Susan G. Komen for the Cure founder Ambassador Nancy Brinker spoke to cancer researchers at the European Association for Cancer Research (EACR) 22nd Biennial Congress in Barcelona, Spain. Following is a transcript of her speech.
Thank you, Professor Celis, for that introduction and for inviting me here for this historic Congress.
I’m always excited to be in Spain, though it’s also bittersweet. Many years ago, as a college student, my sister Suzy and I spent a summer traveling throughout Europe. Spain was our first stop – literally, our first experience with European culture.
We toured the cathedrals, museums and markets, and fell in love with the fashion, food and people. On our last night in Spain, we had a late dinner at a small restaurant. Suzy insisted that we come back and tour Spain extensively. I agreed, and we joked that we would be the old ladies on the tour bus. Sadly, that was not to be.
Ten years later, Suzy was diagnosed with breast cancer. And a few years after that, she was gone. But before her death, Suzy made me promise her to do everything in my power to ensure that other women didn’t have to suffer and die from this disease. That promise became the foundation of Susan G. Komen for the Cure.
Now, later in life, I am back in Spain… sad that I can’t return with Suzy, yet grateful that I can return on her behalf. And on behalf of the millions of people who have lost their battle with breast cancer.
In the thirty years since Suzy died, we have made some remarkable progress.
Thanks to groups like EACR and the research that has been done, we have a much better understanding of breast cancer.
For starters, we now know that breast cancer isn’t a
disease, but rather many
diseases. We know that different groups of women are susceptible to different forms of the disease. Young women face different threats than older women. Women of color face unique threats. Jewish women do, too.
For that reason, Susan G. Komen for the Cure has invested more than $52 million dollars over the past four years into research that could help us predict who will or will not respond to certain therapies.1
This includes our Promise Grants that go toward research that will hopefully:
- Tell us who will experience the most devastating side effects from taxanes; and
- Who will respond to tamoxifen over aromatase inhibitors (or vise versa); and
- Help us to develop a personalized breast cancer DNA vaccine.
These are exciting developments, but also just one piece of the puzzle. Because our increased understanding of breast cancer must go hand in hand with better forms of screening and treatment.
For example, our work on genetic mutations is giving us a more reliable way to identify individuals at high risk for breast cancer, and better therapies that target their mutations.
Last month, Susan G. Komen for the Cure approved funding for a grant to develop a blood test that, when combined with mammography, could detect aggressive forms of breast cancer very early.
And since 2008, we have supported more than 120 clinical trials2
to look at the safety and efficacy of new treatments. These trials look to answer some of the most challenging questions in breast cancer, such as treatments for inflammatory breast cancer and triple-negative cancer.
Together, we have all come a long way in understanding, identifying and treating breast cancer, but let us not forget the significant achievements we’ve made in changing the culture surrounding breast cancer. Thirty years ago, the words “breast cancer” were spoken with a whisper. Women had no support networks. People thought it was contagious. I remember after Suzy’s diagnosis, people crossed the street to avoid being near her.
Today, we see people all over the world marching proudly together and communicating an important message – that no one should face this disease alone.
But though we’ve made remarkable advancements, we must remain mindful that most of our work still lies in front of us.
- Today, cancer as a whole takes more than 7 million lives worldwide every year – more than HIV, TB and malaria combined.
- And the global cancer burden is expected to double over the next 20 years.
This is what I call the approaching cancer tsunami. But when damaging storms are approaching, government and citizens take precautions, alert people to the danger and focus their resources where they are needed. That is not happening here.
Today, over 60 percent of cancer deaths occur in the developing world, yet only 5 percent of world cancer resources are dedicated there. This lack of resources and lack of attention is going to cost millions of people their lives. It shouldn’t be this way. Where a person lives shouldn’t determine whether they live. So we must ask ourselves what we can do to tackle this issue head on.
At Susan G. Komen for the Cure, we believe that focus should be on the continuum of care. The continuum of care is the chain of events that begin with education and screening, and carry a patient through diagnosis, treatment, follow-up and hopefully remission. Today, in too many instances, women are getting lost along this continuum for a variety of reasons – lack of awareness, lack of money, lack of child care/transportation or lack of access to quality care.
The sad fact is that people once died of cancer because of our lack of knowledge. People are now dying of cancer because of our lack of imagination.
This is what could have happened to Annie, an African-born American immigrant and mother of three. Annie noticed a lump in her breast, but had no idea what to do next. She and her husband were shuttling between the United States and Cameroon, where they were trying to start a business. Her physician in Cameroon told her the lump was nothing to worry about.
But Annie noticed the lump getting larger, and returned to her physician who did a needle biopsy. It was malignant. Annie then returned to the United States in search of medical assistance, but being uninsured and unemployed, she soon ran out of options.
Fortunately, Annie had heard about Susan G. Komen for the Cure and called us. We were able to provide her with a coordinator who had her medical records translated into English. We were then able to refer her to an oncology breast surgeon, medical oncologist, radiation oncologist and oncology social worker.
Today, Annie is on her way to recovery. But she could have just as easily been a casualty to the system as a casualty to cancer.
I recently learned of a woman living in rural China who was diagnosed with triple-negative breast cancer. Shockingly, her doctor treated her with Tamoxifen which– as we know – does not treat this type of cancer. Fortunately, she finally visited a hospital in Shanghai where they managed to get her the correct care.
Yet for too many women, their standard of care is doctors who aren’t properly trained, a health care system they can’t navigate and a social network that lacks support.
The western world is not immune from this problem.
Despite all the advancements over the past 30 years, there are a large number of American women for whom time has stood still.
Washington, D.C., now has the worst breast cancer mortality rate in the United States. In the shadow of the Capitol and White House, women are less likely to survive a breast cancer diagnosis than anywhere else in the country. That is shocking. And shameful.
And African-American women have a 35 percent higher breast cancer rate than Caucasian women in the United States, despite being less likely to get breast cancer.
So what do we do?
We must start by bridging the gap between basic research and clinical application.
Too often, our work exists in silos. We need to break those walls down. For researchers, that means thinking about how your work is applied down the continuum. How it can be delivered to patients.
But it is not just taking discoveries form the bench to the bedside. We must also take them to the curbside, and deliver therapies, access, education and support to all the women who need it.
In May, I had the honor of addressing graduates at the Yale School of Public Health. There, I stood in front of hundreds of young people whose careers in health care are just beginning. And what I told them is a message that I’m determined to deliver at every opportunity: that we must avoid falling into the trap of believing that medical breakthroughs can only occur in research labs. That’s not only wrong, it’s dangerous. Because it limits our thinking about what is possible.
That’s why Susan G. Komen for the Cure is focused on supporting translational research, bringing the gap from basic research to clinical application. And in the past five years, we have begun to see a true translational component to our work.
We’re improving collaboration across disease platforms. I remember visiting a PEPFAR clinic in Tanzania several years ago. As I observed the great work being done there to combat AIDS, I was struck by how simple it would be to extend that work to cancer education and screening.
So last year, Susan G. Komen for the Cure helped launch the Pink Ribbon Red Ribbon Partnership. With this campaign, we are taking the infrastructure used to fight AIDS and using it to fight cancer. And in fighting one disease from a platform built to treat another, we are saving lives.
Efforts like this require collaboration, which I know from experience is not easy. But it is critical.
Conquering cancer will require more than a cure, it will require new global paradigms that leverage resources, and foster innovation, interactions and consensus. If we can find ways to work together, we will be stronger, better and faster. And we can finally reach our shared vision of a world without breast cancer.
Twenty days from now, the eyes of the world will be trained roughly 1,500 kilometers north of here – where 4 billion people are expected to tune in for the Opening Ceremonies of the London Olympics.
But twenty years ago, the eyes of the world were focused here in Barcelona for the 1992 Olympics – one of the most memorable of modern times.
The Barcelona Olympics were notable because for the first time in three decades, there were no boycotts. The fall of the Berlin Wall led to a united team from Germany. And the fall of the Iron Curtain led to independent teams from nations like Latvia, Estonia, Lithuania and Croatia. Athletes from the former Soviet republics competed as one team, but were saluted with their own national anthems and flags. And South Africa, which had at last abolished apartheid, sent its first racially integrated team.
In just four years, so many walls had been broken down and new bridges built that it was impossible to ignore – and impossible to forget. And it is what we need to see in the cancer community.
For us to defeat cancer, we must break down borders between nations.
We must tear through our own professional silos.
We must bridge the gap between research and treatment.
We must work together, as one force, united for one cause – the complete eradication of cancer.
1 From 2008-2011, there have been 53 grants totaling $52,282,822 specifically for predictive biomarkers
2 From 2008-2011, Susan G. Komen for the Cure funded 106 grants that supported 129 clinical trials – trials may be planned, active or closed and may be observational, diagnostic, prevention, treatment or supportive care/QOL trials