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American Cancer Society Updates Colon Cancer Screening Recommendations

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Colorectal Cancer is the fourth most common non-skin cancer in the United States and the second leading cause of death due to cancer. Generally colorectal cancer most impacts those over age 50, but recent studies have revealed that the number of cases in young people has increased 51 percent since 1994. Andrew Wolf, an associate professor of medicine at the University of Virginia says, “We don’t know why it’s going on, but it’s increasingly clear that it is happening.” Most of the nation’s 140,000 annual cases and 50,000 deaths from colon and rectal cancer still occur among people over age 55, but the share of cases involving younger adults is concerning.

Some researchers believe the consistent rise in colon cancer in younger Americans is the result of poor diet and obesity. Whatever the cause, the result of recent studies has led the American Cancer Society to reevaluate its long-standing guidelines on colon cancer screening.  While the overall costs and benefits of earlier screening remain a topic of debate within the cancer care community, the message that early screening is important rings true. David Weinberg, chairman of medicine at Fox Chase Cancer Center in Philadelphia says, “The bottom line is that if you regularly participate in colon cancer screening, you have a reduced risk of getting and dying from colon cancer.”

The American Cancer Society (ACS) is now recommending that all adults at average or low risk get screened for the disease at the age of 45, instead of 50 as it previously recommended. Those in good health, at average risk, and who have a life expectancy of more than 10 years should continue screening through the age of 75. Men and women at high risk, such as patients with a family history of colorectal cancer, may require a more aggressive screening program.

A colonoscopy has long been the most common form of testing a patient for colorectal cancer but is a procedure that many avoid or delay. New prescreening solutions are now available which can alleviate the discomfort of the pretest requirements. Several other tests are available by prescription, including stool tests that can be administered at home, eliminating the time spent in a clinic or hospital and the risk of bowel perforation and complications from anesthesia.

The professional staff and Oncologists at Gettysburg Cancer Center (GCC) understand the importance of prevention as well as treatment of cancer. With Medical Oncology, Radiation Oncology, Diagnostic Imaging and an onsite laboratory and pharmacy, GCC offers comprehensive screening and treatment options.

Genetic Testing for Cancer, is it the Right Decision for You?

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Knowing something is almost always better than not knowing. Cancer will impact one in three people over their lifetime; a statistic that suggests that contacting the deadly disease is a matter of random chance. Knowledge that one is in the “more likely to get” column can be seen as good news, resulting in closer monitoring and additional testing that could potentially lead to earlier discovery and therefore an increased chance of treatment and survival.

Most cancer risks are directly related to personal behaviors such as using tobacco or over exposure to the sun or other cancer-causing substances and activities. Family cancer syndrome (inherited cancer) can occur when inherited gene mutations that are passed from generation to generation increase the odds of contracting the disease. Only about 5% to 10% of all cancers are thought to result directly from gene mutations inherited from a parent.

Family history of the same type of cancer; cancers developing at earlier ages; multiple family members contacting identical or rare cancers or cancers experienced in multiple generations are some cancers thought to be indicative of family cancer syndrome. Cancer occurrence within close relations is more cause for concern than those in distant relationships. For some rare cancers, the risk of a family cancer syndrome is relatively high with even one case. Some types of cancers have no known mutations linked to an increased risk and others may have known mutations, but no way to test for them.

Genetic testing can be performed by either a blood or cheek swab sample and do not detect whether a person has cancer; testing indicates whether a person carries a change in one of their genes which can increase cancer risk. Most people will not benefit from genetic testing for cancer, but those who have a strong indication of family gene mutations may be able to take actions that lower the risk of the disease.

BRCA1 and BRCA2 are the most common genes involved in hereditary breast and ovarian cancers and a positive connection to these genes can also indicate a higher risk for other cancers, but nearly 85% of breast cancers occur in women who have no family history of the disease. No genetic test can determine whether a person will develop cancer with certainty.

The results of genetic testing can be beneficial in making medical decisions for cancer treatment, additional screening and prevention. Selecting the correct test and interpreting the results accurately can be complex, and the decision to have the test may impact personal relationships with other family members. For these reasons, the decision to undergo genetic testing is a very personal one, and one that should be made after considering all unique circumstances.

Availability of Oral Chemotherapy Drugs on the Rise

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When we think about chemotherapy (chemo) treatment for cancer, more often than not we harbor visions of intravenous (IV) injections of chemicals with complicated names, usually being administered in sterile medical environments with the patient surrounded by attending oncology professionals. But advances in chemotherapy drugs over the past decade are quickly changing the perceptions most of us have developed about chemotherapy and how it is administered. The fact that chemotherapy is available in oral (pill) form for numerous types of cancer is a surprise to many. In fact, an estimated 30% of cancer drugs in development are oral, and the trend is increasing.

With cancer survival rates consistently increasing over the past decade, cancer is becoming a chronic illness for cancer patients. The ability to receive extended cancer therapy protocols at home and by mouth is beneficial in time, convenience and cost that accompanies typical IV administered treatments. Oral anticancer medications (OAMs) have become available to treat many different cancers, including lung, leukemia, colorectal, kidney, and prostate and have been shown to be as effective as other forms of treatment. “The efficacy of chemotherapy pills … are similar to the traditional intravenous therapy, with research showing that the overall survival with oral chemotherapy is the same as patients would have with traditional intravenous chemotherapy,” says Dr. Hannah Luu, California-based oncologist and CEO and founder of OncoGambit.

However, OAMs shift much of the responsibility for proper administration from attending medical professionals to the patient and family members. Dr. Luu cautions, “Chemotherapy pills have the potential to cause the same serious toxicities as intravenous chemotherapy. If used incorrectly, they can potentially have fatal outcomes. It’s important for patients to be aware of their treatment plan and take their chemotherapy drugs accordingly. It’s even more important that the patient doesn’t take the missed pills with the next dose.”

Doctor appointments are still necessary with the use of OAMs, to perform regular scans or blood tests to ensure the medication is working safely and effectively. Handling of these oral medications requires careful attention as well as consistent adherence to the treatment regimen. Not skipping doses is critical to effective treatment.

A recent study showed that both providers and patients face barriers from insurance carriers on the use of OAMs. Some insurers cover OAMs as a prescription drug benefit, rather than a medical procedure. Delays in getting approval may be labor intensive and take several weeks. Out-of-pocket costs can vary and may require additional administrative support to overcome.

Gettysburg Cancer Center, a leader in oncology care across south central Pennsylvania since 1989, is dedicated to providing all-encompassing oncology and hematology programs and a complete range of diagnosis, treatment, and follow-up care for patients. For more information call (717) 334-4033.

Immunotherapy Drug Is Providing Exciting Results in the Treatment of Lung Cancers

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Alex was in his early 40s when he was diagnosed with Stage 4 Lung Cancer. A non-smoking, healthy man, who exercises regularly and eats relatively well is not who most people think of when they think of lung cancer.  However, people exactly like Alex are the new faces of lung cancer diagnoses. Alex is also one of a select few who qualified for a new targeted therapy drug recently approved by the FDA.

Lung cancer is the leading cause of cancer death globally, causing 1.7 million deaths a year. In the United States, it is expected to kill more than 154,000 people in 2018, but recent studies are producing credible progress in finding new drugs that, when combined with more traditional chemotherapy, are greatly improving the survival rates among lung cancer patients. The findings are dramatically changing the way physicians are treating lung cancers. “What it suggests is that chemotherapy alone is no longer a standard of care,” said Dr. Leena Gandhi, a leader of the study and director of the Thoracic Medical Oncology Program at the Perlmutter Cancer Center at New York University Langone Health.

So far, four drugs called checkpoint inhibitors, which unleash the patient’s own immune system to kill malignant cells, have been approved by the FDA. “I’ve been treating lung cancer for 25 years now, and I’ve never seen such a big paradigm shift as we’re seeing with immunotherapy,” said Dr. Roy Herbst, Chief of Medical Oncology at the Yale Cancer Center.

In the trial, patients with metastatic nonsquamous non-small cell lung cancer (NSCLC) who received the drug pembrolizumab (Keytruda) plus chemotherapy had improved overall survival and progression-free survival compared with just chemotherapy alone.  The results from the KEYNOTE-189 clinical trial were presented at the annual meeting of the American Association for Cancer Research (AACR) in Chicago on April 16 and published concurrently in the New England Journal of Medicine.

One of the main factors in the high rate of death due to lung cancer is that the disease is most often undetected until it has spread to other organs of the body. Lung cancer is the second most prevalent form of cancer in men and women and the top cancer killer among both sexes. In addition to the encouraging results from immunotherapy drugs, a newly discovered protein is showing promising results in detecting lung cancer earlier, providing new advanced treatment options to patients at the earliest stages of the disease. “The use of CKAP4 as a biomarker could change current practices regarding the treatment of lung cancer patients, and the diagnostic accuracies may be markedly improved by the combination of CKAP4 and conventional markers,” says Yuichi Sato, Division of Molecular Diagnostics, Kitasato University.

While the news of earlier discovery and new treatment options is very good, reducing risk factors for the disease remains the best approach to avoiding cancer. Exposure to tobacco smoke is one of the leading causes of lung cancer. Smoking marijuana and using electronic cigarettes may also increase the risk of lung cancer, but the actual risk is unknown. People who work with asbestos in a job such as shipbuilding, asbestos mining, insulation, or automotive brake repair and who smoke have a higher risk of developing cancer of the lungs. Exposure to radon has been associated with an increased risk of some types of cancer, including lung cancer. Having your home tested for the presence of Radon is a good and economical method for reducing the risk. Some people also have a genetic predisposition for lung cancer. People with parents, brothers, or sisters with lung cancer could have a higher risk of developing the cancer themselves.

Understanding cancer and how to treat it is constantly evolving toward the day when a cure is discovered. The cure is not here yet, but treatment options have greatly improved in recent decades. The treatments and methods used in clinical trials are promising in every environment in which they are tested. For more information on advancements in cancer detection and treatment, visit https://gettysburgcancercenter.com/.

The Importance of Taking Care of the Caregiver

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For cancer patients, receiving a diagnosis is often a time of fear, stress and trauma. The fear of the unknown, treatment processes and the disruption to life’s routines can be overwhelming. The experience is life altering, not only for the patient but also for family and close friends. For certain, life will never be the same for all involved.

While the initial focus and turmoil centers around the patient, the emotional impact on those who step up to be caregivers are too often overlooked. The dedication of time and resources to drive the patient to their frequent treatments, look in on them to monitor the therapies’ progress and extend their understanding and emotional support can be significant. Truly, no one fights cancer alone.

Being a caregiver can be very challenging. Many caregivers are close family and friends who are impacted equally by the diagnosis. The experience often creates a new role and unprecedented change for friend and family relationships. Feelings of confusion and stress accompany the changes in daily routines for all involved. Once relatively equal give and take relationships are now tipped more toward the cancer patient. Over an extended period of time this unbalanced set of emotional and physical needs can leave a caregiver feeling depressed and overwhelmed.

Educating yourself about the patient’s disease and the therapies and treatments they will be experiencing can help a caregiver cope with the challenges that lie ahead.  “I remember it was important for me to understand the kind of breast cancer my wife (Viola) had,” says Nathan Jones.  “It was triple-negative, so it was very aggressive. Because I had learned everything I could about Viola’s cancer, I understood that even though she wasn’t sick in bed or even in pain, her cancer was going to grow fast and we needed to be proactive.” Knowing and understanding is nearly always better and less stressful.

Many caregivers admit, usually in hindsight, that they took on too much. Accepting help from others and sharing feelings of being over taxed is never easy, but having someone assist with routine chores like cooking, cleaning, shopping and yardwork can relieve the pressure on a caregiver’s time, energy and feelings of inadequacy.  Focusing on your own needs, hopes, and desires can give you the strength to meet new challenges and understand conflicting feelings.

Support groups dedicated to caring for the caregiver are widely available in small group settings or online. Studies show that talking with others about what you’re dealing with is very important. It’s especially helpful when you feel overwhelmed or want to say things that you can’t say to your loved one with cancer.

Keeping a journal has been shown to help relieve negative feelings and stress. Share your journey with others who show interest.  Ken Owenson, caregiver and husband to a breast cancer patient says, “We find a lot of strength from sitting down with patients and giving them a place to vent some of their anxiety, and it also gives us a chance to clear our minds, too.  It’s not good to internalize it because that just makes it worse.”

For more information on how you can better manage your caregiver journey, contact the cancer care specialists at https://gettysburgcancercenter.com/contact-us/.

Proper Screening and Lifestyle Changes Can Impact Cancer Risk

GCC February Blog Image 2 (640x427)When Cheryl and her husband of thirty-five years sold their business and headed off to retirement, they looked forward to having more time to dedicate to their three children and four grandchildren. Discovering a lump in her left breast while on vacation dramatically altered their retirement plans and her outlook on the future. With no family history of breast cancer, the results of her mammogram were stunning. Cheryl was diagnosed with Stage 2 triple negative ductal carcinoma breast cancer.

Cheryl is not unlike many thousands of women who receive an unexpected breast cancer diagnosis. While aware of the disease and its impact on the lives of those suffering from it, the thought of receiving the bad news is one stuck in the back of the mind, hopefully never to be realized.

In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 63,960 new cases of non-invasive breast cancer. Death rates have been decreasing since 1989, but approximately 40,920 women in the U.S. are expected to die in 2018 from breast cancer. About 85% of breast cancers occur in women who have no family history of breast cancer. The two most common risk factors are gender and growing older. While you can’t change some breast cancer risk factors there are some risk factors that you can control.

Personal behaviors, such as diet and exercise, and taking medicines that contain hormones can impact the chances of getting breast cancer. Drinking alcohol is clearly linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Being overweight or obese increases the risk in women after menopause. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity. Moderate and vigorous physical activity lowers risk for postmenopausal breast cancer. Vigorous physical activity lowers risk for pre-menopausal breast cancer, according to the recently released American Institute for Cancer Research “Breast Cancer Report.”

Early detection of breast cancer is the leading factor in the historic decline in cancer deaths. With screening mammography, treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74.

“The importance of love and life hits you square in the face and it takes a strong toll on your body and spirit,” says Cheryl of her diagnosis and treatment regimen.  Today she is more than one year cancer free.

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting close to home. The all-encompassing oncology and hematology programs provide a complete range of diagnosis, treatment, and follow-up care for all types of cancer.

Early Detection and Treatment May Prevent Cervical Cancer

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Each year, an estimated 12,820 women in the United States will be diagnosed with some form of cervical cancer. Approximately 4,200 women die from the disease each year, and more than a quarter of a million women will live with the disease each year.  While the numbers can be daunting, when detected early, 91 percent of those diagnosed with cervical cancer will survive.

Long-lasting infections with certain types of human papillomavirus (HPV) cause almost all cases of cervical cancer. Normal cells of the cervix can gradually develop pre-cancerous changes.  These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop pre-cancerous changes that may turn into cancer.

The two main types of cervical cancer are squamous cell carcinoma and adenocarcinoma and represent the vast majority of cancer of the cervix. Only some of the women with pre-cancers of the cervix will develop cancer, and it may take several years for cervical pre-cancer to change to cervical cancer. For most women, pre-cancerous cells will go away without any treatment, but others will have their pre-cancers turn into invasive cancers.

Detecting and treating all cervical pre-cancers may prevent true cervical cancers. The Pap test (or Pap smear) and the HPV test may prevent cervical cancer by detecting pre-cancers before they can turn into an invasive form of cancer. During the past several decades, screening has reduced deaths from cervical cancer by finding the cancer early and treating it or preventing it from developing.

For women it can be very hard not to be exposed to HPV. Passed from one person to another during skin-to-skin contact with an infected area of the body, HPV can be spread rapidly and easily.

Available vaccines can protect against infection with the HPV subtypes most commonly linked to cancer. These vaccines help prevent pre-cancers and cancers of the cervix. The vaccines require a series of injections and may cause some mild side effects. The most common are is short-term redness, swelling, and soreness at the injection site.

The American Cancer Society recommends vaccinations for girls and boys beginning at age 11 or 12. HPV vaccination is also recommended for females 13 to 26 and males between the ages of 13 and 21. Vaccination at older ages is less effective in lowering cancer risk. No vaccine provides complete protection against all cancer-causing types of HPV, so routine cervical cancer screening is still recommended.

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting close to home. A leader in Oncology care across the region since 1989, Gettysburg Cancer Center’s cancer team provides screening and treatment options to women across York and Adams County.

For the latest information on early detection and treatments for cervical cancer, contact the Gettysburg Cancer Center.

The Value of a Community-Based Cancer Center

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The diagnosis of Cancer most often is accompanied by an intense emotional reaction, denial and a deep sense of dread and fear. The initial reaction is to seek the most information about the disease and the best treatment options available, no matter the cost of time and expense. The travel can impose a significant burden on cancer patients and their families already struggling with a significant life challenge.

In the historically famous but small community of Gettysburg, Pennsylvania, The Gettysburg Cancer Center (GCC) is meeting the challenges of providing expert comprehensive medical oncology, radiation, diagnostic and radiology services to their community in one location, eliminating the need to travel to regional centers.  With access to expert clinicians and staff, GCC is able to offer quality and comprehensive care in one location.

Adams Diagnostic Imaging (ADI) is an integral part of the GCC. An ACR Certified Imaging Center, ADI is a fully accredited facility focused on providing comprehensive diagnostic services. Whether it is MRI, PET-Scan, Stand Alone CT, Nuclear Medicine, Ultra sound or XRAY, the professional staff at ADI has the latest diagnostic tools available to serve their patient’s specific and individualized needs at affordable prices for the insured and those who self-pay. Their Physicians and highly trained technologists are certified through the ARRT with comprehensive experience and knowledge in radiology. The facility provides flexible scheduling to better accommodate patients by offering longer time slots to improve the patients’ recovery experience.

Clinical trials are an important part of the constantly evolving process of bringing new treatments to market to improve patient outcomes. At GCC, clinical trials are conducted after exhaustive research and development in the lab and are offered to patients to treat or prevent the recurrence of the disease. The first site in the United States to enroll a patient in a pivotal oral chemotherapy trial for all patients with advanced malignancies, GCC clinical trials are some of the most advanced in the field of cancer treatment. The clinical research department at Gettysburg Cancer Center is on the cutting edge of cancer clinical trials.

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting, close to home. The Center works with Hershey Medical Center’s Surgical Oncology Department for all solid tumor board conferences and also collaborates with John Hopkins University and NHI for complicated patient diagnoses.

The Gettysburg Cancer Center prides itself on providing individualized treatment, utilizing the best technical approach, and recognizing each individual patient’s psychological, emotional, and spiritual needs during their journey with their illness and healing.

For more information about Gettysburg Cancer Center, visit www.gettysburgcancercenter.com.

October is Breast Cancer Awareness Month Around the World

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Billed as the most common cancer in women, breast cancer is impacting the lives of one in eight women in the United States. The second leading cause of cancer death in women after lung cancer, breast cancer most commonly occurs in women 50 years of age and older. Breast cancer is caused by a genetic mutation in the DNA of breast cancer cells but how or why this damage occurs isn’t fully understood. Some mutations may develop randomly over time, while others are inherited or may be the result of environmental exposures or lifestyle factors. More than 3.5 million women are living in the U.S. with a history of breast cancer.

Early detection remains the most important factor in the successful treatment and survivability of breast cancer. Caught early when known treatments have the best chance of success, breast cancer is survivable. Successful treatments include surgery, chemotherapy, radiation and immunotherapy. “Risk factors include being female, obesity, a lack of physical exercise, drinking alcohol, hormone replacement therapy during menopause, ionizing radiation, early age at first menstruation, having children late or not at all, older age, and family history.” With the clear lack of knowledge for its causes, early detection of the disease remains the cornerstone of breast cancer control.

National Breast Cancer Awareness Month (NBCAM) was founded in 1985 by the American cancer Society and what is now known as AstraZeneca Pharmaceuticals. Held each October, the event is an attempt to increase the awareness of breast cancer and to aid the solicitation of funds for research and treatment of the disease. NBCAM unites cancer organizations around the world in providing information and support for those suffering from the cancer. Breast Cancer Awareness is represented by the display of pink ribbons, first introduced by the Susan G. Komen Foundation at its New York City race for breast cancer survivors in 1991.

The effort by so many to bring worldwide attention to the disease appears to be having a positive impact. A new report from the American Cancer Society finds that death rates from breast cancer in the United States have dropped 39% between 1989 and 2015. The overall declines in breast cancer death rates have been attributed to both improvements in treatment and early detection by mammograms. The American Cancer Society recommends women find breast cancer earlier when treatments are more likely to be effective. While there is a lack or definite agreement on when and how often screening is most effective, The National Comprehensive Cancer Network recommends annual screening beginning at age 40.

The professional team of oncologists and staff at Gettysburg Cancer Center supports the efforts of Breast Cancer Awareness Month in its world-wide goal to provide the latest information, research, treatment options and support for those who suffer from breast cancer.

Targeted Radiation Therapy Effective For Breast Cancer Patients

A new cancer research project funded by the United Kingdom is revealing some very positive results for breast cancer patients. The study (IMPORT LOW trial), led by The Institute of Cancer Research, London and the Cancer Research UK Cambridge Centre indicates that breast “cancer patients who received radiotherapy targeted at the original tumor site experience fewer side effects five years after treatment than those who have whole breast radiotherapy, and their cancer is just as unlikely to return.” The results which were recently published in The Lancet, an independent, international weekly general medical journal. “This approach could spare many women significant physical discomfort and emotional distress,” says Professor Arnie Purushotham, Cancer Research UK. “One of the challenges when treating early stage breast cancer is trying to minimize the side effects that can have a real impact on a woman’s life, without affecting the chances of curing her.”

The study included more than 2,000 women aged 50 or over who had early stage breast cancer that was at a low risk of coming back. Radiation therapy or radiotherapy uses ionizing radiation as part of cancer treatment to control or kill malignant cells. A common and effective treatment for breast cancer for many decades, large field radiotherapy is relatively painless in its application, but often the treatments produce side effects that range from low, short term to more severe, long term in nature. Depending on the intensity of the radiation, higher doses can cause varying, acute side effects for months or years following treatment. The nature, severity, and longevity of side effects depend on a number of treatment factors and the individual patient.

Precisely targeted radiation therapy can eradicate all evidence of disease in patients with cancer that has spread to only a few sites. Because radiation destroys cells, targeting the treatment to specific cancer cells limits the collateral damage to areas not affected by the cancer, reducing the side effects suffered by the patient.

The IMPROT LOW trial found that women who received partial radiotherapy reported fewer long term changes to the appearance and feel of their breast, than those who had radiotherapy to the whole breast. Dr. Charlotte Coles, Reader in Breast Radiation Oncology at Cambridge University, chief investigator for the trial and first author of the publication, said, “We started this trial because there was evidence that if someone’s cancer returns, it tends to do so close to the site of the original tumor, suggesting that some women receive unnecessary radiation to the whole breast. Now we have evidence to support the use of less, but equally effective, radiotherapy for selected patients.”

The technique, delivered by standard radiotherapy equipment, may lead to increased use of this treatment at cancer centers across the country and around the world. Professor Judith Bliss, scientific lead for the study within the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, said: “We’re delighted that the results of this trial have the potential to lead to a real change in the way selected breast cancer patients are treated.”

Gettysburg Cancer Center is actively working with researchers on clinical trials, providing alternative treatments for its patients. For more information on clinical trials at Gettysburg Cancer Center, click here.