A little 101 on metastatic breast cancer…

What is metastatic breast cancer?

When a person first gets cancer it is called primary cancer.
70% of people with breast cancer will be successfully treated and go on to never have their cancer return.
Around 30% will have their cancer return, this can be local, such as return to the breast area, and this is also often curable… or it can return as metastatic.
Metastatic means cancer cells from the original cancer escaped to other parts of the body and in my case, after 5 years, these started making tumors throughout my liver and in my spine… breast cancer spread to my liver and spine.

But can’t they cure metastatic breast cancer?

There are many many things people can recover or be cured of…
But there are a few medical conditions they can’t cure and which will end that person’s life in their body.
One of these is metastatic cancer.

But I’ve heard of people who spontaneously recovered from even metastatic cancer after taking x, y, or z….

2% of people with cancer at any stage will have spontaneous remission regardless of what magic potions or beliefs they attribute that to. 98% will not have a spontaneous remission regardless of what they do.

But I know people who did chemo and went on to be fine

Yes, people with primary cancer who do chemo will often go on to be fine and many will never have their cancer return as metastatic. Around 2% of people with metastatic cancer will also have unexplained spontaneous remissions which may or may not last. 98% will not. Some people will have metastatic breast cancer that has spread to bone and may live 5, 10, 15 years with it. Those who have had it spread to brain, lung or liver generally have less time than that. If that spread is caught early they may have a longer time. If it is caught late, as mine was, they may not have as much time. It depends on many things, including how well and for how long they respond to chemo and whether they have enough neutrophils… essential to being able to do weekly chemo… and I got my first chemo, had only enough neutrophils for a reduced dose second chemo and not enough neutrophils for a third chemo… so immunity or lack thereof is a biggie in deciding if one’s trip will be longer… or shorter.

But won’t the chemo kill you?

Metastatic cancer has spread through the bloodstream and lymph to other parts of the body. Because of this the only treatment is systemic treatment of the whole body – which means chemo. Chemotherapy means I get IV drugs weekly for chemo the rest of my life and will stop the metastatic cancer killing me sooner than it would without treatment. These powerful drugs will fight cancer cells but also kill all new good cells too; skin, mucous membranes, hair, blood cells. The cancer cells can also mutate and become resistant to a particular chemo drug. Then they try a different drug, and another, until none work any more.

Extensive metastatic spread of breast cancer to the liver can mean 4-6 months to live. With weekly chemo, if the cancer can be controlled, even reduced, the person can live longer… 9 months, a year, sometimes 20 months… some people with metastatic breast cancer that has spread to the liver live for up to 2-3 years, around 10% will make it to 5 years. It all depends on how extensive the spread to the liver is (my liver has innumerable tumors throughout the entire liver… more than can be counted), whether chemo is effective and remains effective in shrinking and even eliminating the tumors, reducing the number and size of the tumors so that the rest of the liver can be cut out so it can regrow without tumors (only for people with 1-2 tumors in the liver, I don’t qualify).

Can’t you get a liver transplant like Derryn Hinch did?

Derryn Hinch had primary liver cancer that had started in the liver and not spread to any other part of his body.
A liver transplant is not possible for someone with metastatic cancer because it would involve suppression of the immune system to avoid rejection of the new liver and the cancer would immediately spread like wildfire throughout the body and to the new liver.

But what about Mary Smith who cured her own cancer….

There are many people who have claimed to have had cancer and cured it who actually never had it, many who had early cancer that had spontaneous remission who then exaggerated the extent of their cancer when telling their story, and those with metastatic cancer lucky enough to be in the 2% who have spontaneous remission who attribute that to a whole array of beliefs, fairy dust, fruit juices, alkaline water, cannabis oil, etc etc which has unfortunately not yet ever been proven to help others in the same boat. If you are reading such things then reality test your beliefs by fact checking these things with Quackwatch or Google Scholar articles.

Aren’t you being pessimistic?

Being realistic, pragmatic, positive, and celebrating life without demonising dying or death means nothing more than being grounded and unafraid of reality and open to whichever way that reality goes.

Polly Samuel (aka ‘Donna Williams’)
Author, artist, consultant and presenter.
http://www.donnawilliams.net

I acknowledge Aboriginal and Torres Strait Islander people as the Traditional Owners of this country throughout Australia, and their connection to land and community.