Metastatic breast cancer is the real killer

By RONI CARYN RABIN 

(New York Times - Health Section - 18 January 2011) 

 

But theirs [MBC'ers]  are not pink-ribbon lives: They live from scan to scan, in three-month gulps, grappling with pain, fatigue, depression, crippling medical costs and debilitating side effects of treatment, hoping the current therapy will keep the disease at bay until the next breakthrough drug comes along, or at least until the family trip to Disney World. 

While perceptions of the disease may have changed in recent years, the number of deaths it causes has remained fairly static, said Dr. Eric P. Winer, director of the breast oncology center at the Dana-Farber Cancer Institute in Boston. 

“All too often, when people think about breast cancer, they think about it as a problem, it’s solved, and you lead a long and normal life; it’s a blip on the curve,” he said. “While that’s true for many people, each year approximately 40,000 people die of breast cancer — and they all die of metastatic disease. You can see why patients with metastatic disease may feel invisible within the advocacy community.” 

 

In some cases, metastatic breast cancer appears to go into long-term remission, but experts say that in most cases it will recur, eventually becoming resistant to all treatment. 

Since it is metastasis that ultimately kills, some advocates want more resources devoted to its study and treatment. Even though many cancer drugs are initially tested on patients with advanced disease, Danny Welch, an expert on metastasis, says only a few hundred scientists in the world are trying to understand the process. 

“It’s responsible for 90 percent of the morbidity and mortality, but gets less than 5 percent of the budget,” said Dr. Welch, a senior scientist at the Comprehensive Cancer Center at the University of Alabama at Birmingham, who studies genes that suppress metastasis. (Those genes are turned off when cancer is advanced.) “Funding agencies as a rule want to say their research portfolio is successful — they want a return on their investment very quickly.” 

 

Christi Turnage, 48, of Madison, Miss., who has been using Avastin for two and a half years, said she was terrified about losing access to it. “This drug is literally keeping me alive,” she said. 
By RONI CARYN RABIN 
This kind of uncertainty keeps many patients from throwing themselves wholeheartedly into the ethos of hope and empowerment that helps sustain many women with less aggressive forms of the disease. 

Dr. Hebert says that while the pink-ribbon campaign has raised awareness about breast cancer, it masks a relentless killer. 

“People like the pretty story with the happy ending,” she said. “We don’t have the happy ending. 

“You always hear stories about women who ‘battled it’ and ‘how courageous’ they were. Cancer doesn’t care if you’re courageous. It’s an injustice to all of us who have this. There are women who are no less strong and no less determined to be here, and they’ll be dead in two years.” 

Please read the entire article here: 
A Pink-Ribbon Race, Years Long 
http://www.nytimes.com/2011/01/18/healt … wanted=all 
By RONI CARYN RABIN 


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