I believe in America. America has made my fortune. That’s why the whole metastatic breast cancer thing really blows.
In America, effort and virtue are rewarded. Maybe we don’t say it out loud like the Boy Scouts do, but most of us, on our honor, will do our best. We play fair. Too bad breast cancer doesn’t.
Some of the comments at Being Sarah’s Blog made me do a little reading on recurrence. (Unfortunately, it’s a moot point for me.)
According to the Third Consensus on Medical Treatment of Metastatic Breast Cancer:
Although impressive improvements have been made in the adjuvant treatment of early breast cancer, ∼20% of patients initially diagnosed with regional stage disease will develop metastatic breast cancer (MBC) [1, 2].
Recurrencs can be local, regional or distant. Local means the cancer reappears in or near the same place it was first found . It hasn’t spread to the lymph nodes or other parts of the body.
Regional recurrence happens in the lymph nodes and tissue near the original cancer.
Distant (AKA mets) refers to cancer that has spread to areas farther away from its original location.
I presented with mets, as about six percent of people with MBC do. Right now, my cancer isn’t doing much. It is probably lying around eating Doritos and watching “I Love Lucy” reruns. Still, I know it’s not a matter of if my cancer will come back, but when.
It’s certainly not an ideal scenario, but at least I know where I stand. It’s not like my cancer can jump out from behind the couch and yell “Surprise!”
I can’t imagine what it would be like to endure months of aggressive treatment and then have a recurrence. Just when you thought you were out, they pull you back in.
This is America. The Washington Generals aren’t supposed to win. After 15 rounds, Rocky always decks Apollo Creed. Silly rabbit, Trix are for kids.
Some day, and that day may never come, we’ll have a cure.
Breast Cancer Recurrence: Some Risk Factors
Prognostic indicators are characteristics of a patient and her tumor that may help a doctor predict a recurrence of breast cancer. These are some common indicators:
- Lymph node involvement. Women who have lymph node involvement are more likely to have a recurrence.
- Involvement of the microscopic lymphatic system or blood vessels within the breast increases the risk of recurrence.
- Tumor size. In general, the larger the tumor, the greater the chance of recurrence.
- Hormone receptors. About two-thirds of all breast cancers contain significant levels of estrogen receptors, which means the tumors are estrogen receptor positive (ER+). ER-positive tumors tend to grow less aggressively and may respond favorably to treatment with hormones.
- Histologic grade. This term refers to how much the tumor cells resemble normal cells when viewed under the microscope. The higher the histologic grade, the greater chance of recurrence.
- Nuclear grade. This is the rate at which cancer cells in the tumor divide to form more cells. Cancer cells with a high nuclear grade (also called proliferative capacity) are usually more aggressive (faster growing).
- Oncogene expression. An oncogene is a gene that causes or promotes cancerous changes within the cell. For example, tumors that contain the HER2 oncogene may increase a patient’s chance of recurrence.