Wednesday, June 2, 2010

Breast Cancer Vaccine: Medical Miracle or Scary Science?

Dr. Vincent Tuohy of the Cleveland Clinic's Lerner Research Institute thinks he may have found a way to eradicate breast cancer as we know it. Dr. Tuohy found that a single vaccination with the antigen alpha-lactalbumin prevented breast cancer tumors from forming in mice. Because of the favorable results, human trials of the vaccine could begin as early as next year.

So how does this work? Unlike most doctors who work in cancer research, Dr. Tuohy is an immunologist, so his approach to curing cancer has been different. Rather than targeting cancers that are already present and developed, his idea was to attack the tumor before it even has a chance to grow. What we already know about cancer is that  it is an overdelopment of the body's own cells, rather than an invasion of foreign bodies. So this vaccine attacks the healthy cells before they can become cancerous, rather than vaccinating against a virus.

In the research article published in this month's Nature journal, the researchers explain how they came to develop the vaccine.

"We selected a-lactalbumin as our target vaccine autoantigen because it is a breast-specific differentiation protein expressed in high amounts in the majority of human breast carcinomas and in mammary epithelial cells only during lactation. We found that immunoreactivity against a-lactalbumin provides substantial protection and therapy against growth of autochthonous tumors in transgenic mouse models of breast cancer and against 4T1 transplantable breast tumors in BALB/c mice. Because a-lactalbumin is conditionally expressed only during lactation, vaccination-induced prophylaxis occurs without any detectable inflammation in normal nonlactating breast tissue. Thus, a-lactalbumin vaccination may provide safe and effective protection against the development of breast cancer for women in their post–child-bearing, premenopausal years, when lactation is readily avoidable and risk for developing breast cancer is high."

So basically the key to curing cancer is finding a target within the tumor that is not typically found in healthy people. Alpha-lactalbumin is not found in healthy women, except when they breastfeed. So this vaccine will attack the a-lactalbumin. Did you catch that this vaccine would prevent women from being able to breastfeed? From the full text of the article (which I'm able to access through a subscription database):

 "This unique conditional expression of a differentiation protein provides an opportunity for prophylactic breast cancer vaccination of normal healthy women who are either willing to avoid lactation or are past their child-bearing years." [emphasis mine]

It sounds like they've figured out a way to remove healthy tissue before it becomes cancerous that would allow women to keep their breasts and not have to have mastectomies. Sounds good, right?

But what about younger women who have a genetic predisposition to breast cancer? Will they be encouraged to get the vaccine before their child-bearing years are over? And what if they want the vaccine, because in their minds, giving up breastfeeding is a small price to pay to eliminate the risk of cancer AND get to keep your breasts. According to a press release from the Lerner Institute, the strategy would be to vaccinate women over 40. But many women are still having children well into their 40s. These women would also likely have to forget about being able to breastfeed

And what about the most ironic thing of all, that we already know that breastfeeding can reduce your risk of getting breast cancer in the first place? A study at Yale found that breastfeeding for two years cut a woman's breast cancer risk by 50%. 

Where does it end? Dr. Tuohy thinks an adult vaccination program is the wave of the future. Instead of your vaccine schedule ending in childhood, you'd start all over at age 40, getting a vaccine for breast and ovarian cancer and maybe even Alzheimer's one day.

So what do you think about a breast cancer vaccine? Would you get it?

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