This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
Breast Cancer & Metastasis: What does it mean?
By Pamela Lucchesi, PhD, FAHA
Dr. Lucchesi Chair of Basic Sciences and Professor of Physiology at Geisinger Commonwealth School of Medicine
Suzanne Alba O’Hara, from Wyoming in Luzerne county, was kind enough to share her story in an effort to help raise the level of awareness for fellow citizens of NEPA. She received her first breast cancer diagnosis in 2012, after her dermatologist noticed some skin discoloration. She endured eight cycles of chemotherapy and 42 radiation treatments and believed she had achieved remission. After four years of celebrating life cancer-free, Suzanne began feeling pain on her right side under her ribs. Thinking it must be her gallbladder or some other non-cancer-related problem, she visited her primary care doctor, who ordered an ultrasound. The ultrasound showed “spots” on her liver. Subsequent CT and PET scans confirmed that her breast cancer had come back and spread to her liver and spine, leading to a diagnosis of stage IV or metastatic breast cancer. Suzanne knew at the time of her original treatment that there was a possibility that the cancer would return, but cancer was the last thing on her mind in 2016.
Breast cancer is a disease caused by uncontrolled growth of breast tissue cells. The disease is treatable with chemotherapy and radiation, which kills these rapidly growing cells, or with surgical removal of a tumor. Typically, people diagnosed with early stage breast cancer manage to achieve remission, meaning there is no longer any evidence of the cancer. However, although there may be no signs of disease, sometimes the errant cells manage to escape treatment, and move to other places in the body. This process of tumor cells migrating and growing in other places is called metastasis.
Metastatic breast cancer (MBC) is also known as stage IV, advanced or chronic breast cancer. Once breast cancer reaches this stage, it cannot be cured, but it can be treated. Sometimes when breast cancer is first discovered, it has already metastasized, but MBC is frequently diagnosed as a recurrence, often several years after a patient has already achieved remission of an early stage breast cancer. This was the case for Suzanne.
Nationally, there are an estimated 150,000 to 250,000 people in the U.S. living with MBC. This broad estimate reveals a data-collection problem that clouds our ability to say with certainty what percentage of people treated for early breast cancer later suffer a recurrence. Currently, statistics are not collected for metastatic recurrences, which comprise the larger portion of MBC cases. Most U.S. registries only count new cases and cancer deaths. If a breast cancer patient has a recurrence sometime after initial treatment, there is no national registry to which doctors must submit that information.
No matter the statistics, a person hearing the news that he or she has MBC can be overwhelming and may provoke grief and anxiety. The person is plunged into a new medical reality – and a very difficult world to navigate. MBC patients often feel alone and overlooked. They need to know that while MBC is a lifelong disease, it is possible for people with the diagnosis to live well.
Our NEPA Komen affiliate has devoted itself to identifying local resources that can help MBC patients to not only cope, but to thrive. On April 29, Komen NEPA and Geisinger Commonwealth School of Medicine (Geisinger Commonwealth), with a generous grant from the Moses Taylor Foundation, will present a symposium covering a range of MBC topics. From emerging treatments and clinical trials to social support and the tools need to care for mental health and physical wellbeing, people living with MBC (and the healthcare professionals who care for them) will receive the most up-to-date and comprehensive information available.
In addition to wellness tips and activities, there are several nationally recognized researchers speaking, including two Komen scholars from Pennsylvania. Komen Scholars are a group of 60 distinguished scholars and leaders in breast cancer research and advocacy. The scholars speaking on April 29 are Adrian Lee, Ph.D., from the University of Pittsburgh Cancer Institute and David A. Mankoff, M.D., Ph.D. from the Perelman School of Medicine at the University of Pennsylvania. Dr. Lee’s lab uses genomic approaches to identify the unique “signatures” of metastatic cells that may be used as personalized therapy for MBS. He will discuss the present gaps in MBC research. Dr. Mankoff’s research focuses on developing new imaging techniques to more accurately diagnose MBS and monitor treatment effectiveness. Both scholars are committed to improving progression-free survival and quality of life in MBS patients.
Other speakers are Michael Murray, M.D. and Craig Piso, Ph.D. Dr. Murray is director of Geisinger’s clinical genomics and the MyCode data project. He will talk about how genomics is changing the detection and treatment of cancer. Dr. Piso is a psychologist whose presentation is entitled, “Finding Courage and Strength During Life’s Biggest Challenges.”
If you or someone you know is affected by breast cancer or metastatic disease, or if you would like to learn more, the details of the free event are:
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: firstname.lastname@example.org
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).