Groundbreaking New Drug for Breast Cancer

Join us as we explore Medical Frontiers！ In 2020, female breast cancer surpassed lung cancer

as the most commonly diagnosed cancer globally.

And it's projected to increase dramatically.

Researchers are working tirelessly around the world to advance treatments.

Today on the program we are going to report on a very promising new drag, that is helping to turn the tide in the fight against breast cancer.

Nice to meet you.

56-year-old Inoue Miyako was diagnosed with cancer in her right breast in 2015.

My world suddenly lost color and time stopped.
I realized people can't cry when they're shocked.

She had surgery to remove her right breast and was given anti-cancer drugs to keep the cancer from spreading or coming back.

But in 2022, a new cancer unrelated to the first one formed in her left breast.

I felt more strongly than after the
first diagnosis that I might soon die.

I thought about what I should
prioritize in my time left.

Every year, about 2.3 million women are newly diagnosed with breast cancer worldwide.

The disease claims nearly 700,000 lives annually.

Breast cancer can cause few obvious symptoms in its early stages.

Patients notice abnormalities only when the cancer has progressed.

There are many lymph nodes near the breasts and under the armpits where the cancer develops.

This makes it easy for cancer cells to spread to the bones, the lungs, the liver and the brain via the lymph and blood flows.

Breast cancer is treated with surgery, which removes all or part of the breast, or with radiation therapy.

In addition, many patients take anti-cancer drugs, such as chemotherapy or hormone therapy.

Breast cancer is divided into several types, depending on the cancer's genetic makeup.

Their characteristics and progression differ, and they require different medications.

Today, we will focus on a type called HER2-positive breast cancer, which accounts for about 20 percent of all breast cancers.

HER2 is a type of protein found on the surface of cells.

It is said to control cell growth.

In many breast cancer patients, this protein is overexpressed by 10,000 times the normal level.

Abnormally high levels of it prompt the cells to propagate uncontrollably.

This causes the cells to turn cancerous.

HER2-positive breast cancer is considered highly malignant, as it can recur or spread easily.

Various drugs have been developed in the past.

But they have not been effective for all patients.

Meanwhile, a new drug developed jointly by Japanese and UK pharmaceutical firms has been found highly effective, even against advanced HER2-positive breast cancer.

We examined how the new drug could transform treatment.

It's a pleasure meeting you.

Nice to meet you.

Hara Fumikata uses anti-cancer drugs to treat breast cancer at a cancer hospital with over 600,000 annual patients.

What are some of the characteristics of this very new drug and how does it actually work?

In conventional treatment for
HER2-positive breast cancer, anti-HER2 drugs and chemotherapy drugs
are administered separately.

But the new drug delivers
both types of medication at once.

Chemo drugs destroy not just cancer cells
but also normal ones - an unwanted effect.

By combining chemo with an anti-HER2 drug,
we can deliver them straight to the cancer cells.

Anti-HER2 drugs are made from artificially produced versions of the antibodies made by our immune systems.

When such drugs are administered, the antibodies find and attach to HER2 proteins on cell surfaces.

This is believed to suppress HER2 activity and stop cancer cells from propagating.

Currently, chemotherapy drugs are given along with anti-HER2 drugs.

However, chemotherapy drugs destroy not just cancer cells, but also normal ones.

The new drug is a combination of an antibody and a chemotherapy drug.

It's called an antibody-drug conjugate, or ADC.

ADCs are administered intravenously.

Antibodies carrying the chemotherapy drug head to their target, the HER2 proteins.

When an antibody binds with HER2, it is taken into the cancer cell.

Once inside, it unleashes the chemotherapy drug it is carrying.

It kills the cancer cell from the inside.

The ADC enables both drugs
to reach cancer cells, but not normal cells.

This keeps the side effects to a minimum.

It also ensures the efficient delivery of
chemotherapy drugs to cancer cells, and is therefore highly effective.

Hara helped to conduct a clinical study to verify the efficacy and safety of the new drug.

The subjects were patients with advanced HER-2 positive breast cancer that was inoperable or had recurred.

They were given the drug once every three weeks and the size and condition of their tumors were checked.

The cancers either shrank or disappeared in about 60 percent of the 184 patients.

There have been other drugs that use a similar mechanism.

But the new one contains a larger amount of a higher-quality chemotherapy drug.

This increases the new drug's lethality toward cancer cells.

So what was your initial reaction on seeing the results?

I was stunned.

The new drug carries twice the amount of
chemo drug compared with its predecessor.

The chemo drug is also more lethal and can kill
nearby cancer cells through the bystander effect.

All of these factors make the drug
more effective than its predecessor.

The United States became the first country to approve the drug in 2019.

In Japan, use of the drug began in 2020.

This CT image shows breast cancer that has spread to the lungs, in white.

Eight months after the patient began taking the new drug, the tumors became significantly smaller.

The treatment appears to be effective.

There have been no cases in clinical practice
in which a patient's cancer disappeared.

But during the trial, there were several cases.

Incredible!

As of March 2023, the new drug is prescribed only to patients who meet certain criteria, including those with inoperable or recurring HER2-positive breast cancer.

Ongoing clinical studies aim to examine whether the drug can be administered in the disease's earlier stages.

Cancer patient Inoue says the tumor in her left breast turned out to be HER2 positive.

I'm extremely grateful for the new drug.

I hope more such drugs are developed so that
if one doesn't work, there are other options.

What are some of the issues involved with this brand new drug?

It is known to cause interstitial pneumonia
in about 15 percent of patients.

We are very wary because a few patients died of
the pneumonia in the early stages of development.

Other side effects include nausea and
lower white blood cell counts, but they are not so serious.

The drug's high price is another issue.

One dose for a patient who weighs 50 kilograms, costs about 3,800 dollars in Japan.

This is an enormous financial burden on patients, given that they will need to keep taking the drug until their cancer shrinks.

I mean it gives so much hope because I think everybody is affected by cancer.

It's family, friends.

And I think so many people feel quite helpless.

We believe ADC drugs will change
the future of not just breast cancer, but other types of cancer as well.

We've always told our patients
that metastatic cancer is incurable.

But as more new drugs become available, I believe that one day, we'll be able to assure
patients that even metastatic cancer is curable.

Now it's going to be so exciting to see the future of all of these incredible ADCs.

So thank you so much.

Thank you very much.

Inoue has been receiving drug therapy for her second cancer.

She has been troubled by various changes in her appearance caused by the treatment.

Her hair started to fall out about two weeks after she began taking the drugs.

Her eyebrows and eyelashes followed.

Her toenails changed color and began to peel .

About five months after the treatment began, her hair started to grow back, but it's not the same as before.

I think fewer hairs are growing back
compared with the last time I had cancer.

I massage my scalp to encourage hair growth.

A survey in Japan asked breast cancer patients what troubled them the most about cancer treatment.

Seven out of the top 10 responses were related to appearance, including hair loss, which was number one; removal of the breast; cracking of the nails; and surgical scars.

Patients must deal with not just treatment, but also the changes in appearance that it causes.

A national cancer hospital has a department that helps patients cope with such changes.

Toma Shoko, a clinical psychologist, heads the Appearance Support Center.

Her team receives consultations from about 3,000 patients every year.

Please come in.

It's been a while. How have you been?

It's getting warmer, so I've started
to wear less clothing.

But that makes the difference between
my right and left breasts obvious.

60-year-old Kotani Hitomi visits Toma regularly for consultations.

She developed cancer in her left breast and received a mastectomy in 2016.

She is troubled by her uneven breasts.

I was using a pad I made myself, but it
didn't fit properly, so it would fall off.

There's one made of adzuki beans.
You can put it inside your underwear.

Or you might want to try one that you
attach directly to the skin with special glue.

I will do some research and decide
which one is best for me.

An increasing number of patients are continuing to go to school or work during their treatment.

The team receives many questions about wigs to hide hair loss.

They say there's no need for a medical wig.

Their advice is for patients to pick an affordable one that they like.

Wigs may look or feel unnatural at first, so they recommend one that gives a completely new look.

It will suit you better if you take it to a
hair salon and get the bangs cut.

Chemotherapy drugs can cause hyperpigmentation of the skin.

Medical makeup can help conceal what looks like age spots or other darkening.

Toma says patients who are undergoing care for changes in appearance should be given psychosocial support from medical workers with specialized knowledge.

Many patients are not concerned about
attractiveness, but about changes in appearance.

They think they no longer look like themselves.

Or the changes may remind them of cancer
or death every time they look at themselves.

They may also worry that people around
them will notice that they have cancer, which could affect their
social status or relationships.

It's not about beauty.
Rather, it's about how to live with cancer.

Through appearance care, we can help
patients to maintain a high quality of life.

Kotani first contacted the center to seek advice on hair loss.

She has been taking their guidance and adjusting it to suit her.

Doctors do their rounds every morning.

I greeted them wearing this hat one day,
and they were greatly amused.

Kotani says that she prefers hats over wigs.

She chooses a suitable hat from her collection every day.

Once, she decorated her bald head with a garland of flowers.

At first, all I could think about was treatment.
I now focus on how to make the best of my day.

I'll have to continue with treatment and
will need help from the center.

I'm determined not to look away from
what happens to my body.

I will stay positive and
try not to push myself too hard.

Toma aims to make patient support available across the country.

She is working to train new specialists to that end.

As part of her effort, she gives talks to nurses who take care of cancer patients.

The participants look at actual cases and discuss how to respond to patients.

One of them involves a woman with a 4-year-old daughter.

The woman wants a wig that the other mothers won't be able to detect.

There are other options besides wigs.

She worries her child might be bullied due to
her disease. What should we say to this?

4-year-olds have no interest in
someone else's mother's hair.

True. But she fears something bad will happen.

Patients have different backgrounds, lifestyles and anxieties.

They worry about appearance for various reasons.

Toma stresses the importance of acknowledging their differences when providing support.

I wish medical professionals would
pay more attention to this issue.

I also wish that people working in various fields,
including local officials, would come together to make life easier for cancer patients.

It's not easy to achieve all that, but I will
continue studying as part of the efforts.

"Pinky Smile" is a group of cancer survivors who perform cheerdancing, which originated from cheerleading.

Hirose Manami is the team captain.

After studying physical therapy for cancer patients in New York, she launched an organization in 2014 to support cancer survivors.

She began offering cheerdancing lessons and formed the team.

Erica decided to take a lesson to understand how cheerdancing can help cancer survivors.

I had breast cancer. My left breast was removed,
then I underwent chemotherapy and radiation.

I went home feeling depressed,
thinking I was no longer the same person.

I couldn't raise my arm, had no physical strength,
and thought a normal life wouldn't be possible.

Cheerdancing is fun.

It involves various moves which help strengthen
the muscles and improve flexibility.

It provides energy, both mentally and physically.

So, I'm ready for learning a little bit today.

Don't make it too difficult, though.

Don't worry. Let's have fun.

Let's learn four easy cheerdancing moves together with Erica.

We'll do the exercises using pom-poms.

This is the first time I've actually held pom-poms in my life.

But I can see what they're fun.

Open your chest and look up at the sky
while shaking your pom-poms like this.

In cheerdancing, it's important to express yourself by making bigger movements.

You can stretch the muscles in your upper body by leaning forward or back.

Repeating these movements improves blood circulation and helps to warm up your body.

I have to say, doing this with the pom-poms is so much more fun than doing it regularly.

Next is a signature cheerdancing move.

Even those who have difficulty raising their arms due to surgery will be able to do it after repeated practice.

The third move involves taking side-steps while extending your arm to the side.

Coordinating your movements with others creates a sense of unity.

The move works out your entire body and strengthens your muscles.

Finally, precision dancing.

Line dance!

Cheerdancing isn't complete
without precision dancing.

Reach out to the side as if you're putting
your hands on someone's shoulders.

Then, touch your calf with your foot.
Drop it, extend your leg forward, and repeat.

Now that Erica has learned some cheerdancing moves, she will participate in a special performance with the Pinky Smile members.

Take it away, Erica!

Come on! Join us!!

Whooo-----!!!!!

Let's dance together, Erica!

This team is made up of survivors of breast,
uterine, ovarian and other types of cancer.

Some are undergoing treatment.
Some have experienced metastasis and recurrence.

Many had difficulty raising their
arms or legs due to treatment.

But they strived to be able to
dance with their team members.

They took up cheerdancing to cheer themselves up.

But now, their goal is to make others smile.

Keep smiling!!

Yeah-----!!!!!

Cheerdancing makes me forget all my worries.

Being a cancer survivor, sometime we feel loneliness.

But when we cheerdance together, the loneliness it just disappeared and we realize that we are not alone.

You don't have to do it well
or worry about making mistakes.

The best thing about cheerdancing
is that everyone can enjoy it.

I want more people to know
about it and to join us.

I think it's just you've made it so much fun that I really think from now on it's going to become a global revolution.

Whooo-----!!!!!