Numbers bring special comfort to Cynthia Toms, 43, who is a breast cancer patient and an accountant.
Last week she found out her new number is 85. That is, there is an 85 percent chance that her cancer -- an especially virulent and fast-growing one -- will not come back.
It's enough to change how she thinks about living the rest of her life, she said.
She's one of about 3,000 women who have been taking the cancer drug Herceptin as part of two national research trials to see if it stops their cancer from coming back after surgery and chemotherapy. Last week the National Cancer Institute announced that the drug works so well, the institute stopped the trials early so other women can take advantage of it.
Now doctors are using words like "quantum leap" and "amazing" to describe the drug.
Within weeks it is expected to become the new standard treatment for 20 to 30 percent of all breast cancer patients. They have a type of cancer called HER-2 positive, which has much faster and higher rate of recurrence than other types of breast cancer.
"I don't consider anything a home run until we cure everyone," said Dr. P. J. Flynn , a Minneapolis cancer doctor who participated in the study. "But this is certainly a stand-up triple."
Researchers found that Herceptin, with chemotherapy, stopped the growth of new tumors in 85 percent of women who took it during the four years of the trials. Chemotherapy alone prevented recurrence in 67 percent, researchers said.
That outcome is far better than the numbers imply.
If breast cancer returns after treatment, it usually comes back within five years and spreads to other parts of the body, doctors said. Advances in treatment mean that women with other types of breast cancer often live with it for years. HER-2 positive cancer, however, is so aggressive that when it does come back, women often die. Stopping it from coming back is the key to survival, doctors said.
"This is the real thing," said Dr. Edith Perez, a cancer doctor with the Mayo Clinic in Jacksonville, Fla., and one of the lead researchers. "This is patients' lives."
A nasty shock
When Toms found out she had cancer a year ago -- and that hers was a particularly nasty one -- her priorities suddenly shifted, she said. She and her husband, who live in Bloomington, had always been disciplined savers and workers, she said.
But after her diagnosis she realized it would be foolish to wait until their 11-year-old daughter is grown or they retire to have fun, she said.
"You worry that you won't have enough in the bank when we get there, she said. "But I might not get there."
Now she knows that her chances of getting there are pretty good, she said. Thanks to the Herceptin she started taking once a week in late December, she hopes she won't have to cram a lifetime into just a few years. More important, she's bought time, she said. If her cancer comes back in five years or 10 years, medical treatments probably will have advanced as well, she said.
"Ten years is a lot of time in the world of medicine," she said.
Herceptin is a case in point. Made by Genentech Inc., a biotechnology company based in South San Francisco, the drug has been used since 1998 to treat advanced HER-2 positive breast cancer that has spread throughout the body. One study showed that 78 percent of women who took Herceptin were alive a year later, compared with 67 percent who had just chemotherapy. Genentech, along with the National Cancer Institute, was a sponsor of that research and the most recent studies.
Herceptin is one in a new generation of drugs called targeted therapies that are designed to interfere with the function of specific cells. In HER-2 positive breast cancer, the cancer cells carry a gene mutation that produces a protein called HER-2. That protein is what makes the cancer cells grow quickly, experts said.
Herceptin is an antibody that interferes with the HER-2 protein and makes the cancer cells more sensitive to the killing power of the chemotherapy, experts said.
There are still some questions, doctors said. The one that concerns many doctors is that the drug combined with chemotherapy increased the risk of congestive heart failure up to 4 percent. That raises concern about treating cancer patients who also have heart disease, they said.
Flynn, the Minneapolis cancer doctor, said he fears that news of the drug's power will prompt a rash of unnecessary and expensive testing among women whose cancer is in remission. They will want to know if they had HER-2 cancer, he said. But as long as their cancer is in remission, they don't need the drug, he said. And if it returns, they will automatically be tested because, thanks to the new studies, testing for the presence of HER-2 protein will become routine, he said.
Cancer doctors from around the world will wrestle with those and other questions at the annual meeting of cancer researchers in Orlando, Fla., starting May 16.
But after that, Flynn said, Herceptin will very quickly become the expected treatment for patients like Toms.
"I think we will have enough answers," he said.
"Go confidently into the direction of your dreams. Live the life you always imagined" Thoreau
Life is not measured by the number of breaths we take, but by the moments that take our breath away.