Dr. Susan Love, who has dedicated her professional life to the eradication of breast cancer, explains why she became a vegetarian:

"I had leukemia seven years ago and a bone marrow transplant, and lost all my sense of taste and smell. Meat is boring now."

Dr. Love calls the side effects of her leukemia treatment "collateral damage," a term usually reserved for military operations, when injuries are caused on things other than the intended target. But the analogy sounds exactly right to her audience of women and men, most of them diagnosed with breast cancer. Many of them are experiencing a host of effects caused by treatments that attacked their tumors.

Dr. Love, a breast cancer surgeon, author, and chief visionary officer of Dr. Susan Love Research Foundation (DSLRF), understands well the collateral damage in cancer care. She has lost partial hearing from leukemia treatments, suffered from neuropathy pain for many years, and says she has chemo brain (a term used to describe a decline in cognitive function).

"But here I am," she smiles.

Her signs of chemo brain were not apparent to me, as I listened to her compassionate and brilliant talk on breast cancer updates. She spoke with a particular mix of hope, science, and humor, at Cancer Support Community of Los Angeles, August 27, 2019.

Breast cancer has the best clinical data and is the most researched cancer presently. Valuable data emerged, because "women were willing to be in studies," Dr Love says with admiration. We have better treatments, outcomes, and higher life expectancy in the U.S after a breast cancer diagnosis. But the conversation about the consequences of treatments for breast cancer, which can often be disabling, "are not talked about enough," Dr. Love says.

The collateral damage from even the most effective treatments, include:

• neuropathy

• chemo brain

• loss of fertility

• cardiovascular risks

• premature menopause

• pain and numbness from surgeries

• lymphedema

• side effects from aromatase inhibitors, medications used to block estrogen production in post-menopausal women

• fatigue

• anxiety and depression

• changes in bone density

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Labeling them late effects (from treatments for breast cancer), are a "euphemism," Dr. Love says. Collateral damage is more accurate. She encourages those affected to work with their doctors and medical team to find solutions, from understanding the benefits to each person of a particular treatment, and asking about medication for neuropathy pain, to working with your oncologist to slowly increment dosages for medications such as aromatase inhibitors. There are now apps to calculate your benefit from medical treatments and medications for breast cancer, to help you and your oncologist decide.

There are more breast cancer survivors than ever. According to the Breast Cancer Research Foundation, the U.S. has more than 3.5 million breast cancer survivors. Survivors are defined as anyone that has had a breast cancer diagnosis, whether they are currently being treated or not. The rate of survival after 5 years has reached 89% in 2016, according to the relative survival rate by the CDC. Mortality, or the rate of death from breast cancer, has also declined since 1999. Racial disparities still exist, although those have narrowed as well.

While we don't have any home runs in breast cancer research—akin to the vaccine for cervical cancer—Dr. Love says, each step brings us closer to better treatments. On the horizon now is precision medicine, where an exact drug may be prescribed based on a person's tumor DNA. Precision medicine will also result in fewer side effects. While still in its infancy, there may be better data in the next 5-6 years.

But to generate better data, she encourages people to sign up for The Army of Women®, which aims to connect women and men of all ages, ethnicities, and locations to researchers committed to solving important breast cancer questions. The goal is to accelerate and increase diversity in breast cancer research. All supported studies are conducted by research teams around the country and have passed a three-step review process.

Current research includes fear of recurrence, designing tests to identify cognitive impairments, or developing and testing safe, effective, and individualized exercise, nutrition, and mindfulness programs that can help survivors, among many other helpful studies.

"We can be the generation that ends breast cancer, and we're getting closer," Dr. Love says.

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