Newspaper Claims Most Breast Cancers in the US Are Cured: We Beg to Differ

From the original article: Vanderbilt University researchers are learning why some breast cancers are resistant to treatment. Source: http://www.tennessean.com

Update 4/24/2013 :
Reporter Tom Wilemon  invited me to call him. I appreciated his outreach and we did speak. I hope to continue the dialogue.
–KOB
Editor’s Note: Carol Marrero is an MBCN volunteer from Brentwood, TN.  “I read this article in today’s Tennessean newspaper and the ending really pissed me off,” she told myself and fellow MBCN board member Ginny Knackmuhs. “My friend Pam tells me that Dr. Arteaga is one of the top BRCA researchers in the world. So, I was even more surprised by his quote.”

We urged Carol to respond to the reporter, Tom Wilemon, to express her concerns and to ask him to do a follow up article or at least clarify the context of the original article. Wilemon declined. We present Marrero’s letter followed by  Wilemon’s reponse and welcome your thoughts.

Tom, 
In your April 23 article, “Scientists Try to Unravel Breast Cancer Mysteries,” you have perpetrated some egregious errors. The most glaring concerns this quote from Dr. Carlos  Arteaga of Vanderbilt, president-elect of the American Association for Cancer Research:

“Most breast cancers in the U.S. are cured today,” he said. “This is a disease for which we have many standard therapies that work. Of course, there’s the unfortunate patient for whom those therapies stop working. The advice I would give that individual is to seek a clinical trial — seek a center where they are trying to do cutting-edge research.”

There are currently 150,000 U.S. people living with metastatic breast cancer. Metastatic breast cancer remains incurable in 2013. Every year, metastatic breast cancer claims 40,000 lives. Now, does that sound like “most” to you?

Dayton, Ohio, has a population of 142,148. Imagine if every single citizen of Dayton had metastatic breast cancer and were therefore NOT CURED.

Niagra Falls, NY, has a population of 50,086.  Imagine if the entire NOT CURED population DIED EVERY SINGLE YEAR FOR THE PAST TWO DECADES.

Again we ask, does that sound like “most” breast cancer to you?

We are living with metastatic breast cancer. We will be on some form of treatment for the rest of our lives. When one stops working, we will go to the next one. One of us [MBCN volunteers] is “fortunate” in that her subtype of breast cancer has many treatment options. People with metastatic triple negative breast cancer, inflammatory breast cancer and other less common types, do in fact NOT have many standard therapies, let alone therapies that WORK.

Dr. Arteaga further references the “unfortunate” patient for whom standard therapies stop working and suggests he or she seek a clinical trial. A clinical trial should NOT  be considered some kind of last ditch effort for the truly hopeless as one might infer from this statement. Many breast cancer patients—early stage and metastatic alike–participate in clinical trials. They are not exclusively for someone who has exhausted all other options. Indeed, in some cases, a patient should go with a clinical trial–even if there are standard options available. It’s a case by case decision.

“Cured”  is word to be used with caution when discussing any kind or stage of breast cancer. Until a person with breast cancer dies of something else, there is always a chance breast cancer can come back. Breast cancer, sadly, is not like most other cancers in this regard. Lance Armstrong is cured of testicular cancer. But someone like Susan Henson of Goodlettsville, who was diagnosed with triple negative type cancer four years ago, cannot truly ever know she is cured of breast cancer.

Unfortunately, for about 20% of women like Susan Henson who have been treated for early stage breast cancer, will have a metastatic recurrence. (Triple negative breast cancer can be more aggressive–without knowing the facts of Henson’s case we can’t make any definitive statements.)

Early detection is NOT a cure. In general, the reason more people are surviving breast cancer is  we have better imaging technologies. The  average size lump found by first mammogram is about the size of a dime (~1.5 cm) but even tumors as small as pencil erasers can be seen.

The real problem is we don’t know WHAT we are looking at.

We don’t know  WHY some tumors spread beyond the breast.

We don’t know HOW to stop metastatic growth.

We are seeing more and more breast cancers earlier and earlier. In some cases, people are overtreated: It’s the oncological equivalent of using a shotgun to kill an ant. Many women may be diagnosed and treated for a cancer growing so slowly it might never have caused any symptoms or threatened their lives,
Perhaps you have misquoted Dr. Arteaga. We urge you to do a follow up piece correcting the misconceptions your article created. We further urge you to read this New York Times article from January 18, 2011:

While perceptions of the disease may have changed in recent years, the number of deaths it causes has remained fairly static, said Dr. Eric P. Winer, director of the breast oncology center at the Dana-Farber Cancer Institute in Boston.

“All too often, when people think about breast cancer, they think about it as a problem, it’s solved, and you lead a long and normal life; it’s a blip on the curve,” he said. “While that’s true for many people, each year approximately 40,000 people die of breast cancer — and they all die of metastatic disease. You can see why patients with metastatic disease may feel invisible within the advocacy community.”

Amen, Dr. Winer, amen.

Sincerely,

Carol Marrero
MBCN Volunteer,
Brentwood, TN

Here is Tom Wilemon’s  response:

Carol,

Reporter Tom Wilemon

Thanks for reading The Tennessean and taking the time to send me an email. Dr. Arteaga was speaking of breast cancers in general , not metastatic breast cancer. I can assure you his heart is in the right place and his team is doing all it can to find new therapies for all types of breast cancer. And yes, he and other researchers are working to understand the WHAT, HOW and WHY.

I transcribed my interview from a recording and then wrote the article. I do not believe I misquoted him. I’ve not heard complaints from Vanderbilt about the article. He was simply seeking to further clarify the point that not all breast cancers are the same. Some types do have accepted treatment regimens that can work – and even cure.

Tom Wilemon

Reporter

The Tennessean

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9 thoughts on “Newspaper Claims Most Breast Cancers in the US Are Cured: We Beg to Differ

  1. Trevor Hicks says:

    I don’t understand why you’d pick on the guy for saying something obviously true that you even demonstrate yourself – if 20% of breast cancer patients have a recurrence, then 80% were cured. That sounds like “most” to me.

    I too prefer to see more effort directed to reducing that 20% and the 40,000 deaths per year. I fail to see how bristling over the mention of a fact that we should celebrate advances that cause.

    • katherinembc says:

      Trevor–it’s not that simple. First off, even if they don’t have a metastatic recurrence, it’s possible for those treated for early stage breast cancer to have a recurrence. “Cured” is not a word one can use with confidence in breast cancer.

      Although some would say DCIS is curable, consider my friend Ginny. She was diagnosed and treated for DCIS and declared “cured.” Seventeen years her had a metastatic recurrence. (Read her story here: http://mbcnbuzz.wordpress.com/2012/06/26/i-have-a-confession-to-make/)

      Second, mortality numbers tell the story more precisely than survival numbers, and screening skews the survival numbers. The more we screen, the more we diagnose and treat women 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.

      This is only a 5-year survival number—and includes the 20-30 percent of women who will have recurrence and may die of the disease later. For Stage II and III, one-half to two-thirds will develop metastatic disease within five years and they are included in the 5-year survival statistic. Women die of metastatic disease, not primary breast cancer.

      Incidence has risen during the past 20 years from 1 in 11 to 1 in 8, it’s now leveling off; mortality has declined slightly but a key point is incidence of stage IV breast cancer—the cancer that is lethal—has stayed the same; screening and improved treatment has not changed this.
      (See: http://www.breastcancerdeadline2020.org/get-involved/tools-and-resources/toolkit/resources-and-tools-for-advocates/ByTheNumbers.html )

      If you take the time the understand the numbers, I don’t think you’ll find much to celebrate.

      • Trevor Hicks says:

        I see your point and the other comments. I think the word ‘most’ was not the language you really object to, rather the word ‘cure’ is what’s problematic. My wife was diagnosed about 3 years ago and I know she doesn’t feel ‘cured’ even though she is NED. In fact she is constantly coping with the fear of recurrence.

        Maybe what the doctor should have said is that most women diagnosed with breast cancer die of something else.

  2. dear katherine,

    i applaud all the time and effort you have taken to set the record straight. considering the orginal quote of dr.arteaga, the response (non) of the reporter, and the first comment offered above, is it any wonder that those of us dealing with with any form of breast cancer, but especially those more rare and more aggressive forms , feel bewildered, appalled, frustrated, and angry with quotes that spin such erroneous information? this post serves as a very sad reminder that the death rate of 40,000 persons annually has not changed in decades. and it also serves to reassure us that dedicated, informed and committed advocates are on the case, and will never rest until the dirty underbelly of this devastating disease – that NO ONE diagnosed with breast cancer can ever rest easy with the word, “cure” – is recognized as the truth it is.

    thank you so much, katherine, carole marrero, and dr. eric winer for shedding needed light on a very dark issue surrounding breast cancer.

    • katherinembc says:

      Thanks for writing Karen. I think the story would have been greatly improved if the reporter had provided some context for the disputed quote.
      Tom Wilemon prefaced the final quote with this statement: “However, effective treatments already exist for the majority of breast cancer types, Arteaga said.”
      Really? I think that statement is certainly open to debate.
      Also, in his response, Wilemon writes: “Some types do have accepted treatment regimens that can work – and even cure.”
      What breast cancer, pray tell, are we curing in 2013? I would like to know so that the King of Norway can present the people responsible for that cure with a Nobel prize.

  3. I am the co-founder of METAvivor Research and Support – a non-profit for metastatic breast cancer and I too take exception to the quote by Dr. Carlos Arteaga of Vanderbilt. I must also say that with all due respect, the response to Katherine’s input by Tom Wilemon only worsens the problem. Mr Wilemon’s response states that some “types” of breast cancer are curable. In truth, any TYPE of breast cancer can metastasize. Further, any STAGE of breast cancer, including stage 0, can metastasize. And … ALL types of breast cancer have accepted treatment regimens and any of these TREATMENT REGIMENS can fail. Finally, given the fact that breast cancer can metastasize even 25 to 30 years after treatment, there is no way one can gauge whether or not someone has been “cured” of their breast cancer. Once you have had breast cancer, you almost certainly have cancer cells in your body, and I hardly call that a cure. The only question is whether these cells will remain dormant or whether they will activate as metastatic breast cancer in your lifetime … and that can happen to anyone.

    I would also comment that Dr. Arteaga’s statement that “there’s the unfortunate patient for whom therapies stop working” suggests that only an occasional isolated patient metastasizes. In fact, 30% of breast cancer patients go on to metastasize and at least another 5% are diagnosed with stage IV breast cancer right from the start. While this may be a minority of breast cancer patients, it is nevertheless a very sizable group.. Indeed, it has been estimated that anywhere from 65,000 to 83,000 Americans are diagnosed every year with metastatic breast cancer – a fatal condition for 97-98% of those diagnosed. We are a community of significant size.

    I would welcome the opportunity to speak with Mr. Wilemon to tell him more about metastatic breast cancer. I’m certain Katherine would be happy to do likewise. He is not alone is his mis-perceptions. Perhaps he would consider speaking with both of us amd then doing an article on metastatic breast cancer to help educate his readers?

  4. It’s articles and statements like this that continue to perpetuate the lie that breast cancer is “curable”. It’s this public perception that makes the public feel that a breast cancer diagnosis is “not such a big deal” as we have all gotten comments from well-wishes like “So, you beat it, right?”

    Once again….you don’t “beat” breast cancer unless you die from something else. 30% of those diagnosed will go on to get METS. Everyone diagnosed has that reality shoved in their face every time they hear of another friend, mother, sister, daughter that has had the disease return.

    I think CJ has a great idea in educating….Can we all have Dr Arteaga’s e-mail or contact info so that we all can “educate” him?

  5. Just Me says:

    I would like to thank all of you for your efforts to educate the public (and apparently some researchers) on the lack of any real cure for breast cancer – whether found at stage 1, 2, 3 or 4.

    As all of you know, the fact of the matter is that just about any breast cancer can recur and can metastasize and there’s no reliable way to know at this point which will and which will not. In essence, any of us with breast cancer could find ourselves with metastatic cancer at any time. Those who think otherwise are just kidding themselves.

    I am very grateful for all of you who are staring down the pink and fighting for REAL awareness of the meaning of breast cancer. Your actions benefit all of us.

    (Please don’t use my name. I’m not ready to go public with this disease. Thank you.)

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