One of the first questions a newly diagnosed cancer patient usually asks: “Will I die from this disease?” The very first question of a newly diagnosed  metastatic patient is inevitably, “How long do I have?”  Breast cancer  is the second leading cause of cancer deaths in women. (Only lung cancer kills more women each year).  It is estimated that over 44,000 will die from breast cancer this year. Simply put, 116 of our MBC brothers and sisters will die today and tomorrow, and the day after.  These numbers are grim and they have not changed dramatically in the last 20 years. They are a  testament to the cleverness of the disease and its ever-growing list of known variations and mutations.

And yet… there are important exceptions, instances where long-term disease-free survival occurs. We all know some of these people,  we call them unicorns.  Every busy cancer clinic has patients who have had metastatic breast cancer for 20 to 25 years. 

Cure isn’t a word thrown around lightly by oncologists, but now the top scientists in the cancer field are willing to bandy it about aloud, publicly and often. 

 In 2016, a prominent oncologist and a Stanford University professor George Sledge, M.D. published a paper in the Journal of Oncology Practice called “Curing Metastatic Breast Cancer.” In this article Dr. Sledge suggested that the existing paradigm around metastatic breast cancer—that it is incurable—should be updated in the face of new science developed in the past decade or so. Pointing to the fact that 1-2% of metastatic breast cancer patients are cured of their disease or survive for many years, he wrote, “If some patients are cured, might not we cure more?”  

He is not alone in this way of thinking. In his keynote address at the 2020 Dana Farber Cancer Institute EMBRACE conference, Dr. Eric Winer opined: 

“Our treatments for HER2+ breast cancer  have become so much better that the question that's arising - are some patients curable? In particular patients who are de novo. May those patients  have the ability to be cured of their cancer? And so with all of these drugs that seem to be non-cross resistant or non-overlapping, can we develop curative approaches? If we do, what would we still need to do?”  

Our MBC Life’s crack team of investigators is taking these and many other questions on the virtual road in the series that we call “Road to a Cure.” Over the next two months we will explore these and other topics with the leading clinicians and researchers in the field of breast cancer.

In this episode we sit down with a  group of the  Our MBC Life co-hosts and the friends of the podcast who are living with MBC to discuss what it means to live with an incurable disease and  consider a possibility of a cure. What is a cure? What is a chronic disease? In the next hour we will tackle these and many other questions.

Mentioned in this Episode

• The Future of Metastatic Breast Cancer Treatment Is Bright  (HealthCentral, 2020)  Simple summary of research updates / reasons for hope, by subtype 

• Sledge Jr. (2016) Curing Metastatic Breast Cancer

• Wang (2019) Long-Term Survival of De Novo Stage IV Human Epidermal Growth Receptor 2 (HER2) Positive Breast Cancers Treated with HER2-Targeted Therapy

• 2020 EMBRACE MBC Virtual Form Series - Welcome Session

• Susan G. Komen Breast Cancer Statistics

Resources discussing how hope can be tricky:  

• Brene Brown  Unlocking Us: Session 3 on the Gifts of Imperfection   While not on hope specifically, Brene Brown discusses the concept of "foreboding joy" and why we might feel apprehensive when good things happen to us.  If you find yourself on the more cynical side when it comes to thinking about hope, you might resonate with Brene Brown’s trademark snark in this short discussion.  

• Kelly Grosklags is a clinical social worker specializing in working with those of us with serious illnesses & takes a more earnest approach to how we might work intentionally with the concept of hope:  "It’s important to realize that hope isn’t about flowers and balloons and magical unicorns. Hope is a form of medicine. It gives us a mental break from negativity and fear. It helps us stay in the moment and believe in ourselves."

  • When Cancer Happens, Does it Take Courage to Hope?  (print article from Coping Magazine)

  • The Courage to Hope (podcast)   

• Kate Bowler How Cancer Changes Hope: a young theology professor living with metastatic colon cancer talks about how the concept of hope changed for her after diagnosis: "I was confident that hope had its uses, but I began to think of it as a kind of arsenic that needed to be carefully administered. As far as I was concerned, it poisoned the sacred work of living in the present". Kate discusses how she has begun to tentatively live within the contradiction of present / future that comes with metastatic disease. She continues this discussion in her new book No Cure for Being Human.