It started with an unusual feeling and a frozen shoulder for Elissa Simms, who decided to seek answers from her regular GP. After being referred for an ultrasound, the scan came back as breast cancer, and the news felt surreal.
This was 12 months ago, and at the time, she was focused on trying to share the news with her mum and two daughters in a way that had a positive spin on the otherwise shocking diagnosis.
“We’ve got a lady I worked with and am good friends with who’s had breast cancer, and she’s okay now. Also one of my oldest daughter’s best friend’s mum has also had breast cancer, and she’s okay now,” Elissa tells Women’s Agenda.
“So, I sort of sold it to my children that [those women] have had breast cancer and they’re okay now, so we’re going to get through this and it’ll all be okay.”
Elissa was also worried the news would be hard on her mum, as her dad had passed away from heart complications in 2021 after being treated with chemotherapy for lymphoma. For that conversation as well, Elissa maintained a positive mindset.
Within a couple weeks of diagnosis, Elissa underwent surgery. The margins for her breast cancer- stage two, ER positive, HER2-negative- weren’t cleared, however, so she had to have more surgery and get her lymph nodes taken out from under her armpits.
OPTIMA Clinical Trial
That’s when one of Elissa’s doctors, Dr Nick Zdenkowski, told her about the OPTIMA Clinical Trial and explained she could be a good fit.
The OPTIMA trial aims to find out if using a test called Prosigna can help make safe and accurate decisions about whether or not a participant with ER positive, HER2-negative early breast cancer will need chemotherapy treatment.
“We prescribe chemotherapy with the hope that the treatment will prevent cancer from returning, and that it will cure the cancer,” Dr Zdenkowski tells Women’s Agenda. “But there are many people for whom chemotherapy is not needed.”
“Chemotherapy is not as bad as it used to be, but it still causes significant side effects, and we need to do a better job of working out who really needs it and who really doesn’t,” he says.
Elissa says that Dr Zdenkowski explained all aspects of the clinical trial to her, and she ultimately decided to become a participant to ensure her best chance of survival. She also says she thought about her daughters and how if they ever got breast cancer as well, she would want the results of the trial to benefit their lives.
During the OPTIMA trial, participants are randomly allocated into the treatment most optimal for them. For Elissa, this meant she was given standard care, which in her case, meant she underwent chemotherapy.
Cambria-2 clinical trial
Further down her line of treatment, Dr Zdenkowski recommended another clinical trial that would be suited to Elissa’s treatment.
It’s called the Cambria-2 clinical trial and aims to find out if giving a new endocrine therapy treatment known as a ‘selective estrogen receptor degrader’ (SERD) is better at stopping cancer from coming back compared with the usual endocrine (hormone) treatments such as letrozole, anastrozole, exemestane or tamoxifen.
“This is a large, potentially practice changing clinical trial that is being run around the world,” Dr Zdenkowski says.
“This drug overcomes some of the resistance mechanisms that cancer can develop towards treatment, ” he says, adding that researchers are hoping that if they give the drug to patients early on, those resistant cells will be eradicated and make it “more likely that a patient’s cancer will be cured”.
Successfully randomised into this trial, Elissa is currently undergoing the treatment and says she’s taking one tablet a day, as well as being on an estrogen suppressant which she receives once a month. Her treatment, she says, is expected to take between five and seven years.
“I knew that I wasn’t being thrown into the deep end,” Elissa says about the Cambria-2 trial.
“There’d already been previous stages of the trial done, so there were some known side effects and with a clinical trial, you can pull out at any time- no questions asked. If you don’t want to do it anymore, you just say so. I knew that if I didn’t feel good on the trial, then I had that option as well.”
Looking towards the future
Elissa continues to see Dr Zdenkowski every three months and is in touch with the clinical trial nurses if she ever has any questions about anything.
While her breast cancer journey certainly hasn’t been easy, she says that what keeps her going is a drive to prove to herself that “breast cancer isn’t the end of everything”.
“You can still get on with life, and you can still enjoy things and do what you used to do,” Elissa says.
“Even if there are some side effects- like sore joints has slowed me down a bit- I’m still able to get out there and do things that I enjoy, and I also want to show that sort of positivity to my girls- one is 18 at the end of March, and the other one is 20.”
“I just look forward to getting stronger and just getting back to living life.”
Join Breast Cancer Trials on Wednesday 19th March , from 5-6:30pm (AEDT), for a free online Q&A, where a panel of experts will discuss key research areas that are transforming the landscape of patient care. The session will be moderated by author and journalist Annabel Crabb. To register click here.