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A Matter of Survival: Advances in Chemotherapy are Making Breast Cancer Treatable, Not Terminal

Publication: Paint it all Pink Magazine 2019

Advancements in medicine and technology mean breast cancer patients are living longer, and many cancers are now treated as chronic illnesses rather than terminal diseases.

Life expectancy, even for multiple stage 4 cancers, has risen.

“It’s not a stretch to tell a woman newly diagnosed with stage 4 breast cancer that her survival will be measured in years and not months,” Dr. Mika Cline, medical oncologist at Texas Oncology in Austin. “It’s not unusual for patients to be treated for stage 4 cancer while planning their children’s weddings, graduations, traveling and even continuing to work. That’s not true for everyone, of course, but we see these scenarios much more frequently than we used to.

“Given that, patients, caregivers and their oncology teams can focus on the impact of treatment and side effects on quality of life, not just life expectancy,” she said.

Reduced side effects
Because of new medications with reduced side effects, chemotherapy is now delivered in an outpatient setting rather than a hospital.

“The benefits are plentiful. Patients miss less work and sleep in their own beds. There’s less risk of infection, a higher level of function and more interaction with family, friends and co-workers who can help support the patient through treatment,” Cline said.

Chemotherapy sounds scary, but once a patient understands what to expect, most gear up and are motivated to get through it.

“Chemotherapy is certainly not something someone would choose to put themselves through, but once someone understands that it is necessary to prevent cancer recurrence or to stop cancer growth, the ultimate goal makes the idea more bearable,” Cline said.

Supportive measures now make some side effects of cancer treatment much less impactful than before.

“We’ve seen a sea change in management of nausea and vomiting. It used to be one of the scariest side effects,” Cline said.

Previously after chemotherapy a patient may have been severely nauseated for days and there was nothing to do except bear it.

“Now, though it is still a pleasant surprise for me to hear that a patient had no nausea with his or her treatment, it is becoming more common. It’s not true for enough patients yet, but it’s getting there,” Cline said.

Another innovation is immunotherapy, which “involves boosting a patient’s immune system to fight off the cancer,” Cline said. “For decades, a great deal of our practice was in managing side effects of chemotherapy, especially the immunosuppressive side effects. We’ve had to get comfortable with therapies that may actually cause side effects as a result of immune stimulation or from a now overactive immune system.”

Less effect on fertility
While chemotherapy can affect a woman’s chances of becoming pregnant, innovations are improving the chances of preserving fertility.

“Fertility preservation gives patients peace of mind that they aren’t giving up on their views of their future if it includes children because they got this cancer diagnosis and are facing systemic therapy,” Cline said.

“When contemplating cancer treatment, it helps to remember that it’s a marathon and not a sprint. You, your loved ones and your oncology team all have the same goal, which is successful treatment with side effects impacting your life as minimally as possible. That said, cancer and its treatment are going to impact your life, so be patient with yourself and take it one day at a time,” Cline said.

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