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.
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.
Here is Tom Wilemon’s response:
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.