More women are surviving breast cancer in Northwest Indiana, thanks to improved treatments and rising screening rates.
Breast cancer is the most common type of cancer in women, affecting 1 in 8 females. But the breast cancer mortality rate in the United States fell by 25 percent between 1990 and 2014, according to the National Cancer Institute.
And Northwest Indiana cancer specialists say the Region offers any treatment available anywhere else.
"I personally don't think you need to leave the area to find a very good quality oncologist or hematologist in Northwest Indiana," said Ann Peters, president of the Pink Ribbon Society, a breast cancer awareness organization in Merrillville.
Parts of Northwest Indiana have higher rates of breast cancer than the state and nation. Those rates are 33 cases per every 100,000 women in Lake County, 26.5 in Porter County and 29.5 in LaPorte County. The Indiana rate is 26.7, while the national rate is 25.9, according to the Institute for Health Metrics and Evaluation.
But screening is becoming more common across much of the Region.
In Northwest Indiana, the mammography screening rate is 61 percent of women in Lake County, 58 percent in Porter County and 64 percent in LaPorte County, according to the Robert Wood Johnson Foundation's County Health Rankings. Those numbers are trending up in Lake and LaPorte counties and staying the same in Porter County. The state average is 62 percent.
Cancer treatments are getting better because they are becoming more targeted, improving their effectiveness and reducing side effects from medications, Region treatment experts conclude.
"The research focus is on moving away from chemotherapy to more targeted therapies," said Dr. Janet Retseck, a medical oncologist at Porter Regional Hospital.
She uses the results of the TailorX trial to customize her patients' treatment plans. That study found that most women with early stage breast cancer don't benefit from chemo. These women specifically have hormone-receptor positive breast cancer, a common form of the disease.
"More women will not need chemotherapy to be successful cancer survivors," she said. Chemo also doesn't help late-stage cancer.
Targeted therapy is the go-to treatment for stage-four, or incurable, breast cancer, said Dr. Mohamed Farhat, a medical oncologist at Franciscan Health hospital in Crown Point. The medication gives those patients a better quality of life, as well as longevity.
He believes that within 10 or 20 years, targeted therapy will replace chemotherapy, which has a bevy of side effects.
"The shift is changing towards more of a targeted treatment," he said. Where chemotherapy kills good and bad cells, targeted therapy just goes after the cancer cells.
"The therapy has definitely improved survival rates in these patients," he said. "It's definitely improved from 10 years ago, but we still have a long way to go."
He credits the growing survival rate to increased awareness and better and more frequent screening.
Dr. Farhat recommends women self-check for cancer at least once a month. He says when they're in the shower, they can feel for lumps or bumps that are persistent and getting bigger.
Mammograms are recommended annually starting at the age of 40, or earlier if the woman has a first-degree relative (mother or sister) who has had breast cancer, said Dr. Chadwick Mills, medical director of breast imaging at the Franciscan Health Breast Care Center in Crown Point
"If the mother had been diagnosed at 42, we would start that woman at 32," he said.
He said despite the advances in screening technology, mammograms are still the most "sensitive and specific" way to detect breast cancer.
"There is nothing to take the place of mammography," he said.
However, he sees molecular imaging as the future of screening and predicts a day when all mammograms are 3D. Women with dense breast tissue can also opt for automated breast ultrasounds.
Technology enhancing radiation, biopsies
Radiation is used after breast cancer surgery to reduce the risk of the tumor returning to the breast or lymph nodes, said Dr. Luke Miller, a radiation oncologist at the Franciscan Health Cancer Center in Munster. He said recent technological advances have made radiation "safer and easier" for patients.
He said the cancer center offers treatments that divert radiation away from the heart when treating left-side breast cancer. Radiation can cause heart disease.
The facility also has short-course radiation for early-stage breast cancer patients, three weeks instead of the typical five to six.
Biopsy technology is improving as well.
The Community Hospital Women’s Diagnostic Center in Munster offers the Brevera system, which doctors there say produces faster and more accurate biopsies.
"Regardless of how we do a biopsy at the Women’s Diagnostic Center, we get the majority of the results the next day," said Dr. Mary Nicholson, director of breast imaging services for Community Healthcare System. "The sooner we get the results, the sooner our patients get to treatment."
More support available
Support for breast cancer survivors also has improved.
For instance, the Franciscan Health Breast Care Center in Crown Point has cancer nurse navigators that assist patients with everything from scheduling tests and doctor's appointments to obtaining wigs and transportation.
"My job is to provide them emotional support, educational information and advocacy," said Joan Filipowski, a cancer nurse navigator.
Community Healthcare System offers the Cancer Transitions program, which helps survivors eat well, exercise and reduce stress.
"It's to help people transform from active treatment to post-treatment survivorship," said Roxy Karnes, director of cancer care support at St. Mary Medical Center.