This Is the Most Common Misconception About Metastatic Breast Cancer
“Metastatic breast cancer used to be considered a death sentence; that’s absolutely not true anymore.”
Metastatic breast cancer—the most advanced stage of breast cancer, in which the cancer has spread to other parts of the body—isn’t considered a death sentence anymore, thanks to breakthrough discoveries in metastatic breast cancer treatment.
In a study conducted by the National Cancer Institute, researchers found that between 1992-1994 and 2005-2012, five-year relative survival among women initially diagnosed with metastatic breast cancer at ages 15-49 years doubled from 18% to 36%.
“More and more we’re seeing complete responses to therapy. That’s something that was previously unheard of for metastatic breast cancer,” says Amy Tiersten, MD, a hematologist and oncologist at the Mount Sinai Hospital in New York City. “That’s not true in every single case, but many patients with metastatic breast cancer can live good quantity and quality of lives—we have great treatment for it.”
How Metastatic Breast Cancer Treatments Have Improved
While metastatic breast cancer can’t be cured (the way many early-stage breast cancers can be) and is more difficult to treat than early-stage breast cancer, there are many treatment options for metastatic breast cancer available, such as chemotherapy, hormonal therapy, and targeted therapy.
“Amazing changes have happened in options for treatment for metastatic disease,” says Dr. Tiersten. “More and more we’re seeing complete responses to therapy. That’s something that was previously unheard of for metastatic breast cancer.”
Researchers have discovered certain characteristics that help cancer cells (or other cells near them) grow and thrive. This has led to the development of drugs that “target” these differences from normal cells, a class known as targeted therapy.
Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. “Chemotherapy was the old gold standard we had to treat these patients with,” says Dr. Tiersten. “Chemotherapy is pretty course. You’re killing cancer cells, but you’re also killing normal cells.”
Targeted therapies are different, because they go after the cancer cells’ inner workings—what makes them different from normal, healthy cells—while leaving most healthy cells alone. These drugs tend to have side effects different from standard chemo drugs. Depending on the type of breast cancer, however, doctors may use targeted therapies along with chemotherapy for maximum effectiveness.
“The age of targeted therapies is really about understanding what pathways make a cancer cell proliferate more than a normal cell,” says Dr. Tiersten. “The medications that have been developed to target those specific pathways [are] absolutely incredible.”
Learn more about how targeted therapy treats metastatic breast cancer.
Dr. Tiersten is a professor of medicine, hematology, and medical oncology at the Icahn School of Medicine at Mount Sinai. She sees patients at the Dubin Breast Center.
1
00:00:00,000 --> 00:00:06,081
[MUSIC]
2
00:00:06,081 --> 00:00:08,933
Metastatic breast cancer used to be
considered the death sentence and
3
00:00:08,933 --> 00:00:10,540
that's absolutely not true anymore.
4
00:00:10,540 --> 00:00:12,210
We think of it more as a chronic disease.
5
00:00:12,210 --> 00:00:16,130
That's not true in every single case but
many patients with metastatic breast
6
00:00:16,130 --> 00:00:19,440
cancer can live good quantity and
quality of lives.
7
00:00:19,440 --> 00:00:21,300
We have great treatment for it.
8
00:00:21,300 --> 00:00:25,276
I think it's really important to educate
people about how metastatic breast cancer
9
00:00:25,276 --> 00:00:28,524
in general requires some sort of
treatment and definitely the way for
10
00:00:28,524 --> 00:00:31,560
example diabetes or
high blood pressure requires medication.
11
00:00:31,560 --> 00:00:35,994
And definitely sometimes, we need to
do something to keep the disease under
12
00:00:35,994 --> 00:00:39,458
control, but amazing changes
have happened in options for
13
00:00:39,458 --> 00:00:44,380
treatment for metastatic diseases compared
to from when I was in training 20 years
14
00:00:44,380 --> 00:00:46,666
ago to ten years ago to now, there's so
15
00:00:46,666 --> 00:00:52,070
much incredible research that's been done
mostly in the area of targeted therapies.
16
00:00:52,070 --> 00:00:55,730
So if you think about chemotherapy which
was the old gold standard which we had to
17
00:00:55,730 --> 00:00:58,780
treat these patients with,
chemotherapy is pretty coarse.
18
00:00:58,780 --> 00:01:00,870
You kill rapidly dividing cells.
19
00:01:00,870 --> 00:01:04,010
You're killing cancer cells, but
you're also killing some normal cells that
20
00:01:04,010 --> 00:01:07,900
rapidly divide, like hair, or
the stomach lining or nails.
21
00:01:07,900 --> 00:01:11,230
The age of targeted
therapies is really about so
22
00:01:11,230 --> 00:01:15,980
much science that has gone on
understanding what pathways make a cancer
23
00:01:15,980 --> 00:01:21,270
cell proliferate more than a normal cell
and medications that have been developed
24
00:01:21,270 --> 00:01:26,570
to target those specific pathways
is absolutely incredible.
25
00:01:26,570 --> 00:01:29,420
The goal of treatment for
metastatic breast cancer is to
26
00:01:29,420 --> 00:01:33,380
optimize the person's quality of life
by controlling any symptoms that they
27
00:01:33,380 --> 00:01:38,410
have from metastatic disease as well as
possible and to extend their life as well.
28
00:01:38,410 --> 00:01:41,520
More and more, we are seeing
complete responses to therapy.
29
00:01:41,520 --> 00:01:45,340
That's something that was previously
unheard of for metastatic breast cancer.
30
00:01:45,340 --> 00:01:48,566
And so I don't think you want to be
unrealistically positive if someone
31
00:01:48,566 --> 00:01:51,704
doesn't have a great prognosis or
a lot of good treatments options.
32
00:01:51,704 --> 00:01:56,530
But in those patients who do, I think
it's important to reiterate that time and
33
00:01:56,530 --> 00:01:58,978
time again so that they really can own and
34
00:01:58,978 --> 00:02:02,016
accept that they can live
well with this disease.
35
00:02:02,016 --> 00:02:06,106
[MUSIC]
Study estimates number of U.S. women living with metastatic breast cancer. National Cancer Institute. (Accessed on January 10, 2021 at https://www.cancer.gov/news-events/press-releases/2017/metastatic-breast-cancer-survival-rates)
Systemic treatment for metastatic breast cancer: General principles. UpToDate. (Accessed on January 10, 2021 at https://www.uptodate.com/contents/systemic-treatment-for-metastatic-breast-cancer-general-principles)
Breast Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute, 2018. (Accessed on January 10, 2021 at https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/_148)