Thursday, January 30, 2020

Docs still unsure how to quash metastases

Women most likely to die of breast cancer have been getting the least attention, says Time mag excerpt 

Women with breast cancer that has metastasized are rarely the focus of breast-cancer research.

At least that's the position taken by health-care journalist Kate Pickert in a recent Time magazine excerpt from her book, "Radical: The Science, Culture, and History of Breast Cancer in America."

In the piece, Pickert notes that three-quarters of the 160,000 U.S. females who live with with metastases were originally diagnosed with early stages of the disease. 

And she quotes Lianne Kraemer, whose breast cancer has spread and formed tumors inside her brain, resulting in her being labeled a terminal patient, as bemoaning that "I believed the narrative that is pushed on women, that if you check your breasts and if you catch it early, you're fine."

But, she says, "you can do everything right and still end up metastatic."

Pickert, who herself was diagnosed with and treated for breast cancer in 2014 at age 35, claims that many "women who die of breast cancer succumb to the disease for no other reason that that it manages to outwit the protocols" — even for those who have access to high-quality treatment and don't ignore signs of the disease until it's incurable. 

Dr. Cyrus Ghajar

The Time excerpt also quotes Dr. Cyrus Ghajar, a cancer biologist at the Fred Hutchinson Cancer Research Center in Seattle, who pointed out that the Cancer Moonshot, a National Cancer Institute initiative launched by President Barack Obama and Vice President Joe Biden, "does not explicitly provide funding to address the challenges of metastatic cancer."

Ergo, he asks, "How can you have a moon shot trying to cure cancer and not mention people dying of cancer?"

Ghajar, whom the article cites as "one of the relatively small number of scientists studying metastatic breast cancer full time," is also quoted as indicating that "25 percent to 40 percent of early-stage breast-cancer patients already have cancer cells in their bone marrow, and these patients are, on average, three times more likely than those who don't to develop other metastases later."

While asserting that women most likely to die of breast cancer have gotten the least attention, Pickert admits that pharmaceutical companies and researchers do "often test new drugs on metastatic patients before anyone else" — albeit because they are "women who are dying anyway, and they are the ones most willing to be part of experiments."

About 40,000 American women die of the disease each year, the article reports, adding that physicians still don't know "why some breast cancers eventually form deadly metastases or how to quash the disease once it has spread."

As a result, the excerpt continues, patients with metastatic disease "are typically treated with one drug after another, their doctors switching the medications whenever the disease stops responding to treatment. Eventually, nearly all patients with breast-cancer metastases run out of options and die."

Those interested in additional details about metastases can find them in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at caregivers.

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