Tuesday, May 17, 2016

Metastatic Breast Cancer Treatment Protocol

While I do not have metastatic breast cancer, I have friends who are stage IV and follow their treatment issues. One thing I have wondered what the standard treatment protocol is for MBC as I have often heard complaints about treatment options for them. Finally, I found an article covering the options, the full text of it can be found here.

First of all, I want to say I am a little appalled by this statistic:

"Depending on prognostic factors, in the worst scenario, up to 30% of node-negative and up to 70% of node-positive breast cancers will relapse. The prevalence of metastatic disease is high because many women live with the disease for several years."

I had no idea the numbers were that high. I had one tiny little node that was positive at my diagnosis so that puts me in the second group, I think. But 70%? I do have to keep in mind that the words "up to" and ignore the "70". But yowza!

Other words that are intimidating are:
  • Isolated local–regional recurrence should be treated like a new primary with a curative intent including ‘secondary’ adjuvant treatment modalities as appropriate
Okay, that's pretty good if isolated recurrences can be treated with a curative intent. Its nice to know you can have a recurrence which is not considered terminal.
  • "The management of metastatic breast cancer (MBC) should involve all appropriate specialities in a multi/interdisciplinary team (medical, radiation, surgical and imaging oncologists, palliative care specialist, psychosocial support), and patients should be offered personalized appropriate psychosocial, supportive and symptom-related interventions as a routine part of their care.
Well that's nice to know they want all sorts of help to support the patients and they include the emotional side as well as the medical side. Often I think doctors don't think outside their medical realm. And a team discussion on treatment protocol is better than a single person's decision.
  • There are few proven standards of care in MBC management, therefore well-designed, independent, prospective randomized trials are a priority.
Yes few standards. Clinical trials are key.
  • The vast majority of MBC is incurable and hence the main treatment goal is palliation, with the aim of maintaining/improving quality of life, and possibly improving survival."
Thanks for putting this out there. Incurable is not a nice word. But I think its important that it is stated. Too many have misguided thoughts that 'oh, we can just fix this'. Please do not let the patients have any delusions about their prognosis. It would not be fair.

I strongly suggest people read this article to better understand the options available and what should be expected for a treatment protocol. Often patients are not fairly treated especially if they do not know what they should expect. I hope this gets expanded in the future.

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