Legendary breast cancer researcher Carol Fabian reflects on the progress of research and its impact on survivorship

When Robin Love entered a clinical trial at The University of Kansas Cancer Center 18 years ago, her prognosis was bleak. In the years since, the field of cancer research has advanced significantly, making types of breast cancer that were once deadly survivable. While more research needs to be done, it’s important to recognize the impact of trial participation on the progression of treatment for cancer.

Carol Fabian, M.D., director of the Breast Cancer Prevention and Survivorship Research Center and clinical oncologist with KU Cancer Center, has seen tremendous progress in cancer research in her lengthy career.

While breast cancer used to be used as a catch-all term, Fabian noted that it is no longer appropriate now that researchers know more. “Breast cancer is actually many different diseases, they all just happen to start in one organ — the breast,” Fabian said.

Fabian noted that roughly 70% to 80% of breast cancers are fed by estrogen and generally respond very well to treatment. “But about 20% to 30% of tumors have growth factors on their surface, and one of those is HER2,” she said.

Those types of tumors are very aggressive, and Fabian noted that they often attack people at both ends of the age spectrum — the very young and the very old. Love was quite young, with elementary school children, when she received her diagnosis. Fabian helped Love with a clinical trial that fought her specific form of the disease, which was a type of HER2-positive breast cancer.

Love’s goal was to see her children, who were 7 and 9 years old when she was diagnosed, graduate from high school. Now Love is a grandmother, with young adults in their late 20s. Her diagnosis even inspired her son’s choice to become a doctor.

Her son was even able to meet Fabian at a conference. “For him, she was a mentor he had never met,” Love said, noting that she would never have seen any of the milestones of the last 18 years if Fabian hadn’t found a clinical trial for her specific type of breast cancer.

“We did have a clinical trial for her,” Fabian said. “In 2006 when she was diagnosed, we didn’t know all the ins and outs about HER2-positive (cancers), but we did know that a tumor like hers was very aggressive.”

Research takes time, and it takes many trials to learn whether different treatments are safe and effective. That is time well spent, Fabian said. She saw many young women die early from aggressive cancers, and she has devoted much of her life to research. “I’m very interested now in prevention and survivorship trials,” she said. “I want to know what we can do to assess who is at higher risk and what we can do to intervene and lower that risk.”

Clinical trials can be initiated by drug companies or by researchers themselves; the latter are known as investigator-initiated trials. Both are available at KU Cancer Center, and Fabian encourages patients to look for options as well as speaking with their provider.

“I will guarantee you that doctors can’t know everything about every clinical trial or what all clinical trials are available,” she said. “There are a variety of ways to find out what trials are going on not only at a particular institution but all across the United States. Patients can go on clinicaltrials.gov and there’s also the KU Cancer Center app.”

While not all patients are good candidates for clinical trials, research benefits all patients over time. Fabian noted that much has changed since she began her career in oncology in 1975, with survivorship increasing dramatically thanks to research and advancements in early detection, new drugs and prevention.

“The bottom line is that the stage of disease at diagnosis has gone down, down, down and the survival rate has gone up, up, up, and people’s treatment, importantly, is now tailored not only to the stage but to the type of cancer they have. That is called precision medicine,” Fabian said. “Now what we’re trying to do is breach that last barrier and prevent people who have precancerous cells in their body from developing cancer in the first place.”

Fabian, Love and research and treatment provided by the KU Cancer Center was featured on the Medical News Network. Watch the video