The Tribune Democrat, Johnstown, PA

Breast Cancer

October 1, 2012

Local couple's breast cancer research making impact

WINDBER — Darrell Ellsworth’s research focuses on examining breast cancer at the molecular level for characteristics that make tumors unique.

His wife, Rachel Ellsworth, is developing ways to bring new discoveries into patient treatment protocols.

Both Windber Research Institute scientists are working on studies that illustrate Windber’s commitment to translational medicine, defined as bringing advances from the lab bench to the bedside.

Using a laser beam to ionize protein cells, Darrell Ellsworth is studying how breast cancer may spread to other areas of the body.

When removing breast cancer tumors, doctors also check for cancer cells in the lymph nodes because that is the first place that cancer metastasizes, or spreads. Darrell Ellsworth’s study is examining the lymph node cells to see why some cancers spread faster than others.

“When breast tumors develop in the breast and spread around the body, that’s the reason people die from breast cancer,” Darrell Ellsworth said. “We’re trying to determine how cells spread to different parts of the body.”

Examining the proteins expressed by the lymph nodes in patients with slow-spreading cancer might be different than in those with more aggressive disease.

“Maybe we can prevent the tumor cells from anchoring and starting to grow in other parts of the body,” Darrell Ellsworth said.

His preliminary results are promising because they show significant difference in the so-called negative lymph nodes.

“We are beginning to characterize how different the proteins are,” he said.

In March, Rachel Ellsworth presented a study at Society of Surgical Oncology’s annual meeting, calling into question the American Society of Clinical Oncology/College of American guidelines for treating a certain type of cancer.

“It was the group that set guidelines on how you evaluate a certain tumor,” Rachel Ellsworth said. “I looked at how the guidelines meld with reality, and I found they were too stringent.”

The guidelines were established in 2010 to define what is considered positive or negative for estrogen receptors. Estrogen is a female hormone that can accelerate breast cancer development. If a cancer is estrogen-receptor positive, it is considered low-risk and can be treated with endocrine therapy, or estrogen blockers.

Before 2010 there were no guidelines, and physicians decided on the treatment.

The problem is that the guidelines consider a tumor ER-positive if 1 percent or more of its cells test positive. Rachel Ellsworth’s review of more than 5,000 breast cancer patients showed the estrogen blockers were not effective in women with up to 10 percent positive cells.

The prognosis would be better for them with more traditional chemotherapy, but they might not be eligible for insurance coverage because they don’t meet the new guidelines, she said.

“They take women who have the worst-case scenario and they are getting good news that the tumors are much less aggressive,” Ellsworth said. “The treatment is different; outcomes are different; the  prognosis different.”

Her report at the meeting attracted a lot of attention, but Rachel Ellsworth said it’s a little early to tell if the organization will change the guidelines.

“The paper just came out,” she said “But I haven’t had any serious rebuttals.”

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