News
Midi pioneers menopause care for breast cancer survivors
Midi Health, the US-based virtual care clinic for women aged 35+, has launched a menopause care service specifically for women who have survived or are at high risk of breast cancer.
Its ‘survivorship programme’ has been developed and led by Dr. Mindy Goldman, a clinical professor in the department of OB/GYN at UC San Francisco and founder of UCSF’s Gynecology Center for Cancer Survivors and At-Risk Women,
It offers a treatment options, advice and counselling; and gives patients a personalised treatment plan involving specialised clinicians and the individual’a existing medical team.

Midi CCO Dr. Mindy Goldman
Too many women suffer perimenopause and menopause symptoms due to outdated beliefs about hormone therapy and breast cancer risk, the company believes.
Misunderstandings around hormone therapy (HT) and breast cancer risk can be traced back to initial findings from the 2002 Women’s Health Initiative study that have now largely been debunked.
Later data from the same study showed that estrogen actually decreases the risk of breast cancer, and the initial findings are now thought to have resulted from the type of progesterone used alongside estrogen.
Newer formulations of progesterone are now used and may not raise the risk of breast cancer at all, according to more recent studies.
However, this newer reassuring data on HT and breast cancer risk has not reached a wide swath of the general public.
The latest data shows less than two per cent of women over 40 are taking hormone therapy for menopausal symptoms – a huge drop from the 40 per cent of women who used HT before the now largely debunked WHI study.
In particular, breast cancer survivors, “pre-vivors” (defined as those with a genetic mutation who have not been diagnosed with cancer) and those with a family history of cancer generally believe they cannot use any hormonal therapies, or other medical interventions, for the symptoms of peri/menopause.
Unfortunately, many doctors continue to reinforce this outdated belief that all hormones are off-limits for breast cancer survivors, and generally are unaware of the many non-hormonal treatments.
Dr. Goldman, who is also chief clinical officer at Midi Health, says: “Because of mistaken and outdated thinking around hormone therapy and risk factors for breast cancer, far too many women needlessly suffer through symptoms of midlife hormonal change without getting the relief and care they deserve.
But the good news is that there are so many safe options available to help all women, even those with a personal history of breast cancer, live a fulfilling and active life beyond menopause. We have dedicated a whole team to staying abreast of the latest studies on new medications, clinical trials and other relevant research and designing state-of-the-art protocols for this population.”
Midi CEO and co-founder Joanna Strober adds: “With this launch, Midi becomes the first and only virtual care clinic dedicated to providing personalised menopause treatment to all women – including cancer survivors and those at risk.
Cancer
Lung cancer drug shows breast cancer potential
Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.
PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.
Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.
The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.
In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.
Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.
Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.
Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”
John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”
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