In response to this pancreatic cancer group’s “I wish” campaign:
Pancreatic cancer and metastatic breast cancer share some things in common.
>Poor median survival. Median survival for metastatic breast cancer is 2.5 to 3 years. Ultimately no one “beats it.”
>Woefully underfunded research. Less than 5% of all cancer research funding is allocated to metastatic breast cancer. (ALL metastatic cancer research is underfunded.)
>Limited surgical options. Metastatic breast cancer spreads to bone, brain, lung and liver. It can’t be cut be cut out.
When you quote a five-year 87% survival rate for breast cancer, please understand the context.
>Those statistics are for early stage breast cancer; not metastatic disease.
>People die of metastatic disease, not primary breast cancer.
>Survival, mortality and incidence are not the same.
>Mortality numbers tell the story more precisely than survival numbers. Breast cancer kills 40,000 annually in the US and half a million worldwide.
>Screening skews the survival numbers. The more we screen, the more we diagnose and treat people with breast cancers that would not have been a threat to their lives (some DCIS, other slow growing invasive breast cancers, and others that are dormant or regressive); so it looks like survival for early stage breast cancer is 98 percent in the US.
>But this is only a 5-year survival number—and includes the 20-30 percent of people who will have a metastatic recurrence and die of the disease later.
>The incidence of stage IV breast cancer—the cancer that is lethal—has stayed about the same; screening and improved treatment has not changed this.
Suggesting breast cancer is “enviable” unfortunately may give people the idea that everyone who has it is cured. With these “great” numbers in mind, perhaps people will be tempted to skip their regular doctor and screening appointments–why worry? By the “I Wish…” campaign’s reckoning this is a “good” cancer.
Early detection is certainly helpful, but it is NOT a breast cancer cure. Indeed, early detection carries its own set of complexities–over treatment, a false sense of security, etc. (See http://mbcnbuzz.wordpress.com/2013/04/27/our-feel-good-war-on-breast-cancer-mbcn-responds/ )
Finally, I concur with the American Cancer Society’s Otis Brawley: “Basic scientific research, some of it not focused on a particular cancer site, has given us so much insight into cancer that we can actually see a day in the very near future in which it doesn’t even matter where the cancer started. In other words, the clinician is not going to be interested in whether it’s lung cancer or breast cancer or colon cancer. The significant questions for treatment will be: Which genes are mutated? Which genes are turned on? Which genes are turned off? Which genes are amplified?”
Please no more Disease Olympics. Funding the best science helps us all.