The growing spectrum of cancer therapies provides improving prospects for patients. Our Baystate Regional Cancer Program practice actively participates in Phase 2 and Phase 3 cooperative group and industry sponsored clinical trials. However, identifying which therapies will be successful for individual patients as well as managing the long-term consequences of the treatments remains a challenge. This requires multidisciplinary approaches to identify novel diagnostic tools to recognize disease early, indicate targeted therapies and monitor side-effects that develop acutely and cause chronic complications.
Breast cancer has been a focus of my clinical practice. We have demonstrated that insulin resistance and weight gain are common consequences of cytotoxic therapies, but not radiation and surgery alone. Strategies that limit weight gain is a focus of our survivorship program. In addition, we have collaborative projects to develop a diagnostic test for women with premalignant breast lesions. This population is growing due to improved screening, but for whom treatment options are unclear. Several medications can reduce the risk of developing breast cancer by 50% however, many women are not inclined to take medication for prevention. Since only 20% of women with premalignant breast lesions develop cancer, diagnostic tests are critical to identify the subset of patients who will benefit from preventive therapies and the ~80% for whom treatments are unnecessary.
As Co-Director of the Rays of Hope Center for Breast Cancer Research, I participate in translational research and have actively fostered the development of a Breast Research Registry. This provides a growing resource of women who have consented to provide personal and clinical data as well as tissues for research projects. They have also consented to be re-contacted for follow-up. We are presently consenting >100 new patients annually but can be increased to ~300 given the patient volume. The Registry provides a valuable resource to quickly identify patients for potential studies related to interventions and to improve survivorship.
Konieczny E, Makari-Judson G, Mertens W, Katz D, Sturgeon S, Bigelow C, Reeves, K. Perceived Recurrence Risk and Health Behavior Change among Breast Cancer Survivors. Manuscript submitted.
Makari-Judson G, Braun B, Jerry DJ, Mertens W. Weight Gain after Breast Cancer: Implications and proposed Mechanisms. World J Clin Oncol; 2014 August 10; 5(3): 272-282. DOI: 10.5306/wjco.v5.i3.272.
Makari-Judson G, Loke C, Katz , Mertens W. Knowledge of Prior Treatments and Appreciation of Future Health Concerns in Breast Cancer Survivors. Manuscript under review.
Makari-Judson G, Hubbard S, Wrenn T. Use of Survivorship Care Plans to Re-Engineer Breast Cancer Follow-up. The Open Breast J. 2013; 5:23-26.
Jerry DJ, Makari-Judson G, Crisi G, Dunphy K. Pregnancy offers new insights into mechanisms of breast cancer risk and resistance. Breast Cancer Research 2013; 15:312.
Makari-Judson G, Wrenn T, Mertens WC, Josephson G, Stewart JA. Using Quality Oncology Practice Initiative Metrics for Physician Incentive Compensation. J Onc Pract. Oct 22, 2013; doi:10.1200/JOP.2013.000953.
Schwartzberg L. Tauer K, Hermann R, Makari-Judson G, Issacs C, Beck J, Kaklamani V, Stepanski E, Rugo H, Wang W, McQuinn K, Kirshner J, Eisenberg P, Emanuelson R, Keaton M, Levine E, Medgyesy D, Qamar R, Starr A, Ro S, Lokker N, Hudis C. Sorafenib or Placebo with either Gemcitabine or Capecitabine in Patients with Her-2 Negative Advanced Breast Cancer that progressed during or after Bevacizumab. Clin Cancer Res 2103 19 (10):2745-2754(CCR-12-3177R1).
Makari-Judson G, Capizzi T, Mertens WC. Does Switching from adjuvant tamoxifen to an aromatase inhibitor alter the pattern of weight change in Post-menopausal women with breast cancer? The Open Breast Cancer Journal 2010; (2):52-56.
Loke C, Mertens W, Yunes M, Levy R, Makari-Judson G. Association of spontaneous bilateral femoral fractures with zolendronic acid use in a patient with metastatic breast cancer: A cautionary tale. Community Oncology March 2011; 8:137-140.