Can You Imagine a World Free of Breast Cancer? - RAH Research Fund
News 27 July 2016

Can You Imagine a World Free of Breast Cancer?

In the world of science, a paper published in the journal Nature, the “Mount Everest” for researchers, is an incredible achievement. For Dr Theresa Hickey, who recently accomplished just this, her greatest personal triumph is the ability to have a potential impact on the lives of women with breast cancer.

Thanks to you supporting life-changing research through the RAH Research Fund, Dr Hickey is able to focus on combatting breast cancer, currently in the second year of a three year RAH Research Fund Career Development Fellowship.

As the Head of Breast Cancer Research at the Dame Roma Mitchell Cancer Research Laboratories (DRMCRL), located within the Hanson Institute Building at the Royal Adelaide Hospital (RAH), Dr Hickey is leading research that is a potential game changer for breast cancer, working with a new drug currently in several clinical trials. This work not only has the potential to lead to a new treatment for breast cancer patients, it could also eventually be used to prevent this heartbreaking disease.

Explaining the basic science of her research, Dr Hickey said “most breast cancers are driven by excess estrogen hormone activity and in women, androgen hormones oppose this estrogen action in the body.

“A good, simple example of this opposing sex hormone activity is that women develop breasts and men don’t. For women, estrogen dominates over androgen, so you get breast growth. In males it’s the opposite: androgen dominates over estrogen and breast tissue development is blocked. It is not the case that males have no estrogen and females have no androgen; it’s all a matter of balance.

“If that balance gets disturbed, breast tissue can develop in men, and while it’s rare for men to get breast cancer, it does happen. Most male breast cancers are driven by estrogen, indicating that somehow their androgen hormones are not adequately suppressing estrogen action to inhibit growth.

“So this kind of hormone tug of war is happening all the time and one of the things that we’re doing is trying to find out what mechanisms are at play and whether we can develop therapeutic drugs that target the androgen receptors.”

“This work not only has the potential to lead to a new treatment for breast cancer patients, it could also eventually be used to prevent this heartbreaking disease.”

Current treatments for breast cancer work to eliminate estrogen in the body, which result in side effects negatively impacting a woman’s quality of life. One of Dr Hickey’s main areas of work is looking at inhibiting estrogen action in breast cancer, but in a more natural way than current therapies by ‘awakening’ their androgen receptors.

“We’re doing a lot of work now with a drug called Enobosarm that is showing really good results in a clinical trial of women with metastatic breast cancer being conducted in the US. We’re really excited about it as this drug doesn’t have negative side effects so far and may even improve muscle and bone strength in postmenopausal women.

“The other trial that we are doing with this drug is called a Window of Opportunity trial, which we’re doing in international collaboration with Cambridge University, UK and a partner in Liverpool.”

“It’s considered unethical for a woman with breast cancer who has just had her surgery to go on a brand new drug, it is our duty to ensure they are first given drugs known to work in most women and fully approved by governing agencies.

“So the only way you can test a potential new treatment on its own is to test it in that window of time in between when a woman is diagnosed and her surgery date. This is something we’re also working on, which is really exciting as the tissue from the trial will be coming here to our labs for us to analyse.”

With a recently published paper in Nature, and another in Nature Genetics, Dr Hickey said her team’s work is helping to lead toward a new way of thinking about the treatment of breast cancer.

“This is all quite a new way of thinking. If your estrogen receptor is behaving really badly in your breast, can we push it towards good behaviour?

We want to keep the estrogen, because obviously the body wants to have it around, but can we push it away from that bad, cancer-promoting behaviour to a more benign type of activity?

This is what was discussed in the recent Nature paper we had published and we’re going to have a shot at getting another paper published in the same journal soon!”

For Dr Hickey, her work is all about impact.

“This is why I’m really excited about these clinical trials! To see some of your work actually enter into a trial, or form the basis for a new trial, that’s amazing,” she said.

“Personally I’m also excited about the prevention side of things. I think there is a real potential in what we’re doing to eventually lead to a preventative therapy.

“We use hormones for contraception and all kinds of other things; can you imagine taking a pill at night to prevent breast cancer? It could happen!”