Polly's pages (aka 'Donna Williams')

Ever the arty Autie

Realistic hopes about metastatic cancer are grounded in context


Polly and Chris Samuel I was diagnosed mid September 2016 with metastatic breast cancer to the liver (and spine). Statistically the usual life expectancy for metastases (mets) to the liver is 6mths-3yrs, the former being extensive/innumerable tumors to liver, the later, a few. I have extensive/innumerable tumors to liver. We’re doing a great job shrinking them, but this will only last around 10 months when this drug is known to stop working because the cancer cells become resistant to it.

20% of those with liver mets can live to 5 yrs, which depends on immunity and whether and how they respond to drug after drug after drug. I’m immune deficient and not able to do full chemo so being logical and realistic, its fair to assume there’s a reasonable chance that I may be in the 80% who don’t get that far.

2% of all cancer patients at any stage will have spontaneous recovery as immune system suddenly ‘wakes up’ and goes to town on cancer cells. I’ve waited for my immune system to do this all my life. It hasn’t. So it’s reasonable to assume that I may be more likely to be in the 98% who don’t have such an unexplained immunological backflip.

My mother’s lot have a 70% cancer rate and this follows through on both her mother’s and her father’s side, followed through to her siblings and to the children of her siblings and has even appeared in a child of one of my cousins. I’m cousin 5, the eldest of them, the first to go metastatic. The youngest (the daughter of one of these cousins) died aged 4. The others, still surviving, have had bowel, breast and bowel/lymphoma/melanoma. All are younger than me, and hopefully will never become metastatic but with 20-40% of those who have had cancer eventually becoming metastatic, and with the family history (and in each case they had 1-2 parents with cancer), its equally possible they’ll one day follow in my shoes. On my father’s side, there are fewer with cancer, though my father had bowel cancer at 55 and died aged 59, when it became metastatic and spread as bowel/liver/pancreas and he died weeks after that diagnosis. So I’m not that surprising one off anomaly who was the first one in the family with cancer, nor one who had not lived their life with immune deficiencies.

The chemo I’m on, Abraxane, is known to be effective in those with metastatic breast cancer for an average of 10 mths (doing ripper job, shrunk the liver brilliantly) when cells mutate and become resistant to it. Saying that, this is usually shorter with metastases to liver and shorter again in those with extensive/innumberable liver metastases where the usual can be shorter, around 6-8 months depending on how responsive the person is to the drug.
2nd line chemo treatment may or may not work… cancer cells ultimately become resistant to all chemos and each new drug has less effect

I’m not able to have the 3 weeks on, one week off, or full dose chemo because I’m neutropenic – immune deficient – so I’m on a reduced dose 2 weeks on, one week off… not ideal but at least its something.

My oncologist feels it’s realistic that I may be in a fairly comfortable space until around July (the 10 months mark on the present chemo drug – Abraxane -provided I don’t become resistant before the 10 month mark). After this it will depend on whether I respond to a 2nd drug, or not.

Yes, new drugs are coming out all the time… but these generally take 5 years from working in petrie dishes to being tested on animals, to being trialed on the select few accepted into a study, and at that point these ‘miracles’ may be found to not work anyway.

Yes, the internet spouts a gazillion snakeoil, quick fix, conspiracy warrior ‘cures’ and theories. Fact check them with Quackwatch, with Google Scholar or even Wikipedia‘s entry for List of unproven and disproven cancer treatments and you’ll get a little more informed and grounded.

Trees, cats, people of all faiths, all get cancer, also die of cancer. We all have cancer cells, just some people’s immune system cleans these up and keeps cancer in check and some people’s immune systems fail to do so… just like some people get dodgy joints, early baldness, predisposition to mental illness or diabetes… we all have our susceptibilities.

So, those are the facts and we can build whatever hopes out of these we like/wish and they will be realistic ones.

Polly Samuel (aka ‘Donna Williams’)
Author, artist, consultant and presenter.

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