Posted on October 12, 2015
Think Beyond Pink: When Breast Cancer Spreads
By now, most are aware that October is Breast Cancer Awareness Month. It’s hard to miss the countless community events scheduled or the pink shirts, hats, bumper stickers, and so much more around town—even the NFL participates with players wearing pink shoes, arm bands, and towels. This month is all about prevention and early detection and urges women around the country to perform breast self-exams and to schedule regular mammograms.
Raising awareness to prevent breast cancer is crucial, but what about the thousands of women already diagnosed with breast cancer now fighting a new, and extremely difficult, battle?
What is Metastatic Breast Cancer?
When cancer spreads from the place it first started to another area in the body it’s called metastatic cancer. Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lung and forms a metastatic tumor is metastatic breast cancer (MBC), not lung cancer.
A diagnosis of MBC can be very frightening because it is considered to be incurable. But as treatments improve, metastatic women are living longer and more productive lives. Living with metastatic breast cancer usually involves ongoing treatment: Chemotherapy, hormonal treatment, or radiation.
New Bern’s Beth Fairchild, who was diagnosed with Stage IV MBC more than a year ago, said in a recent Sun Journal article, “The message of just simply early detection saving lives has to go away. Thirty years ago, we lost 40 to 45,000 people a year to metastatic breast cancer. In 2015, we will lose around 45,000 people a year to metastatic breast cancer. So, early detection clearly isn’t saving any lives.”
“It doesn’t matter if they caught it early, there could be a rogue cell in your body that could metastasize. To me, it makes sense to put research dollars into finding out why cells break off,” she continued. Her goal, through the METAvivor organization, is to sustain hope for those living with Stage IV MBC. The non-profit funds research to help improve the longevity and quality of life for those facing MBC while also raising awareness and rallying public attention to the needs of those in the MBC community.
Although some types of metastatic cancer can be cured with current treatments, most cannot. Nevertheless, treatments are available for all patients with metastatic cancer. In general, the primary goal of these treatments is to control the growth of the cancer or to relieve symptoms it causes. In some cases, metastatic cancer treatments may help prolong life. However, most people who die of cancer die of metastatic disease.
What Causes Metastatic Breast Cancer?
Doctors still don’t understand why some cancers become metastatic, especially those that are diagnosed years after the first breast cancer. In the past, doctors believed that cancer progressed in a linear manner and that women with positive lymph nodes were more likely to become metastatic. Now researchers are focusing more on genetics and the microbiology of breast cancer. They are trying to learn why some cancers behave more aggressively, what causes cancer cells to grow in different parts of the body, and what treatments can be developed to stop that process.
When is Metastatic Breast Cancer Usually Diagnosed?
Some women, approximately 6%, are initially diagnosed at Stage IV. They may already have symptoms such as pain or shortness of breath that cause a doctor to suspect metastatic cancer. Or the metastasis may be discovered during a CT or PET scan as part of the initial workup for breast cancer.
Most women who become metastatic are diagnosed later—anytime from several months to years after they were initially treated for early stage cancer.
Unfortunately metastatic breast cancer cannot be cured. Unlike breast cancer that remains in the breast or nearby lymph nodes, it’s nearly impossible to get rid of all the cancer that’s spread to other organs. This doesn’t mean, however, that MBC cannot be treated. Treatment focuses on length and quality of life. A treatment plan is guided by many factors, including:
- Characteristics of the cancer cells;
- Where the cancer has spread;
- Your symptoms; and
- Past breast cancer treatments.
If the cancer is hormone receptor-positive, the first treatment is hormone therapy. If the cancer is HER2-positive, anti-HER2 drugs such as trastuzumab (Herceptin) may be given.
Chemotherapy and radiation therapy can be used to shrink or slow the growth of tumors or to ease symptoms of the cancer itself. However, these therapies have side effects that can affect quality of life.
Talking about quality of life issues with your health care provider and your family can help you decide what treatments are best. Joining a support group may help you think through these issues.
In October, 2009, the U.S. Senate and House voted to support the designation of October 13 as a National Metastatic Breast Cancer Awareness Day. The point of those proclamations was to draw attention to the needs of the MBC community.
“We want people to know we exist, that we’re still alive,” says Ellen Moskowitz, president of the Metastatic Breast Cancer Network. The day is not about general cancer awareness; it’s about acknowledging the distinct needs of people who have the advanced, incurable form of breast cancer. “We’ve been hidden in closets,” she says.
A study conducted online in April 2014 with 2,000 participants showed these startling statistics:
- Sixty percent said they knew little to nothing about metastatic breast cancer;
- Seventy-two percent believe that advanced stage breast cancer is curable if diagnosed early;
- Fifty percent believe that breast cancer progresses because patients either did not take the right treatment or preventative measures; and
- Forty-one percent believe that those with advanced breast cancer can live a long time.
Sadly, only 7% of the $15 billion invested in breast cancer research from 2000-2013 by the major government and non-profit funders in the U.S. and UK was spent on metastatic-focused research. As you can see by these numbers, MBC is desperately in need of greater recognition and funds for research.
For more information on any type of cancer, contact the providers at CCHC New Bern Cancer Care by calling (252) 636-5135 or visiting www.newberncancercare.com. They understand every patient diagnosed with cancer or a blood disorder faces unique challenges and believe you deserve specialized care tailored to your individual needs. New Bern Cancer Care’s highly qualified, compassionate physicians will take time to explore treatment options, to answer your questions and to provide the information you and your family need to make important decisions about treatment.
(Sources: National Cancer Institute, The Huffington Post, New Bern Sun Journal, Susan G. Komen Foundation, SHARE, and Pfizer Oncology.)