutic or toxic results.

Lance Armstrong, champion of both cycling and cancer, wrote a commentary recently for CNN. His message was loud and clear -- he is losing patience with Washington politicians set on cutting funds for cancer research -- and while his words have not yet spurred positive change for cancer initiatives, they have inspired cancer survivors from all over the world who are responding with their own commentaries on sickness and survival.

The outpouring of sentiment inspired by Armstrong's commentary is overwhelming. Today, I offer just a glimpse into what survivors -- seven of them -- are expressing in the spirited e-mails they are sending to CNN.

Jerry Kelly of Birmingham, Alabama
My dad died of cancer 10 years ago, almost the same time Lance was diagnosed and subsequently founded the Lance Armstrong Foundation. My wife and I met Lance a few years later after I was diagnosed and we went to Austin for the LAF Ride for the Roses (fundraising bike ride). Lance's story had been very inspirational when I found it just minutes after my diagnosis with testicular cancer. What we didn't realize was how much inspiration we would get from other survivors and caregivers as we shared stories. Lance also spoke of something his doctor told him about, the Obligation of the Cured. The important thing to remember is that we can all make a difference if we are willing to give the effort. You don't have to win the Tour de France to join the LiveStrong Army!

Brian D. of Austin, Texas
The costs of this disease even for folks that have good insurance are well beyond reach. Depending on when you discover the cancer and what type of cancer you have, the out-of-pocket costs are far beyond the average person's ability to pay. This is of course assuming that you want to extend your quality of life and you want access to the latest advancements in cancer treatment. We are called society's "catastrophic cases." I am a 4½-year survivor of primary brain cancer. The technical name for my disease is anaplastic astrocytoma grade III. It is basically a slow-growing glioblastoma multiforme -- a death sentence. But I am young and up to the challenge. I am a card-carrying member of the LAF organization. I think what Lance is doing is great ... I think this article is great and I think our Congress should give more tax credits to those of us trying to live a normal life. Shame on them for not acting!

Anne Hawkins of Douglasville, Georgia
I was diagnosed with breast cancer at age 36. I am now 42½ and I have been diagnosed with breast cancer again -- a different type than the first time. I caught it in time thanks to my diligence in screening. However I am going through chemo for a second time in my life since it was an aggressive cancer and I'm so young. I am appalled that none of our politicians consider this a running topic! And the funding has been cut? That's unbelievable.

Marianna Costa, Melbourne, Australia
While I am writing from Australia, unfortunately the experiences of others sound all too familiar in our world. My wonderful father died in 2005 from cancer. The devastation to lives infested by cancer could never be measured in dollars. My conclusion is that cancer treatment is a global business. While I have faith in people of science to rid us from this world catastrophe, there is a global lack of resolve in governments, the corporate sector and medical institutions.

Casey Cronin of Austin, Texas
I'm 19 years old and I was diagnosed with cancer on December 3. I had my first surgery on December 7 and the second surgery on December 22. The pain I experienced was beyond belief. I had to accept the fact that I had cancer, go through with these surgeries, and sit in a hospital on Christmas. The second surgery was to remove my lymph nodes on my back and the nodes came back negative. Without cancer research I might not have been so lucky. I'm outraged that Congress has cut funding towards cancer research but continue to spend an arm and a leg on defense spending. I have a friend with Hodgkins lymphoma and unfortunately he doesn't have insurance. He's 23 and scraping by trying to make sure he might live past his 30s. Cancer is real threat to our health.

Betty Hoffmeister of Taylorville, Illinois
A year ago, October 2005, my daughter was diagnosed with stage 4 cancer of colon and liver. Not given much hope, but she is a fighter and a real sweet person. She takes chemo every other week on Monday, Tuesday and Wednesday, and then is so sick she has to stay in bed for a day or two. But then she gets up and does what ever her little body will let her do. They just say keep doing what you are doing, but we are really worried. I would like for her to hear some real encouraging news soon before she loses the will to keep fighting. God is very good. But we need help.

Scott Joy of Portsmouth, New Hampshire
I'm a 3½-year testicular cancer survivor, and an administrator for an Internet support forum for other survivors. As the Lance Armstrong Foundation sagely notes, "Cancer may leave your body, but it never leaves your life." Dealing with cancer is life-changing. I was blind to it before it hit me, but now I see cancer -- and its effect on individuals, families, and society -- every day. I am forever grateful for the LIVESTRONG movement, and the passion and power of the community of cancer survivors.

Myocet is in its last clinical trial phase prior to FDA review. The trial is enrolling patients to evaluate the investigative chemotherapy agent Myocet (liposomal encapsulated doxorubicin) in addition to standard therapy for HER2-positive breast cancer.

Myocet is a chemotherapy agent that contains the active form of doxorubicin, you might better know it as Adriamycin. This chemotherapy drug is formulated to reduce the side effects associated with Adriamycin. Myocet allows for more of the active drug to be delivered directly to cancer cells, sparing healthy cells from being damaged.

This trial will directly compare the standard option of Herceptin and Taxol to the combination of Myocet, Herceptin and Taxol. Researchers are now enrolling patients with metastatic, HER2-positive breast cancer with a goal in mind to determine if the addition of Myocet to standard therapy can increase response to therapy or regression of cancer.

Sarita Zouvas knows what it's like to have a child in the hospital. Her daughter, Isabella -- who died while receiving treatment for cancer -- spent many days in the hospital, and Zouvas says it's hard to anticipate what items from home will make a child's stay more comfortable.

"We don't go prepared," she says. "You don't take clothes; you don't know what's going on. You get there and they put a gown on them. My first response is, 'I want to make them comfortable because they're scared.'"

Zouvas has found a way to bring comfort to the lives of children at her local Children's Hospital. And her goal is to make sure every child admitted to the hospital during the holiday season gets a complimentary pair of pajamas.

After the death of her daughter, Zouvas became involved with the Friends of Scott Foundation (FSF) -- a non-profit organization founded in memory of Scott Delgadillo who lost his life to childhood cancer. FSF strives to help children with cancer and their families with emotional and financial support in order to cope with this devastating disease. Zouvas became a part of the FSF support team and is thrilled she can help bring comfy jammies to sick children.

Zouvas says the response to her call for help has been overwhelming. Most pajamas are donated and have come from as far away as Boston. Employees of the San Diego Padres, Southwest Airlines, and the district attorney's office have also helped Zouvas in the endeavor she hopes will continue year-round.

For more information on the Friends of Scott Foundation and Zouvas' pajama drive, click here.

Oncotype DX is a diagnostic test that quantifies the likelihood of disease recurrence in women with early stage, node negative breast cancer. With the information provided by the test it may be possible for doctors and patients to make more informed decisions about breast cancer treatment options.

Oncotype DX analyzes a specific set of genes within a tumor to determine a recurrence score. The recurrence score is a number between 0 and 100 that corresponds to the likelihood that a recurrence with happen within 10 years of initial diagnosis.

Results presented at the 2006 annual San Antonio Breast Cancer Symposium (SABCS) stated that the Oncotype DX test can more accurately predict estrogen receptor (ER) status than the two other commonly used tests, immunohistochemistry and ligand binding.

Another Oncotype DX study presented at the SABCS said that the test could predict the response to Tamoxifen by the levels of estrogen expression.

The researchers concluded that ER and PR expression, as measured using the Oncotype DX test, provide different pieces of information about prognosis and likely response to Tamoxifen among patients with node-negative breast cancer.

Recurrent ovarian cancer patients usually do not have many effective treatment options and long term survival is low. Research continues to evaluate ways to improve outcomes for patients with this disease.

An article published in Gynecologic Oncology said that Thalomid (thalidomide) appears to be safe and may provide an effective treatment option for patients with recurrent ovarian cancer. Thalomid is a pill that helps block angiogenesis. Anti-angiogenesis medication inhibits blood vessel formation so that cancer growth is limited by the lack of blood supply to the tumor. The drug is also thought to cause activity that stimulates the immune system to help fight cancer cells.

Researchers from Stanford University recently conducted a clinical trial evaluating Thalomid in the treatment of recurrent ovarian cancer. The trial included 17 patients who had received prior therapy. Three patients achieved an anticancer response, 18 percent and six patients achieved stabilization of their cancer, 35 percent. After one year of treatment, nearly 67 percent of patients who either achieved an anticancer response or disease stabilization had not experienced a progression of their disease.

Patients with breast cancer that have disease progression after being treated with chemotherapy drugs, anthracyclines and taxanes, are left with limited treatment options. Researchers are always looking to find new drugs to keep the drug arsenal full for these women so they don't run out of treatment options. One chemotherapy might stop working on the cancer and it can become resistant so we need to have a plan B, C, D, E ...etc.

An article published in the British Journal of Cancer says that vinflunine provides anticancer activity among women who's cancer has recurred or progressed following prior therapy. This new chemotherapy drug is classified as a vinca alkaloid. The study showed that the anticancer response rate was 30 percent.

The positive results of this study will prompt further studies. Patients with recurrent breast cancer may wish to speak to their physician regarding their individual risks and benefits of participating in a clinic trial further evaluating vinflunine.

If you have been diagnosed with cancer it is important to understand what a clinical trial is and also where you can find out information on how to get into one. Clinical trials must be done before a new treatment is approved by the US Food and Drug Administration (FDA).

There are different types or phases of clinical trials. Each phase is designed to find out different information. Each new phase of a clinical trial depends on and builds on information from an earlier phase.

• Phase I clinical trials are to find out the best way to give a new treatment and how much of it can be given safely. Researchers will closely monitor the patient's side effects and adjust the dosage as needed. This phase is usually only tested on a small amount of participants. Phase I trials can have significant risks associated with them for the patient because the drug or new treatment regimen has been studied in the lab but not on humans. The research in the lab cannot identify all the side effects that might occur. Phase I trials are usually only offered to those who's cancer cannot be helped by other known treatments available.
• Phase II clinical trials attempt to determine a patient's response to treatments. Patients are closely monitored to see if the new treatment controls the cancer or shrinks it. Side effects are also assessed at this phase because the trial involves more people so they can see a larger group and how they react to the new treatment.
• Phase III clinical trials look for longer life, better quality of life, fewer side effects and fewer cases of the cancer returning. These trials enroll a large number of patients (sometimes thousands). The patients are usually divided into two groups. One group will receive the standard therapy available for their type of cancer and the other group will get the new treatment. Patients are usually assigned by chance for the two separate groups being studied.

Cancer patients do not have to just count on trial information from their physicians. The patient can directly investigate their own eligibility for a clinical trial by calling the Cancer Information Service at 1-800-4-CANCER. Another valuable resource for patients to find out about clinical trials is the website www.clinicaltrial.gov.

I love the terminology used by those behind the scenes at Hurricane Voices. This is where I first read the words breast cancer dancer and where individuals have gathered to advance the rebellion against breast cancer. The content on this site is powerful, edgy, and truly inspiring -- it incites public action. And it makes me want to jump up and do something -- now. To break down the barriers to progress in pursuit of the causes and cures for breast cancer -- which is the whole purpose of Hurricane Voices.

Hurricane Voices began because of one woman -- Lois Egasti, a wife and mother living with metastatic breast cancer. Lois, who passed away on April 15, 2003, knew she was not alone and felt the need to take a stand against the disease. So she put her urge into action and formed this not-for-profit organization. And in just four years, a great community of voices emerged -- voices that have helped raise support and participation in far-reaching programs and events.

Hurricane Voices offers on its website a family reading list, a regular newsletter, an empowering overview of breast cancer and its statistics, and a sampling of various myths surrounding breast cancer. Hurricane Voices provides direction for involvement in unique conferences -- such as When a Parent Has Cancer: Strengthening the School's Response which helps school systems support families affected by parental cancer and Breast Cancer: Truth & Consequences, a conference that challenges the status quo concerning breast cancer. Hurricane Voices initiates thought-provoking public awareness campaigns and strives to inform the public that the disease we call breast cancer is a very serious illness.

Every day, more people are being diagnosed. Every day, more people are dying. Yet we are not beating this disease -- in fact in the time it takes to brush our teeth or drink a cup of coffee, another person has died of breast cancer. And this is what Hurricane Voices wants us to know. This and the fact that well-meaning, misconstrued survival rates in the 90 percentiles only extend for five years. And five years is just not enough.

Powerful -- that's what Hurricane Voices is -- powerful. And each of us can contribute our own power to this organization by becoming a Hurricane Voice. So speak up -- by simply clicking here.

On Friday, I was full of anxiety and panic and worry -- all over a lump I feel in my left breast that my oncologist says is probably just scar tissue from my lumpectomy two years ago. I don't like the word probably and the more I thought about it, the more unsettled I became. Too many young women hear that the suspicious bumps and lumps they detect in their breasts are nothing to worry about -- and too many women go on to later discover that these same bumps and lumps are in fact cancer. Sometimes it's in enough time to treat the cancer -- and sometimes it's too late.

I am a young woman -- 36 years old -- and I have already had breast cancer. I do not wish to obsess for my entire life about cancer but when I feel a lump in my breast, I want to know it is definitely nothing to worry about. Or I want to know that it is definitely something to worry about -- so I can treat it early.

So when I first got a mammogram and ultrasound appointment scheduled for a week from Friday, I accepted it and wrote it down in my calendar. And then panic set in. I realized I could not wait one week and that I should be able to demand a quicker response. So I called my doctor's office, spoke to the receptionist through uncontrollable tears, and somehow ended up with the doctor herself on the phone. "What's wrong?" she said. "I'm freaking out," I told her. "What do you want to do?" she asked. "Do you want to come in right now?" She told me she had a busy day, had a biopsy to perform that would take a while, but that I could come hang out in her office until she could get to me. Or I could come in on Monday, she said. I let myself calm down a bit and told her Monday would be good. She asked me what time I wanted to come -- she offered me any time that fit my schedule. I chose 9:00 AM.

So tomorrow morning, I will find out what exactly sits underneath the skin on my left breast, near my armpit -- what exactly it is that feels to me like a little mound of tissue that just doesn't seem right. Maybe it's scar tissue -- and I hope it is -- and maybe it's something else. I can only hope that at the end of my appointment I look foolish for pursuing something that doesn't deserve the attention I'm giving it. But if it does deserve attention, I will know I've done the right thing by vigorously pursuing an appointment I just couldn't wait one week for.

Celebrities have a way of motivating the public to take action. They help dictate fashion trends and set standards for mostly unattainable body shapes and sizes. They add hype to political views and philosophies and make influential statements about all sorts of issues. Like breast cancer. With its backing from celebrities like Melissa Etheridge and Sheryl Crow and Kylie Minogue -- all breast cancer survivors who are speaking out and raising awareness -- breast cancer has burst onto the media scene and is receiving powerful, positive attention. Kylie Minogue's public diagnosis spurred so many women into getting their breasts checked that the Medical Journal of Australia reports a 40 percent increase in bookings for mammograms. But sometimes, celebrity diagnoses don't elicit a response at all.

Italian tenor Luciano Pavarotti was diagnosed with pancreatic cancer last month -- yet the announcement barely registered on the public's radar. Perhaps he does not command the same kind of reaction as pop singers do. Or perhaps it's the type of cancer that keeps his public battle on the sidelines.

The breasts are a visible icon of femininity -- out in the forefront for all to see. And so the issue of breast cancer is in the forefront. The pancreas, on the other hand, are hidden behind the stomach and are out of sight -- and out of mind. When Apple chief executive Steve Jobs was diagnosed with pancreatic cancer in 2004, he didn't even know where to find his pancreas. And so this organ does not attract much fanfare -- and therefore does not attract the funding and research that breast cancer does. Which is sad because this cancer is not just hidden inside the body. It's also a hidden killer. It can't be felt like breasts can be felt. And there is no easy way to detect it, like with mammogram and other imaging techniques. Often a diagnosis of pancreatic cancer -- the fourth leading cause of cancer death in Western societies -- comes with a death sentence. And more and more, breast cancer diagnoses come with promising expectations of survival.

We may not know as much as about pancreatic cancer as we do breast cancer. But there are some behaviors that may contribute to this deadly disease. So in the spirit of prevention, consider this:

• If nobody smoked, 25 percent of pancreatic cancer cases wouldn't happen.
• Alcohol consumption can increase the risk by 15 times.
• Some studies link high meat consumption and low vegetable consumption to incidences of pancreatic cancer.
• Folate, the B vitamin in green leafy vegetables, oranges, legumes, and whole grains seem to reduce the risk. But folate supplements don't seem to have the same healthy effect.