Friday, September 5, 2008

General Principles of Treatment for Metastatic Breast Cancer

By Ray Lam

America received a shocking piece of news in March 2007. John Edward's wife, Elizabeth, had been diagnosed with metastatic breast cancer. She spoke calmly, with inner strength, about how she had asked her husband to continue his presidential campaign, and how she wanted to campaign by his side. She did not want to be best known by her illness; she wanted, in fact, needed, to carry on as normally as she could.

Cancer is defined by four different stages and metastatic breast cancer is defined as stage 4 and it means that the cancer has spread beyond the breast and underarm lymph nodes to other part of the body. Another way to explain this is that the cancer cells have migrated and are now growing outside of the original tumor.

The treatment options for this cancer are the same as treating any other cancer. But treatment must be aggressive based on the stage of this particular disease. Because the definition of metastatic breast cancer is cancer that has spread from the breast to other parts of the body, treatment must be speedy and assertive in order to stop the spread of the cells to any further locations in the body.

Treatment plans may include surgery wherein the cancerous growths are removed from the body; radiation during which affected cells are attacked with pinpoint x-ray technology; and chemotherapy which exposes the patient to a course of intravenous drug therapy designed to stop the growth of cancer cells. In most cases, however, a combination of several therapies will be used in order to achieve the greatest chance of success. There are also experimental and holistic therapies that patients often try in conjunction with other therapies and under the guidance of their doctor. As the needs of each patient vary, so do the treatment plans.

In it, cells break away from the breast, circulating through the blood and lymphatic system. The body's immune system attacks these circulating cancer cells. Most do not survive, but if the immune system malfunctions or is weak, or for another, unknown reason, will usually spread to the bone, then lung and liver next. The cells that have metastasized are still breast cancer cells, no matter where they are found in the body.

Treatment is palliative, improving quality of life, relieving symptoms and aimed at extending a woman's lifetime. But there are new treatments coming that are giving more hope to those patients with this cancer. Many women with this illness choose to become part of a clinical trial in order to access treatments that are not yet approved by the FDA.

If it is "estrogen-receptive," hormonal therapies such as the drug Herceptin can be lifesaving. Chemotherapy is indicated in bone, lung and liver metastases. For bone metastases, radiation and the drug bisphosphonate are often used. For liver and lung metastases, occasionally surgery is used. For cancer that has spread to the brain, radiation and surgery are used.

As far as anyone knows today, metastatic cancer can't be cured. Sometimes, treatments can actually stop the cancer from growing for months or years. When Elizabeth Edwards asserted that she thought her own might be treatable, people listened. She gave a face to this illness - a loving, brave, wise, face - that no one will forget.

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