A Disease No One Gets
Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.
âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped found Breast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â
The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.
Metastatic Breast Cancer Is Terminal
Metastatic breast cancer cant be cured and it is terminal. One thing I didnt know when I was first diagnosed is that breast cancer can only kill you if you have metastatic breast cancer, says Rosen, who explains that if your cancer remains in the breast, the tumor can be removed, but metastatic means it has spread outside the breast.
MBC is almost like a different disease than early-stage breast cancer, adds Ann Silberman, 60, from Sacramento, California, who was diagnosed in 2009. We are going to die. Our concerns are much different from those of a person who has a treatment that will be over . Someone in an earlier stage may worry about losing their hair which is understandable but they will return to their normal life at some point.
People with metastatic breast cancer expect to be on treatment for the rest of their lives. I dont think everyone understands that, Silberman says. I still get, When will your treatment be over? Well, its never going to be over.
How Is Stage 4 Breast Cancer Treatedand Whats The Survival Rate
While every stage 4 breast cancer diagnosis is differentwhich means the methods used to treat it will also differthis stage of breast cancer is usually treated systemically , since the cancer has already spread to other areas of the body. Systemic treatments usually include options like hormone therapy, chemotherapy, targeted therapy, and immunotherapy, according to the NCI.
Still, those treatments vary depending on a variety of factors, including where the cancer is located, as well as the patient’s symptoms, overall health, and previous cancer treatmentsand patients are closely monitored throughout treatment for the best outcome.;Patients are generally started on the treatment of best reflex or biology and followed closely using scans, with change in treatments as needed if the current treatment is not resulting and either shrinkage or stability of the breast cancer, Dr. Tripathy explains.;
In addition to more standard systemic treatment options, Dr. Tripathy explains that there are newer technologies being increasingly usedlike ones that sequence the DNA of cancerous tumor cells for more specified treatmentsas well as various clinical trials designed to offer more options and possibly better outcomes to those dealing with the disease.;
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Is Stage 4 Cancer Always Terminal
More severe cancers are more likely to be terminal. However, that is never a certainty. For example, the American Cancer Society say the 5-year survival rate for breast cancer that spreads to distant body parts is 27%, or 86% when it only spreads locally.
Determining the severity of cancer and its stage is a complex process. Doctors are still learning about all the factors that affect how cancer develops and affects the body.
Recurrence Of Metastatic Breast Cancer
Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.
But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .
These declines are due in part to improved screening and treatment for the disease.
There are a few general facts that are helpful to know about breast cancer outlook:
- Breast cancer is the most common cancer diagnosis in the United States, according to the
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Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youve probably been given a number and letter for your cancer stage. Here, the terms localized, regional, and distant are used instead of numbers and letters. Heres what they mean and the 5-year relative survival rates for each:
- Localized breast cancer is only in the breast. This includes stage IA , some IIA , and some IIB . The 5-year relative survival rate is 99%.
- Regional breast cancer has spread to nearby tissue or lymph nodes. This includes stage IB , some IIA , some IIB , and all stage III . The 5-year relative survival rate is 86%.
- Distant breast cancer has spread to other parts of the body. This includes stage IV, pronounced stage 4). The 5-year relative survival rate is 28%.
Myth #: The Mental And Emotional Experience Of People With Mbc Is The Same As That Of Earlier
People with MBC report hearing comments such as, At least you have a good type of cancer, Arent you glad so much research on breast cancer has been done?, Fortunately you have so many options. These might comfort people with early-stage breast cancer, who can look forward to one day finishing treatment and moving on but people with MBC dont have that luxury. They know they will be in treatment for the rest of their lives. They also know that their life is likely to be shorter than theyd planned.
Mentally and emotionally, people with MBC have a completely different experience. For them, the whole ringing the bell idea does not work, says Dr. Gupta. I have patients who are coming in once a week and have to plan their lives around their treatment. The whole pink brigade idea is very upsetting to them.
Fortunately, more and more people with MBC are speaking up and calling attention to how their experience differs from that of people with earlier-stage breast cancer. People with MBC live with cancer always in the background of their lives, but with new and emerging therapies, many are living longer and maintaining their quality of life.
Clearly, the experience of metastatic breast cancer is quite different from early-stage breast cancer. But there are so many patients who understand just what youre going through. Read more about Living with Metastatic Breast Cancer and join our discussion forum for people with stage IV/metastatic disease.
References
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Breast Cancer Survival Rates
The overall 5-year relative survival rate for breast cancer is 90%. This means 90 out of 100 women are alive 5 years after theyve been diagnosed with breast cancer.
The 10-year breast cancer relative survival rate is 84% . The invasive 15-year breast cancer relative survival rate is 80% .
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How Do Doctors Diagnose Metastasis
If you already had cancer treatment for non-metastatic cancer, you probably have a follow-up care plan. You will see your doctor for regular checkups. Specific tests may be done to look for metastases.
Alternatively, some people already have metastases when they are first diagnosed with cancer. In this situation, the metastases are usually found during the initial tests to stage the cancer.
Cancer may cause symptoms such as pain or shortness of breath. Sometimes these symptoms will lead your doctor to do necessary tests to find the metastases.
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Survival Rates Of Stage 4 Breast Cancer
Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.
Factors affecting survival rate of metastatic breast cancer
Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:
- Response to treatment
- The extent and location of metastases
- The presence of other health issues not related to cancer
- The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.
Finding Social And Emotional Support
Its critical to find a strong source of social support, whether its your friends and family, or a support group with other people with breast cancer. While the journey is challenging, you dont have to navigate stage 4 breast cancer alone.
Ask your healthcare provider if theres an in-person support group where you receive treatments. You can also find online and social media groups to join.
Your healthcare provider can also provide more information about the specifics of your cancer, treatment options, and support programs in your area. If youre not sure where to look for an in-person group, a counselor or social worker can also help.
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How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M:
- the size of the cancer tumor and whether or not it has grown into nearby tissue
- whether cancer is in the lymph nodes
- whether the cancer has spread to other parts of the body beyond the breast
Numbers or letters after T, N, and M give more details about each characteristic. Higher numbers mean the cancer is more advanced. Jump to more detailed information about the TNM system.
Jump to a specific breast cancer stage to learn more:
What Is Stage Iv Cancer
Stage IV cancer is the most severe form of cancer in which cancer has spread to a distant part of the body from its origin. Thus, testicular cancer may have spread to the lungs and bones, thyroid cancer may have spread to the brain, and so on. It is also known as metastatic or advanced disease.
The staging system often used for most types of cancer is the American Joint Committee on Cancer ;TNM system. In these staging systems, three types of key information are used.
- T : It refers to the size of the original tumor.
- N : It describes whether cancer has spread to the lymph nodes.
- M : It refers to the spreading of cancer to other parts of the body.
A number or the letter X is allocated to each factor. A higher number means the cancer is advanced. For instance, a T1 score refers to a smaller tumor than a T2 score. The letter X indicates that information could not be assessed. M1 indicates that cancer has spread to a distant part of the body.
The physician combines T, N, and M results and other factors specific to cancer to determine the stage of cancer for each person. Most cancer types have four stages: stages I-IV, with stages I and IV being the least severe and most severe forms of cancer, respectively. Some types of cancer also have a stage 0 .
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I May Not Feel Like A Fighter Theres No Final Victory
The language used to describe cancer and its treatment is often the language of war: fighting cancer, battling cancer, being a warrior. But those words may not resonate with women who have metastatic breast cancer.
Sendelbach recalls using fighting words when she was first diagnosed with stage 1 breast cancer. I was 30 years old, and I was in fight mode, she says. I was like, Hell yeah, I can kick cancers ass and so on. When she was diagnosed with stage 4, though, she realized there would be no end in sight, no final victory for her.
Theres not a finish line, she says, so to be in fight mode doesnt really work. There has to be an end in sight to stay in that place.
For her, metastatic breast cancer is something she deals with day to day. She describes her journey as a marathon, not a sprint. If you have to stop sometimes to walk and take water breaks, she says, you should. If you try to run as fast as you can all the time, its inevitable that youre going to fail.
How Metastases Develop
Metastases is the plural form of metastasis. Metastases most commonly develop when cancer cells break away from the main tumor and enter the bloodstream or lymphatic system. These systems carry fluids around the body. This means that the cancer cells can travel far from the original tumor and form new tumors when they settle and grow in a different part of the body.
Metastases can also sometimes develop when cancer cells from the main tumor, typically in the belly, or abdominal cavity, break off and grow in nearby areas, such as in the liver, lungs, or bones.
Any type of cancer can spread. Whether this happens depends on several factors, including:
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The type of cancer. Some cancers are more likely to spread than others.
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How fast the cancer is growing
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Other factors about the behavior of the cancer that your doctor may find
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Stage Iv Breast Cancer
BREAST cancer is one of the most common forms of the disease to affect women.
It is the second most deadly cancer in women, after lung cancer – but men can be diagnosed too.
Like with most cancers, catch it early and you increase your chance of surviving.
Signs to watch out for include:
- a lump or thickening in your breast or armpit
- change in size, shape or feel of your breast
- skin changes such as puckering, dimpling, a rash or redness
- fluid or discharge leaking from your nipple when you’re not pregnant or breastfeeding
- changes in the position of the nipple
- breast pain
After you’re diagnosed doctors will try to work out if the disease has spread.
This process is called staging, and the stage determines how advanced the cancer is.
Stage IV breast cancer means the disease has spread out of the breast, to other parts of the body.
It’s also known as advanced cancer, secondary breast cancer, or metatstatic breast cancer.
Catch breast cancer in the earliest stages, 0 to 1 and the five-year survival rate is around 99 per cent, according to the American Cancer Society.
But catch it in the latest stages and that chance falls to just 27 per cent.
Shannen said the dispute relates to her home which was practically destroyed by the California wildfires in 2018.
She said pursuing the case against State Farm was one of the most difficult decisions as she struggles with her illness.
What Is Advanced Breast Cancer
When breast cancer spreads from the breast or armpit to other areas of the body, it is called advanced breast cancer. It’s also called metastatic, secondary or Stage 4 breast cancer.
The most common places for breast cancer to spread to are the bones, lungs, liver or sometimes the brain. A secondary tumour in these distant organs, is still comprised of breast cancer cells so it is readily identified as a secondary breast cancer rather than a new primary cancer.
Advanced breast cancer can occur months or years after a diagnosis of early or locally advanced breast cancer. Occasionally, its diagnosed at the same time as the original breast cancer or, on rare occasions, before any tumour can be felt or even imaged in the breast.
For many people diagnosed with early breast cancer, the future feels very uncertain. The fear that the cancer could come back may never go away completely. Being diagnosed with advanced breast cancer can be even more difficult because the hope of staying well is replaced with the realisation that a cure is no longer possible.
Although there is currently no cure for advanced breast cancer, progress is being made and the growth of secondaries can often be controlled with various treatments.
With the latest treatments, some people with advanced breast cancer may live for many years.
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