Q&A with Kevin Kalinsky, MD

Kevin Kalinsky, MD, director of breast medical oncology at Emory University’s Winship Cancer Institute, told Alexandra Benisek

On the WebMD Webinar “Triple-negative breast cancer: how to learn to treat it more effectively” Kevin Kalinsky, MD, director of breast oncology at Emory University’s Winship Cancer Institute, answered questions from viewers about TNBC and its treatments.

We do not have clear data on stress and how it affects the development of cancer for any type of cancer. There is some preclinical data, which is data in the lab that is being looked at stress hormones and cancer risk will come back. But again, these are preclinical data. And that hasn’t necessarily translated into how we can care for people with TNBC.

When I talk to people about stress management, it’s important to think about how stress can affect our overall well-being and alertness.

There is data to suggest this connection between the mind-body connection and outcomes in people with TNBC. However, there is no clear data on the relationship between stress hormones and the risk of recurrence – and whether this can help reduce the risk of cancer recurrence.

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When we treat triple-negative breast cancer patients and give them systemic therapy, we reduce the likelihood of cancer recurrence. This includes reducing the risk of metastatic recurrence of triple-negative breast cancer (when the cancer has spread to other parts of the body).

Rather, we think of the risk of other cancers if someone carries a genetic predisposition such as the BRCA gene. For BRCA, there is a risk of breast cancer, including BRCA1, as well as a link to triple-negative breast cancer and ovarian cancer, for example.

So if people have a genetic predisposition, depending on what it is, they may be at risk for other cancers.

There are data that looked at people who took nutritional supplements during chemotherapy. We have seen that the more supplements people take, the worse the results. And they may interfere with some of our treatments.

There was definitely an interest in turmeric. But in general, I would say when you’re taking supplements, make sure you talk to your doctor.

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This is on a case by case basis. For example, there was a study that looked at giving a supplement called L-carnitine to see if it reduced the risk of neuropathy. We have seen that this increases the risk of neuropathy.

This is the most common question we get about breast cancer. There are ongoing studies looking into it nutrition and exercise and whether it can help achieve better outcomes, including triple-negative breast cancer.

We await the results to help answer this question.

I would say it’s always helpful to talk to a nutritionist, even outside of a breast cancer recurrence, just for a healthy lifestyle. And I would say, generally everything in moderation.

Yes, this is an excellent question and important for us to continue to evaluate.

I think that’s one of the consistent findings over the years, and it just emphasizes the importance of people – especially young women not hispanic black — continue with screening mammograms and be up-to-date with these images. Especially if they have a strong family history.

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I don’t know if the disparities are related to incidence. But from the point of view of differences in results, this is still an important issue social determinants of health.

It’s not just triple-negative breast cancer, and it’s not just non-Hispanic blacks and non-Hispanic whites. The differences are also visible in the case of urban and rural communities.

This is an extremely important issue in terms of access to care. And even if someone has a problem, is there a difference in their level of care. We know that there can be differences between communities regarding the frequency of mammography screening.

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Source: https://www.webmd.com/breast-cancer/features/cm/triple-negative-breast-cancer-qa-kevin-kalinsky?src=RSS_PUBLIC