A Small Group Of Committed Women

By Dr. Kathleen T. Ruddy

“Never doubt that a small group of committed citizens can change the world; indeed, it is the only thing that ever has.”  Margaret Mead

On April 9, Loreen Arbus and the Harvard School of Public Health held a meeting in New York City, “The Global Burden of Female Cancer:  Tumor Viruses and Preventive Vaccines”.  Scientists working on the human papilloma virus (HPV), the human mammary tumor virus (HMTV), and the world’s first preventive breast cancer vaccine were joined by researchers studying cancer statistics and the challenges of addressing the global burden of female malignancies, especially in countries that cannot or, wisely, are not interested in a race for cure if prevention is a more realistic option, which it is.  Special emphasis was given to the obstacles to cancer screening facing women with disabilities, an interest of Ms. Arbus whose beloved sister had cerebral palsy.  Professors from Harvard University, Columbia University, Mt. Sinai School of Medicine, and the Cleveland Clinic came to present their research to a diverse group of New York City stakeholders, activists, breast cancer survivors, and healthcare reporters.  One of the attendees, Lori Sokol, who writes for the Huffington Post, posted a lovely blog about the event on April 30 (http://www.huffingtonpost.com/lori-sokol/breast-cancer-vaccine_b_3128708.html).  While the blog was most welcome coverage of this important event, there are several errors that must be corrected, for the challenge of meeting the highest standards imposed by the scientific method and its guardians, the academic community, requires accurate conveyance of the facts presented and discussed.

Specifically, I mentioned during the Q&A that approximately $50 billion is spent on breast cancer – all of breast cancer; that is, diagnosis, treatment, education, philanthropy, marketing, and research.  Of this estimated total, only a small portion is spent on research – millions, not billions.  And of that small portion, a scant 2% is devoted to understanding the causes of breast cancer or working for primary prevention of the disease.  My point was this:  breast cancer is a huge industry, a profitable industry.  It is unlikely that any one individual player in this vast breast cancer business will step forward to prevent or end a disease for which there is so much money to be made.  This is not to suggest that there is a conspiracy afoot, but rather a general inclination to keep on the path of diagnosis and treatment because, as Willie Hutton once said, “That’s where the money is.”  Creating a revolution in which the largest portion of breast cancer research funding goes to primary prevention of the disease is, I believe, the greatest challenge we face in facing down this disease.

There were two other errors in Sokol’s blog that are also worth correcting.  Triple-negative breast cancer is a form of the disease for which chemotherapy is effective but for which there is no targeted therapy available.  The mortality rate for triple-negative breast cancer is higher than for other forms of the disease (i.e., estrogen positive and Her-2 positive tumors), but it is not 70%, it is approximately 30%.  The overall survival rate is 70%, which is good news.  But the better news is that the preventive breast cancer vaccine developed at the Cleveland Clinic in 2010 has undergone additional studies in the past few years and appears to be especially useful in triple-negative breast cancers.  The vaccine will not be “available” next year, as Sokol said in her blog, but will be made ready for clinical trials to see if it is safe, provided adequate funding arrives to move this research from the bench to the clinic where it can be tested for use in women.

I would like to express my deepest thanks to Loreen Arbus and the Harvard School of Public Health for granting my request to host this summit in New York City last month, and I would like to thank the scientists and guests who made this great day the lively, invigorating convergence of women (and some very nice men) I hoped it would be.  I am grateful to Lori Sokol for taking the time to attend and blog about its substance and our shared hope for a future in which the ‘cure’ for breast cancer is prevention.  I hope I’ve made a small contribution to this end, bringing all these wonderful people together to share more broadly the importance of this work, the validity of the science that supports it, and the accurate dissemination of information so critical to its acceptance.  I look forward to a future where such meetings are more frequent, and as dynamic and encouraging as this one was.