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CNN LIVE TODAY

Discussion on Fighting Breast Cancer

Aired October 22, 2003 - 11:31   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

DARYN KAGAN, CNN ANCHOR: We continue our discussion now on fighting breast cancer. In the last hour, I told you about my family's personal experience after my mom was diagnosed. This hour, we will be taking some of your e-mail and your phone calls. The address is livetoday@cnn.com. The number: 404-221-1855.
Joining me now, Dr. Leonard Lichtenfeld of the American Cancer Society, an oncologist.

Good morning. Thanks for being with us.

DR. LEN LICHTENFELD, AMERICAN CANCER SOCIETY: Good morning. My pleasure.

KAGAN: And my mom is still with us in Los Angeles, Phyllis Kagan.

There she is.

Hi again, mom.

PHYLLIS KAGAN, DARYN KAGAN'S MOM: Hi, Daryn.

KAGAN: And if you weren't with us in the last hour, we shared that my mom was diagnosed last January. She's had a lumpectomy and radiation, and Dr. Lichtenfeld has had chance to look over her records. And one of the reasons we brought my mom on, not just because she's my mom -- which she is, and I'm glad for that -- but she's an example of a lot of important issues in breast cancer right now, doctor. No. 1, she got a mammogram and she caught her disease early.

LICHTENFELD: That's true. As we were talking a moment before we came on the year, she's -- you said I could say anything about your mother, OK.

KAGAN: Fair game, mom?

P. KAGAN: Yes, absolutely.

LICHTENFELD: Mom is 66 years old. She's a postmenopausal lady who happened to be taking Prempro, which is hormone replacement therapy.

KAGAN: Which has been in the news a lot, a lot of concerns about that. LICHTENFELD: Substantial concerns about that. And now she's on agilent (ph) therapy, not chemotherapy, with a drug called Letrozole, which has gotten a lot of press over the past week or so.

KAGAN: People might know it as Femera.

LICHTENFELD: Femera is the trade name of the drug.

KAGAN: Absolutely. OK. So the e-mails have been coming in, and my mom also coming on, because she and I worked on an article for "Self" magazine this month talking about what helps and how family members can help as well.

We'll go to our first e-mail now, and this is from a woman who I think is facing a mastectomy very early next month, and She wants to know about a breast cancer vaccine. Is there such a thing as a breast cancer vaccine?

LICHTENFELD: Well, there are breast cancer vaccines that are in what we call clinical trials or investigational stage. There's no breast cancer vaccine that's been approved by the FDA for general use.

The interesting cancer vaccine has been around for a long time. I started this business in the early '70s, involved in cancer and cancer research. We were doing vaccines back then. There's been a lot more interest recently, because of new techniques in developing these vaccines and making them very effective. But the bottom line is they're in clinical trials, they're investigational, and somebody has an interest in looking into that, then they have to find a trial, a trial site that's involved, and preferably, before they have the surgery, the mastectomy or lumpectomy for their breast.

KAGAN: Do it before.

OK, mom, this next question is for you. The question is, they want to know how difficult was it for you to tell your kids and to discuss it with your family? And how did you prepare to tell us kids?

P. KAGAN: OK. Well, it is difficult. It's very hard. But I had a very short speech, and I used it with everyone. And whoever I talked to, I simply said I had something that was difficult to say, so I'm just going to say it. And then I said, I have breast cancer. And, you know, once it got out, it was a relief. But it is difficult to say, but you just have to say it.

KAGAN: Just go ahead and do it.

And my mom, like a lot of mothers around there, have her kids scattered around the country.

LICHTENFELD: Let's talk about what's interesting -- 30 years ago parents didn't tell their kids about the fact they had cancer or breast cancer. And how important is it for you to have heard that from her, to be able to help her and support her, to help her make decision about treatment? And that's one of the, I think, very interesting and amazing things that's happened in this country over the past 30 years. We've become open, we've been able to talk about it, and as a result, we've been able to learn more and help more about treating patients with cancer and supporting them.

KAGAN: And so it's hard to put a medical benefit on that, but it does help to have the support.

LICHTENFELD: It's so important. That is a huge medical benefit, because you no longer have people hiding and not knowing what's going on, not participating in their treatment. We've learned a lot in the last 30 years, as I mentioned since I started in the cancer treatment and research, and that's probably one of the most important things to do, be able to talk about it, be able to help make those decisions together, bring your family around you. I can't overemphasize that enough.

KAGAN: Very good. Let's go to the phones right now. Joan in Scottsdale is on with us.

Joan, what's your question, please?

CALLER: I am a 12-year survivor, and I was on Tamoxifen for five years. And I was wondering if the new drug from Morrow (ph) would be any good for me at this point?

LICHTENFELD: Well, it was Joan?

CALLER: Yes.

LICHTENFELD: Joan, that's actually a very interesting question, which a lot of people are asking right now. I'm going to assume that you're postmenopausal. Can I ask how old you are?

CALLER: I'm 64.

LICHTENFELD: So you're 64 years old. So you fit in the category similarly to the category of women that we're studied in the trial that was reported two weeks ago. Now, is there benefit in having you go on Letrizol or Femara for a period of time. It's seven years since you finished your Tamoxifen, and that's an unknown question.

And I would strongly suggest that you talk to your doctor, to your oncologist. And I would suspect that there's going to be some oncologists who are going say yes, you should do it, and some oncologist who would say, well, you're doing very well and why change anything.

So there's no definite answer to that, and lot of people are interested in trying to find the answer to that question.

Now the situation would be different if, for example, you were, let's say, three months after finishing Tamoxifen or perhaps six months after Tamoxifen. In that situation, I think many doctors would put you on Letrizol, assuming you're post menopausal and that your cancer had the right characteristics. That would be estrogen receptor positive, which I suspect it was, since you were on Tamoxifen in the first place. KAGAN: We want to get one more quick e-mail in here, and actually I'm going to, to our producer, we're going to skip ahead to one, because it's from Ronnie. He wants to point out, you know, great to have my mom on, great to talk about women, but men can get breast cancer, too, and they need to be aware.

LICHTENFELD: That's correct. There are 211,000 cases of breast cancer in women, invasive breast cancer in the United States, and another 55,000 of noninvasive breast cancer diagnoses in women.

But there are also 1,300 case in men every year. You may remember recently, Senator Edward Brook from that -- former Senator Brook from Massachusetts had breast cancer. In fact, he was on CNN, and he talked about it as well. So if a man feels a lump and is not certain what it is, he should get it checked out.

The other important bit of information for your listeners is that it can also be a sign of higher risk for the children of that man. We tend to forget that breast cancer, you know, the risk of breast cancer. We always talk about mothers, and sisters and daughters having breast cancer, increasing risk. Well, if your father had breast cancer and you're a woman, that can also be a sign of increasing risk, particularly a genetic transmission of breast cancer, for which you may want to get a specific test called a BRCA test to find out whether or not you have the genetic predisposition to getting the disease.

KAGAN: We could talk about genetic testing on another day. It's a whole other topic.

LICHTENFELD: Yes, we could.

KAGAN: Dr. Lichtenfeld, thank you for being on and giving your expertise in answering questions for my mom and for our viewers out there.

And, mom?

P. KAGAN: Yes.

KAGAN: Thank you so much. Viewers loved you.

P. KAGAN: It was absolutely my pleasure. And, ladies, get regular mammograms.

KAGAN: She said it. Did she say it well?

LICHTENFELD: Absolutely.

KAGAN: As mom can only say it. Thanks to both of you. And we'll have you back again.

LICHTENFELD: You bet.

KAGAN: Appreciate it.

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