The Changing Science Of Metastatic Breast Cancer

It’s a beautiful thing when science catches up to what patients have been saying.

That’s what is happening in the metastatic breast cancer community. I’ve had metastatic breast cancer for nearly three years, and while I admit that I felt like I’d been “hit by a truck,” as my oncologist’s nurse put it on the day I learned breast cancer had metastasized in my body, for quite some time I struggled to get my feet back under me and moving again. I wasn’t blind to what I read online: Research to find out how to prevent, stop and cure metastasis was not adequately funded.

The uproar was loud and, I believe, made much louder by powerful voices like that of Beth Caldwell, who was diagnosed the same year as me and died of metastatic breast cancer just days ago, and by the people standing solidly beside her and other activists. Most of those people were metastatic breast cancer patients themselves or the loved ones of patients. They all had a built-in problem — the average lifespan after a diagnosis of metastatic breast cancer is a scant three years. That’s three years of treatment and three years of trying to pack in a lifetime of love and memories.

But these people have made things happen, and now we see a profound effect on where we’re heading. Most notably, the Susan G. Komen Breast Cancer Foundation has pledged to focus this year’s research funding on metastatic and aggressive breast cancer. At $31 million, that has the potential to change a lot of lives.

Brand-new science backs up the decision to give metastasis the lion’s share of funding. Breast cancer can come back long after that “safe-zone” of five years. In fact, a recent study that followed early-stage patients with ER-positive breast cancer found that many patients will face recurrence after a five-year endocrine therapy is stopped. Even worse? Beyond knowing that a lower initial stage and less lymph node involvement means a reduced chance of recurrence, we don’t know a heck of a lot. Certainly, we haven’t found a way to halt or prevent metastasis.

A 41 percent chance of recurrence in people originally diagnosed stage 2 with between four and nine lymph nodes involved is not the news anyone wants to hear, nor is the finding of recurrence in 13 percent of people diagnosed at stage 1 with no lymph node involvement.

But those are the types of things this study found. Yes, treatments have changed a lot over the past 20 years, and it’s likely that there’s a different percentage of risk for people more recently diagnosed. But no one is saying that those treatment changes mean a zero chance of recurrence. Breast cancer recurs and can metastasize long after we think we’re done with it.

Bringing bad news into the open is not easy. We all want hope, but we can't allow that hope to keep us in the dark. Know your risks, talk to your doctor and keep supporting meaningful research.