Metastatic Breast Cancer ~ Made me teary =(

Monday, February 27, 2012
At Stage IV, the disease is no longer considered curable, with the exception of the estimated 1-3 percent of patients who, for unknown reasons, experience longterm survival with stable disease or complete remission following treatment. However, even when the disease does continue to spread, metastatic breast cancer can often be treated as a chronic disease for a number of years. Until very recently, estimated mean survival time for women diagnosed at Stage IV or with distant metastatic recurrence was about one to three years, but with improvements in care, including a number of new non-cross resistant treatment alternatives that have been approved by the FDA since the mid-1990s, survival time with metastatic disease appears to have increased significantly.

A recent study from M.D. Anderson Cancer Center13 that compared length of survival of metastatic breast cancer patients treated at their institution in five-year increments, found that median survival had doubled to 51 months (range 33-69 months) in 1995-2000 from a median survival of 27 months (range 21-33 months) only five years earlier, 1990-1994. Five years after their diagnosis with metastatic disease, 40 percent of these patients were still alive, as compared with 29 percent during 1990-1994. At the initiation of their study, during the period 1974-79, only 10 percent of patients were still alive at five years and the median survival was only 15 months (range 11-19 months).

The woman whose breast cancer has metastasized or who has been diagnosed initially at Stage IV must live with the reality that her breast cancer can no longer be cured, and that the disease is very likely to take her life. Consequently, the length of the remaining time she has to live, and the quality of that time, become issues of paramount concern. For her, access to the best care can make a significant difference, both in length of survival and in quality of life. With luck, excellent care, family support, personal motivation, and a skillful oncologist, her disease is likely to respond to a number of lines of treatment that can serve to extend her life-many of which may be quite costly. She may join a clinical trial, or try to get compassionate access to experimental drugs prior to their approval through single-patient INDs or expanded access programs.

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