Health Awareness

Finding joy after surviving cervical cancer twice

How one woman embraced life, marriage and motherhood despite her cervical cancer diagnosis and its return

January 11, 2024

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Grenado and family

Several years ago, Christine Granado was living happily in New Jersey with her fiancé and then-9-year-old son, but she felt something wasn’t right.

In the span of a year, she lost three pregnancies. The first miscarriage came as a total shock. With the second, she felt confused. After the third, she was afraid something was terribly wrong. She decided to go for a routine checkup. While undergoing a series of tests ordered by her OB-GYN, she got surprising news: she was diagnosed with stage IIB squamous cell cervical cancer that had spread to her lymph nodes. At just 28, Christine said she felt disbelief.

“How can I have cancer at this age?” she asked herself. “I remember peeking through my bangs, feeling like I was trying to hide behind them.”

Young women are at risk for cervical cancer, too

Granado wasn’t alone in asking herself that question. Cervical cancer is more likely to affect women under 45 globally than most other cancers. In 2020, it was estimated that about 604,127 women were diagnosed with cervical cancer worldwide and about 341,831 women died from the disease. Screenings may help to detect cervical changes before they become cancerous. In several western countries where screenings are routinely conducted, the incidence rates of cervical cancer have decreased by 50% or more over the past 50 years.

Beginning her cancer treatment journey

Granado started treatment as soon as possible. She was prepared for physical side effects but was overwhelmed by the other changes that soon followed, including how she felt about losing her fertility. She and her partner discussed preserving her eggs but decided against it as doing so would have delayed her treatment.

Granado’s cancer went into remission for three years, and she found joy again: She and her fiancé got married and decided to have a baby via surrogate.

The shock of a recurring cancer diagnosis

Then, soon before her son was born, Granado started having unexplained chest pains. A CT scan found enlarged lymph nodes. She was diagnosed with metastatic cancer.

“When I got the recurrence diagnosis, I was devastated. It was hard to hear, but it motivated me to finish things, to contact a lawyer and get things in my kids’ names — to think about life after me,” she said. 

It also motivated her to continue with more treatments. During her second round of treatment, Granado was able to welcome her new son. When she saw him, she took him in her arms: “I bawled my eyes out.” 

A focus on mental health 

In addition to her son’s arrival, Granado said a focus on herself has sharpened her resolve to live her best life. When the cancer came back, she grieved for her life. She would cry and sleep all day. Her depression stopped her from enjoying precious time with her family.

“The most disabling thing I dealt with was the depression,” she said. “There were days when I would feel physically OK, but I’d still stay in bed all day.” Thankfully, Granado had the support of a psychologist and a psychiatrist who helped her feel well again. 

Cervical cancer won’t stop her from living her best life 

Granado has been able to complete a master’s degree in health leadership, and her family has a new border collie named Harry. Even everyday activities like going to the hardware store and winding down with a book mean so much more now. She appreciates the small details, like watching TV with her son on the couch.

“Life has been amazingly boring,” she says. “In a good way.” 

Granado said she hopes her story will inspire women and give them hope that there’s so much life to be lived — including the boring moments — in the face of a cancer diagnosis.

Health Awareness

Empowering others to speak up about HPV-related cancers

The impact of Gina’s diagnosis inspired her to help others prioritize their health

January 9, 2024

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Gina Esposito HPV Story

After 20 years of normal cervical screenings,* Gina Esposito was confident her next routine screening wouldn’t be any different. So, when she was diagnosed with human papillomavirus (HPV)-related cervical precancer at 47 years old, she was surprised.

“The sinking feeling I had when I received my diagnosis was intense because I wasn’t expecting it,” she said.

*A cervical screening, often referred to as a pap test or pap smear, looks for precancers or cell changes that might become cervical cancer if not treated appropriately.

The impact of HPV-related cancers and diseases

More than 80% of cervical cancers are associated with HPV. For most people, HPV clears on its own. But for those who don’t clear the virus, it could cause certain cancers and diseases.

After her diagnosis, Esposito underwent a procedure to remove the abnormal cells from her cervix. When a follow-up test showed that there were still some abnormal cells present, she consulted with a doctor and decided to get a hysterectomy.

At first, she felt embarrassed by her diagnosis. As she started to share her story, she noticed that others felt ashamed to speak about HPV-related cancers and diseases. She knew something had to change.

“I have a newfound responsibility to take the stigma away, to say ‘the shame has to go away,’ whether you’re a woman or a man,” Esposito said.

Throughout her experience, she says her daughter has been a source of strength.

“You don’t want your child to be without you or to experience the loss of a parent. You want to be around for all of their milestones and they want you around,” Esposito said. “So, she keeps me motivated because there’s an expectation that mom’s going to be around.”

Photo of man and woman

“I try to be a positive disruptor in this space and normalize it so that people go for early screenings and routine screenings and that they get treatment if they need it.”

— Gina Esposito

The importance of routine care

In some ways, Esposito considers herself lucky. Her commitment to prioritizing routine care helped her catch her disease early.

“I’m so glad I took the time to go to my screening – it helped catch my disease early,” she said.

Esposito is working to ensure her daughter also prioritizes getting routine care and understands the value of prioritizing her health, especially as she approaches adulthood.

“She knows you need to own your own health because no one else is going to do it for you,” she said. Esposito encourages colleagues across our company to prioritize their health, too.

Esposito plans to continue helping men and women feel comfortable discussing HPV-related disease and get the preventative care they need.

“When I talk with others, I focus on what happened to me so they can use it as an example,” Esposito said. “I get people emailing me, texting me, going, ‘I’m going to make my appointment today.’ And if we can have one person that we get early, then my job is done.”

Health Awareness

Biomarker testing may help inform treatment decisions in certain cancers

An oncologist explains why cancer biomarkers may provide more precise information about a person's cancer

January 4, 2024

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Over the past 20+ years, there’s been an evolution in how we think about cancer. Cancer biomarkers — substances produced by tumor cells that reflect unique features of a tumor — can change the approach to certain cancers.

Advances in biomarker testing may help inform treatment decisions

It wasn’t long ago when conversations were about simply “breast cancer” or “lung cancer.” Now, physicians can get a lot more precise.

Dr. Scott Pruitt

“We’ve come to understand that two people with the same type of cancer may have differences in the specific changes in the genes, proteins and other substances that may allow cancer cells to grow and spread.”

  • Dr. Scott Pruitt
    Associate vice president, early-stage development, clinical oncology, MSD Research Laboratories

“The field of breast cancer research was arguably the first to realize that there are multiple cancer subtypes and that biomarker testing could help inform therapy,” said Pruitt.

In the treatment of breast cancer, understanding various tumor biomarkers and pairing that understanding to help guide selection of relevant medicines has helped physicians evaluate potential treatment approaches. And the same is true in lung cancer where understanding tumor biomarkers has been used to help guide therapy aimed at targeting certain genetic mutations.

Biomarkers may help us understand a cancer better and how to approach it. That’s why biomarker testing may be an important next step after a cancer diagnosis.

Key terms to know:

  • Biomarker: a measurable indicator of a biological state or condition found in blood or tissues.
  • Biomarker testing: medical tests to look for measurable indicators (genes, proteins and other substances) that may provide information about a biological state or condition.
  • Biopsy: the removal of cells or tissue for examination.
  • Genetic testing: medical tests to look for certain mutations in a person’s genes that may be a sign of a disease or condition.

Biomarker testing after a cancer diagnosis

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Blood test

microscope

Biopsy of the tumor

Testing for proteins and/or genes to look for known biomarkers icon

Testing for proteins and/or genes to look for known biomarkers

Biomarker testing and genetic testing may enable detailed characterization of some cancers

Some biomarker tests can find inherited genetic changes that you may have been born with that may increase your risk of cancer or other diseases. Genetic testing might help determine if you have certain mutations (for example, the BRCA gene) which could help inform treatment options.

MSD has been at the forefront of research to advance the understanding of biomarkers for certain cancers.

"We're fully invested in leveraging biomarker data to help inform cancer care."

— Dr. Scott Pruitt

“Across our oncology studies in every phase of development, we continue to incorporate multiple biomarker approaches to more fully understand biology as well as identify new targets of interest,” Pruitt said.

Discussing biomarker testing with a health care provider

If you’ve been diagnosed with cancer, it’s important to ask your doctor about biomarker testing. Start with these questions which may help you prepare for conversations with your doctor:

  • Is biomarker testing appropriate for the type of cancer that I have?
  • If there’s a chance my cancer was caused by an inherited risk factor, should I undergo further testing?
Health Awareness

The new generation making an impact on HIV

Meet these young advocates helping to lead the response to HIV around the world

November 13, 2023

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HIV remains a global pandemic. In 2022 alone, an estimated 1.3 million people worldwide were newly diagnosed with HIV.

MSD has been committed to advancing science for the treatment and prevention of HIV for more than 35 years, but we know it takes all of us to make a difference for the HIV community.

And that’s just what these International AIDS Society (IAS) Young Leaders are doing. In 2022, our company was proud to be one of the groups to support 11 Young Leaders to co-create the Youth Hub — a youth-led networking platform that empowers young change-makers living with and affected by HIV to lead in the HIV response. They’re an inspiring group of advocates with different backgrounds and experiences in the response to HIV, each striving to empower and educate others from their respective corners of the globe.

Let’s meet some of these young change-makers.

Norman Chong | Malaysia

Norman Chong is using their gift of storytelling to encourage young people across the world to ask “Why?” Chong has been working to develop a solution-oriented platform to help address gaps in the HIV response for young people in Malaysia.

With their platform, called “We Ask the Y (WAY)”, Chong aims to provide tools for young people living with and affected by HIV to learn and network in support of social health, as well as economic and political justice. Chong also trains young researchers to translate and communicate findings into evidence-informed policies and practices to address barriers to health care for young people.

“If I have anything at all, it’s anchored on moving the dial with the question, “Why?”, and advocating for health care to be accessible to all, for policies designed to protect and empower, and never to divide and conquer.”

  • Norman Chong

Linda Joseph Robert | Uganda

Dismantling HIV stigma to support young people is the motivation for everything Linda Joseph Robert does. As a youth advocate, he helps to promote increased access to quality adolescent sexual and reproductive health services for young people through peer support interventions, community engagements and strategic partnerships. His passion for youth advocacy, activism and HIV-related programming came to life when he led a campaign to help reduce HIV stigma and discrimination during the COVID-19 pandemic.

As a young person living with HIV, Robert is driven to help increase access to HIV prevention, treatment and care services. Robert has held leadership positions including the role of youth advocate at AIDS Healthcare Foundation-Uganda Cares, and serves as a U=U Africa Forum Ambassador in Uganda.

“I’m motivated by the progress that has been made in the HIV field and excited to be part of the next generation of HIV professionals who will continue the journey toward ending the AIDS pandemic, where no one is left behind.”

  • Linda Joseph Robert

Elizabeth Onyango | Kenya

UKIMWI UNAUA is a term Elizabeth Onyango and others in Kenya know too well. Translated to “HIV kills,” this phrase influenced Onyango’s perception of HIV at a young age — as the messaging around HIV in her country was mostly about death and fear. Growing up, she lost close family and friends to HIV and saw how cultural beliefs and practices exposed young women and girls to HIV. It wasn’t until she went to high school that Onyango learned about ways to protect against HIV, which helped reduce the fear she grew up with — and sparked an interest in HIV prevention.

After high school, she volunteered at a female sex worker-led organization that champions human and health rights of sex workers.  Today, Onyango continues to encourage young women to take action to ensure they have a say in decisions about their health.

“My goal is to champion meaningful engagement of women and girls in HIV prevention and advocate for structural changes to improve the quality of life of women living with HIV.”

  • Elizabeth Onyango

Isaac Ogunkola | Nigeria

A background in public health has given Isaac Ogunkola deep insight into the world of infectious diseases, especially HIV. His passion for HIV advocacy became clear after volunteering to encourage harm reduction for people who use drugs and promote sexual and reproductive health and rights programming for homeless children, refugees and young people.

Having witnessed young people in his community die as a result of drug overdose and HIV, Ogunkola is committed to unifying public health, harm reduction and human rights. Through his peer education project, he engages young refugees in West Africa to lead HIV prevention programs in their communities.

“I don’t want to see death in any age group or population caused by HIV or drug overdose again.”

  • Isaac Ogunkola

Ashley Rose Murphy | Canada

Ashley Murphy was 7 years old when her adoptive parents told her she was living with HIV. By age 10, Murphy began to speak publicly about living with HIV, talking to young people around the world about the stigma around HIV and how to protect and advocate for themselves. She’s been a key voice for youth activists engaged in the HIV response in Canada ever since presenting at the U.N. General Assembly and the Global Fund, and even hosting a TED Talk.

Today, Murphy is an ambassador for several foundations committed to ending the AIDS epidemic through research, government-funded programs, global advocacy, prevention, testing and treatment options. Murphy remains an inspiration for young Canadians living with or affected by HIV.

Ashley Rose Murphy

“I want everyone to know that an HIV diagnosis does not have to be the end of the world. We can continue to live healthy and fulfilling lives, but it starts with educating yourself about your diagnosis and, most importantly, being your own advocate.”

  • Ashley Rose Murphy

Paul Mavesere Ndhlovu | Zimbabwe

Paul Ndhlovu has been using his voice to help young people living with and vulnerable to HIV in his native Zimbabwe for years. He’s produced a peer-led radio show as the creative radio champion for Zvandiri, an organization that “connects children and young people living with HIV with peer counselors to help assure health, happiness and hope.”

In his role, Ndhlovu — together with other adolescents and young people — has created a youth-friendly environment for people living with HIV to freely discuss challenges and issues in their own lives. The show explains to young people the importance of HIV prevention behaviors, the need for increased HIV testing, their sexual and reproductive rights, and available resources to help with mental health and well-being needs.

Paul Mavesere Ndhlovu

“The Zvandiri Radio Show is such an important platform. We’re providing an open forum for people living with HIV to freely come as themselves and talk about any challenges they may face.”

  • Paul Mavesere Ndhlovu

Stefano Regner | Philippines

Stefano Regner’s schedule is always busy, and as a physiotherapist and sexual health advocate, his work revolves around helping others.

As a trained HIV screener, counselor, and speaker, Regner is constantly on the move — traveling across the Philippines to help link people living with HIV to immediate care and empowering people when it comes to understanding safer sex. He’s also been a research assistant for one of the Philippines’ largest grassroots HIV test-and-treat centers.

And today, as both a medical student and a social media influencer, Regner provides educational resources for people living with HIV, using health campaigns and videos.

Stefano Regner

“Social media provides a new platform and method to translate and communicate important topics about health and increasing health literacy. I enjoy sharing key information with my followers, especially as it relates to sexual and reproductive health among at-risk populations in the Philippines.”

  • Stefano Regner

Kalisito Biaukula | Fiji

Kalisito Biaukula’s motivation to give a voice to the voiceless and speak up for those in need is evidenced by their work across their island nation of Fiji and surrounding regions. 

As an intersectional, queer, feminist activist and human rights defender, Biaukula has worked with various civil society organizations addressing intersecting human rights issues for people with diverse sexual orientations, gender identities and expressions, and sex characteristics, in Asia and the Pacific.

Biaukula is a major advocate for people living with and impacted by HIV, fighting to ensure they receive the proper care and government assistance, and calling for comprehensive sexuality education at all levels.

Kalisito Biaukula

“It’s important for young people, especially those living in the Asia-Pacific region, to take a leading role in decisions that affect our bodies. We must all use our voices to stand up for human rights and ensure all populations are receiving equal opportunities to access care.”

  • Kalisito Biaukula

Sara Thapa Magar | Nepal

From a young age, Sara Magar developed an interest in social issues related to women and children living with HIV. This passion eventually led her to advocate for the needs and rights of affected populations living in the Asia-Pacific region.

Magar has been a board member of the International Community of Women Living with HIV Asia & Pacific (ICWAP) and has also spoken publicly about the need to support women-led organizations. In her current role as president of the National Federation of Women Living with HIV and AIDS (NFWLHA) in Nepal, Magar works to tackle gender inequalities and end gender-based violence.

Sara Thapa Magar

“As youth leaders, we need to continue bringing these issues to the forefront and work to partner with the government and advocacy groups to address the challenges of women and children living with HIV.”

  • Sara Thapa Magar

The future is in good hands with these young leaders, advocates and activists, and we’re excited to continue to watch the impact they make on their local and global communities. To learn more about this youth-led collaboration, visit the IAS Youth Hub.

Health Awareness

How you can help slow the threat of antimicrobial resistance

The growing burden of AMR is threatening the return to a world without effective antibiotics

October 31, 2023

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Before antibiotics were discovered in the 20th century, contracting an infection could be fatal. Their discovery was a turning point in human history, revolutionizing medicine and saving countless lives. However, the growing burden of antimicrobial resistance (AMR) is threatening the return to a world without effective antibiotics.

We all have a responsibility to address this threat, and it will take dedicated efforts from all sectors across health care, including patients, to make a difference.

Here are four groups that can play a role in helping slow the threat of AMR:

01.

Patients

Be vigilant in infection prevention efforts and always use antibiotics correctly

We each play an important role in slowing the threat of AMR— starting with preventing infections that require antibiotics in the first place. Washing hands, preparing food hygienically and keeping up to date with vaccinations are all measures to help avoid infections.

Another important action patients can take is using antibiotics only when they’re needed. Always follow health care providers’ (HCPs) directions and never share or take leftover antibiotics, which may not be needed and may cause resistance. If your HCP believes antibiotics are not the correct treatment to help your condition, ask about other options. Taking antibiotics when they’re not needed may advance AMR. Bottom line: It is important to follow the guidance that your medical team gives you for treatment.

Antimicrobial resistance pill

02.

Health care professionals

Be a source of antibiotic guidance

HCPs and medical systems need to preserve the effectiveness of antibiotics. It’s up to the health care providers to help ensure that the right treatment is given based on an accurate diagnosis. Hospitals should have a plan in place, with principles customized to their local needs, to guide the appropriate use of these medicines.

Nurse consulting patient

03.

Policymakers

Encourage antimicrobial innovation

We need new antibiotic options to stay ahead of the evolving bacteria. Governments can help. Incentive packages can provide a sustainable return on investment for the development of new antimicrobials. Encouraging innovation would allow companies to invest in the research and development needed. As a result, this would help provide health care professionals around the world with the tools they need to help patients fighting infections.

Signature

04.

Industry leaders

Invest in new developments

Finally, the participation of leading biopharmaceutical companies is crucial to addressing the growing threat of AMR.

For more than 100 years, MSD has played a significant role in the discovery and development of novel medicines and vaccines to combat infectious diseases. And, in an effort to affect widespread change, we’ve supported efforts around the world that aim to address AMR through surveillance initiatives, collaborating with hospitals to fund education and implement stewardship programs, and advocating for substantial policy changes.

Researcher in the lab

There is no single solution to the complex problem of AMR; it’s up to all of us to take collective action. We hope you’ll join our efforts and play your individual part to help ensure that patients have access to the antibiotics they need, now and in the future.

Health Awareness

Understanding adult pneumonia: causes, symptoms and risk factors

Pneumonia is an infection of the lungs that can cause serious complications

October 31, 2023

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What is pneumonia?

Pneumonia is an infection of one or both lungs that can make it difficult to breathe and limit your ability to get sufficient oxygen.

What are the signs and symptoms of pneumonia?

Pneumonia can present differently in people based on a variety of factors, but common symptoms include:

Fever

Wheezing / difficulty breathing

Cough

Chills

Rapid breathing

Chest pains

Confusion

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Loss of appetite

Which adults are most at risk?

Anyone can get pneumonia, but older adults are particularly at risk.

Medical conditions such as diabetes, chronic heart disease, COPD and HIV can also increase risks of pneumonia — even in younger adults.

What can cause pneumonia?

There are two main types of pneumonia — viral pneumonia and bacterial pneumonia.

Bacterial pneumonia is often caused by the bacteria Streptococcus pneumoniae.

Pneumococcal pneumonia is one of the most common infections caused by this bacteria.

How does pneumonia spread?

Viral and bacterial pneumonias are contagious. People who are infected can spread the virus or the bacteria with respiratory droplets in the air when they cough, sneeze or talk. People can occasionally catch pneumonia by touching something that has the virus or bacteria on it and then touching their noses or mouths.

Ask your health care provider for more information.

Health Awareness

Staying positive with pulmonary arterial hypertension

From struggling to breathe to advocating for others, one woman with PAH shares her story

October 24, 2023

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A decade ago, Nola Martin was having trouble breathing, and she was gaining weight. She assumed it was simple: She started to focus on improving her diet and getting more exercise, but she wasn’t seeing results.

“Little did I know the situation was a lot more serious than that,” she said.

Martin was diagnosed with pulmonary arterial hypertension (PAH) and scleroderma. PAH is a disease of high blood pressure in the lungs. Her PAH was associated with scleroderma, a connective tissue disease that can affect the skin, blood vessels and organs and can cause PAH.

“I had two illnesses, and I had no idea what they were from. How did I get them? I was hearing all these terms I’d never heard of before.”

  • Nola Martin

Finding the right care

Martin said that the confusion and complexity of having two chronic diseases made the beginning of her journey the most challenging. Through her experience with PAH, she said she learned that “you must find a facility that is familiar with your disease.” She recommends the Pulmonary Hypertension Association as a great place to start learning about PAH.

While she knows her PAH is progressive, she chooses to stay positive.

“What I learned about advocating for myself with PAH is that no one is going to fight as hard for me as I will,” said Martin. “I know my body. I know when something is different, but I also know that my doctors are not mind readers. If I don’t share with them what is going on, including the smallest details, they can’t give me the proper treatment I need.”

Nola Martin headshot

Staying hopeful through connection

It’s important to Martin to connect with other PAH patients and educate people about the disease.

Since her diagnosis, she’s educated numerous people about PAH and scleroderma. She believes in the importance of raising awareness and telling her story. It’s sometimes hard for her to explain to people that even if she doesn’t appear sick, she may still be dealing with difficult symptoms.

“PAH has affected so much of my daily life — simple things like vacuuming, doing the laundry, taking a shower and going to the grocery store,” Martin said. “I encourage others to be understanding and avoid making assumptions about a person with PAH based on their outward appearance.”

She urges people to be supportive and listen when someone shares their story.

Health Awareness

A physician committed to advancing pneumococcal disease research

Dr. Kristen Feemster and her team work to help address pneumococcal disease for people of all ages

October 20, 2023

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Before becoming an executive director of global medical affairs at MSD, Dr. Kristen Feemster practiced as a pediatric infectious disease physician. Early in her career, Feemster and her team cared for a 1-year-old patient suffering from pneumococcal meningitis. Sadly, the child succumbed to his illness. Feemster recalls the emotions she felt knowing her own son of about the same age could also be at risk.

“I could barely stay in the room to talk to the child’s parents. As a parent myself, seeing them go through such a devastating loss led me to ask why this happened and what could have prevented the outcome,” said Feemster.

“I was determined to do what I could to help protect people of all ages from pneumococcal disease and its impact.”

At MSD, Feemster and her team work to better understand and communicate the continued epidemiologic impact of pneumococcal disease across all stages of life.

“Knowing that pneumococcal disease remains a leading cause of illness and death globally, I’m inspired by the opportunity to help address challenging and emerging diseases,” she said.

While some factors, like age or underlying medical conditions, can increase the risk of contracting an infection, anyone can get pneumococcal disease.

Noninvasive pneumococcal disease, such as otitis media or pneumonia, are also important contributors to morbidity in children. Recent reports suggest IPD remains a concern and certain serotypes continue to emerge as prevalent causes of serious disease with sometimes life-threatening complications.

Feemster and her MSD colleagues remain committed to addressing pneumococcal disease in people of all ages.

“Too many people worldwide don’t have access to effective treatment and supportive care,” she said. “It’s important that we continue to improve surveillance capabilities and explore this bacterium with such a complex epidemiology. We have learned a great deal, but there is so much left to understand and more that we can do.”

Health Awareness

Acting early in cancer detection

Diagnosing cancer early, before it has spread, may potentially lead to better outcomes

October 16, 2023

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Time is important with a cancer diagnosis. People with cancer may have the opportunity for better outcomes when the disease is detected early. And with increases in routine cancer screening, more cancer cases can be diagnosed before the disease has spread to other parts of the body.

“We’ve seen incredible progress in the fight against cancer in recent decades, driven by advances in early detection and the availability of new treatment options,” said said Dr. Gregory Lubiniecki, vice president, oncology clinical research. “This progress makes me optimistic for a future where cancer is detected and treated as early as possible, giving patients the greatest chance to live cancer-free. We can’t rest now — I’m hopeful that we will continue to build on what we’ve learned about helping people with earlier stages of disease.”

But important work remains to continue to improve care and diagnose cancer early.

What is early-stage cancer?

After someone is diagnosed with cancer, doctors will try to figure out how much cancer is in the body and if their disease has spread — this process is called staging, which can help guide treatment decisions. Different cancer stages have different treatments and possible outcomes, and they’re associated with different odds of recurrence. 

Early-stage is a term that can be used to describe cancer that’s early in its growth, before it has spread to other parts of the body. However, each person’s experience with cancer is unique, and what doctors may define as early-stage can vary by the type of cancer.

When cancer is diagnosed, the goals of treatments are to slow, stop and possibly eliminate tumor growth.

Treatment may be more likely to be successful if it’s started before the cancer has spread, when surgery is a potential option. However, even after surgery, there is a risk that the cancer may spread to other parts of the body. Additional treatment may help lower that risk. In certain instances, other treatment options can be used before surgery (neoadjuvant) to help to reduce the size of the tumor, and/or after surgery (adjuvant) to lower the chance of the cancer from potentially coming back.

Detecting and treating cancer early may help reduce the risk of recurrence and increase the potential for survival.

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Health Awareness

Triple-negative breast cancer: risks, signs and symptoms, and diagnosis

Learn about this aggressive type of breast cancer, including risk factors, signs and symptoms

October 12, 2023

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Breast cancer is the most commonly diagnosed cancer in the world. There are many different types and subtypes of breast cancer that are defined by where in the breast they begin, how much they have grown or spread and how they behave. One of the more aggressive types is triple-negative breast cancer (TNBC).

What’s triple-negative breast cancer?

The tumors of patients with breast cancer may be tested for three receptors, or proteins, that make cancer grow. If the tumor tests negative for estrogen and progesterone receptors and does not over express HER2, then that patient is diagnosed with TNBC.

Worldwide, there were more than 2.3 million patients diagnosed with breast cancer in 2020:

~10-15%

of people with breast cancer are diagnosed with TNBC

TNBC characteristically has a high recurrence rate within the first five years after diagnosis.

Who’s at risk for triple-negative breast cancer?

Primary risk factors for TNBC include:

  • Sex: People assigned female at birth are at higher risk for TNBC compared to people assigned male at birth.
  • Race /ethnicity: Non-Hispanic Black women are nearly two times as likely to have TNBC as non-Hispanic white women.
  • Age: TNBC is more common in women younger than 40.
  • Genetic mutations: Mutations in genes such as BRCA1 and BRCA2 are strongly associated with TNBC.

What are the signs and symptoms of breast cancer?

TNBC can have the same signs and symptoms as other common types of breast cancer.

Most breast cancers are detected before any symptoms appear through regular breast cancer screenings. The signs and symptoms of breast cancer differ from person to person, and some will never show symptoms.

However, some signs of breast cancer to watch out for include:

  • Swelling of all or part of a breast
  • Skin dimpling
  • Breast or nipple pain
  • Nipple retraction
  • Nipple or breast skin that’s red, dry, flaking or thickened
  • Nipple discharge
  • Swollen lymph nodes, under the arm or near the collar bone

How is triple-negative breast cancer diagnosed?

If you’re experiencing symptoms, speak with your doctor, especially if you have a higher risk of having TNBC. Some screening tests include:

  • Mammogram: An X-ray of the breast that allows doctors to look for changes in breast tissue. Mammograms can often find breast cancer early when it’s easiest to treat.
  • Magnetic resonance imaging (MRI): An MRI uses radio waves and strong magnets to make detailed pictures of the inside of the breast. Doctors use MRIs along with mammograms to screen people who are considered at high risk for breast cancer.
  • Ultrasound: An ultrasound uses sound waves and their echoes to make computer pictures of the inside of the breast. While not typically used as a routine screening test for breast cancer, an ultrasound can be useful for looking at some breast changes such as lumps – especially when they can be felt but not seen on a mammogram.
  • Biopsy: After a breast cancer diagnosis is made with a biopsy, a health care provider may determine whether a patient has TNBC with an assessment of cells from that biopsy, which are checked for estrogen, progesterone and HER2 receptors, to determine the cancer subtype.

How is triple-negative breast cancer staged?

Doctors use five stages to classify triple-negative breast cancer and inform next steps in your care plan:

Stage 0

Cancers diagnosed at stage 0 are confined to the milk ducts or lobules of the breast.


Stage 1

Cancers diagnosed at stage 1 are small, localized and have not spread beyond one nearby lymph node. Stage 1 TNBC is still considered early stage, so 91% of people diagnosed with this stage of cancer are alive five years after their diagnosis. Stage 1 cancer can be classified as either stage 1A or stage 1B dependent on the size of the tumor and whether there is evidence of cancer on the nearby lymph nodes.


Stage 2

Stage 2 TNBC may have spread regionally (beyond the initial site), but not beyond the lymph nodes in the underarm area. Stage 2 cancer can be classified as either stage 2A or stage 2B dependent on the size of the tumor and whether the breast cancer has spread to the lymph nodes. For patients whose cancer has spread to regional lymph nodes, 66% of people diagnosed are still alive five years after their diagnosis.


Stage 3

Stage 3 TNBC has extended beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles but has not spread to distant organs. At this stage, TNBC can be classified as stage 3A, 3B or 3C, depending on the size of the tumor and how far it has spread. Stage 3 TNBC is considered to have spread regionally, and 66% of patients who are diagnosed at this stage are still alive five years after diagnosis.


Stage 4

Stage 4 TNBC, also known as metastatic breast cancer, has spread distantly to other areas or organs of the body, such as the brain, bones, lung or liver. This stage is not curable but is usually treatable, and current advances in research and medical technology mean that more people are living longer by managing the disease as a chronic illness. Twelve percent of patients diagnosed at this stage survive five years post-diagnosis.


Being diagnosed with TNBC can be scary. By speaking with your care team, you can better understand your options and the best path forward.