The insidious nature of breast cancer is well-documented. It is a disease not to be trifled with; a medical mystery with all-too-often devastating outcomes. What is less well-known is the significance and sheer volume of groundbreaking research underway in central Indiana into the causes, prevention and treatment of breast cancer. Indeed a global asset for cancer researchers – The Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center in Indianapolis – is hailed as a critically important component in better understanding the elusive answers to why breast cancer happens and how best to treat it.
Lida Mina, M.D., is an Assistant Professor of Clinical Medicine at the IU School of Medicine and a Carmel resident. Dr. Mina is looking at breast cancer from two perspectives: clinical work (she sees patients three days a week) and research focusing on triple negative breast cancer, a particularly stubborn foe with poor prognoses that claims too many lives. She also conducts research in BRCA patients and patients at elevated risk for breast cancer. The most common form of breast cancer is estrogen-driven, and treatment usually includes medications that block estrogen production. The problem for researchers like Dr. Mina is they don’t know what the drivers are for rarer forms of breast cancer. “We have no target for triple negative breast cancer,” she explained in a recent interview with TownePost Publications. “Chemotherapy works poorly in this type of disease, especially in advanced stages.”
The good news is a team of skilled professionals in Indiana is on the case. Dr. Mina, 34, earned her medical degree at the American University of Beirut in her home country, Lebanon, and has been with the IU School of Medicine for a decade. She is a member of what she called “an excellent team” collaborating on cancer at the molecular level using science, clinical trials and DNA research for a holistic approach to the disease. “We have made huge advancements over the past few years with certain kinds of cancer but are far from a general cure,” she said, adding that the important thing researchers now know is that breast cancer is not a singular disease. “We’re trying to figure out the various types of breast cancer and to not treat it as a general disease.”
Instead researchers are collaborating in a field of study called “personalized medicine” – that is, understanding what is happening in an individual patient’s genes and its implications for cancer prevention and treatment. “We are moving in the right direction,” she said. “We want to know what’s wrong with the cell at the DNA and molecular levels to better choose drug treatments instead of treating cancer as a general disease.”
Phase One clinical trials are underway at IU Simon Cancer Center which is among the few medical facilities using PARP inhibitors on humans. PARP is an enzyme (poly ADP ribose polymerase) present in breast cancer cells that, when inhibited by certain medications, can’t do its job in cellular division. “The whole point of the PARP inhibitor is it blocks the repair mechanism in cancerous cells,” Dr. Mina explained. Thus, the diseased cells die.
The Komen Tissue Bank provides researchers with a vast collection of healthy breast tissue. It serves as a control group against which researchers compare cancerous tissue to better understand why cells go bad. “That is its [the Tissue Bank] strength. It’s an important tool that’s been missing,” Dr. Mina said.
Still the best way to “treat” cancer remains prevention. Once it happens, it’s hard to get rid of it. “We know that diet and exercise are important [to prevention],” said Dr. Mina who also points to genomics. “Our understanding of breast cancer at the molecular level keeps me always hopeful.”