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 have consented over 1000 participants to the registry. The Registry provides a valuable resource to quickly identify patients for potential studies related to interventions and to improve survivorship.
Gregory KJ, Roberts AL, Conlon EM, Mayfield JA, Hagen MJ, Crisi GM, Bentley BA, Kane JJ, Makari-Judson G, Mason HS, Yu J, Zhu LJ, Simin K, Johnson J, Khan A, Schneider BR, Schneider SS, and Jerry DJ. Gene Expression signature of atypical breast hyperplasia and regulation by SFRP1. Breast Cancer Res. 2019 Jun 27;21(1):76. Doi:10.1186/s13058-019-1157-5.
Goff SL, Kleppel R, Makari-Judson G. 'No pink ribbons': how women’s lived experiences with breast atypia inform decisions involving risk-reducing medications. J Patient Cent Res Rev. 2018;5:158-66. doi: 10.17294/2330-0698.1594
Reeves K, Schneider S, Xue, J, Kannan, K, Mason H, Johnson, M, Makari-Judson G, Santana M. Bisphenol-A in breast Adipose tissue of breast cancer cases and controls. Environmental Resarch 167:735-738; 2018
Schneider S, Henchey E, Sultana N, Morin S, Jerry DJ, Makari-Judson G, Crisi M, Arenas A, Johnson M, Mason H, and Yadava N. Individual-specific variation in the respiratory activities of HMECs and their bioenergetic response to IGF1 and TNF alpha. Journal of Cellular Physiology 2017 DOI 10.1002/jcp.25932
Makari-Judson G, Loke C, Katz , Mertens W. Knowledge of Prior Treatments and Appreciation of Future Health Concerns in Breast Cancer Survivors. Journal of Oncology Navigation and Survivorship. 6:42-48 Oct 2015
Iacolo EK, Makari-Judson G, Mertens WC, Katz D, Sturgeon SR, Bigelow C, Reeves KW. Perceived recurrence risk and health behavior change among breast cancer survivors. Journal of Women’s Health and Gynecology.; 1:1-8. 2014
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, 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.