Enhancing the Care Team
We believe in a future filled with thriving, breast cancer survivors.
From the day of her diagnosis, a woman becomes a breast cancer survivor forever. Research in the Vera Bradley Foundation Center for Breast Cancer Research is empowering each survivor to live her life with strength and resiliency.
Dr. Tarrah Ballinger, MD
Dr. Tarah Ballinger’s vision is to create a continuum of survivorship care to conduct and implement research so that every newly diagnosed patient, whether she has early-stage or metastatic cancer, will have her functional issues addressed at the beginning. “We’ll actually help them exercise and access supportive care to ward off any toxicity before it happens. Then we’ll help women actively recover after finishing treatment. We’ll maximize her survivorship based on her individual needs.”
Fear of Recurrence
Many patients experience psychological distress at the end of treatment. ‘What just happened to me? I don’t feel like myself. Who is going to hold my hand now?’ Dr. Ballinger’s research is working to understand these concerns and help women transition back to everyday normalcy.
“The fear of recurrence is real. Even women who are very grateful that their cancer is highly unlikely to return, still may have underlying fears.” Dr. Ballinger explains that this is a very normal response. How consuming and impactful these negative thoughts might be is dependent on a patient’s mindset, relationship with her physician, and conversations that may have taken place. “These are all fixable problems.”
Dr. Ballinger is initiating a project to study women at the other end of the spectrum, those who are at high risk for cancer relapse. She wants to understand their fear of recurrence and how it affects their day-to-day life. “How can we intervene to help them cope?” The solution may be to include specific psycho-social support as a component of clinical care.
Muscle Toxicity
Another important part of survivorship is musculoskeletal health. Muscle and fat may impact not only quality of life and physical function, but also survival. Dr. Ballinger is studying women taking drugs to keep estrogen-hungry tumors from developing (aromatase inhibitors). “In the early-stage setting, I am working on musculoskeletal toxicity from aromatase inhibitors. We don’t really understand why that happens, even though it’s the most debilitating side effect patients who take this medicine experience.” She explains that joint pain and muscle weakness force many patients to stop taking the medicine. “If you can’t take the medicine, it can’t prevent cancer from returning.”
Her project focuses on the cellular mechanisms of the toxicity. Patients are donating muscle biopsies and participating in exercise strength testing. As part of the research, they receive low-intensity vibration by standing on a platform at home. “There are stem cells in the bone marrow that either become bone, muscle, or fat. We want to determine if those cells can be manipulated by mechanical sensation to make bone and muscle, instead of fat. This study only enrolls sedentary patients, those who cannot or will not exercise.”
Obesity
“We need to understand racial disparities in survivorship so we can intervene to improve and cure breast cancer in women of African ancestry.”
Dr. Ballinger recently presented her findings from a study comparing differences in patients of African versus European ancestry with early-stage breast cancer. “We found that the body weight of women with African ancestry had a significant impact on the rate of cancer recurrence and death. African American patients were twice as likely to be severely obese, and these same patients were twice as likely to have a recurrence. In European Americans, weight didn’t matter.
“There may very well be a difference in biology in Black obese women versus White obese women. Certainly, there are social determinants such as neighborhoods and access to healthy food that impact your obesity and breast cancer prognosis. There are so many factors, and we must tease out some of these issues to comprehensively address the problem.”
Exercise Intervention and Metastatic Disease
Survivorship research addresses the benefits of exercise for women before, during, and after cancer treatment for early-stage breast cancer. Surprisingly, survivorship research doesn’t currently address women with stable, metastatic disease. Dr. Ballinger is changing this. She’s embarking on research that determines if lifestyle changes that passively impact treatment and recovery for early-stage cancer patients will also impact late-stage survival. “Those who are projected to live a long time with metastatic disease will probably benefit as well.”