Q: Isn’t breast cancer the ‘good’ cancer?
First words of advice — never tell someone who has lymph nodes removed, four months of chemotherapy, a mastectomy and 28 radiation treatments that she had the good cancer.
Here are some key statistics from the American Cancer Society.
- There are 2.8 million breast cancer survivors in the US.
- That said, more than 232,000 new cases of invasive breast cancer will be diagnosed this year. More than 64,000 cases of non-invasive.
- Most sobering, about 40,000 will die of the disease. That more than 100 women per day.
- Early in the 2000s, there was a decrease in mortality rates from the disease due a discontinuation of hormone therapy in menopausal women. A landmark study showing a causal link between Hormone Replacement Therapy and breast cancer was published in 2002.
- Breast cancer is the second leading cause of cancer death in America, the first is lung cancer.
Breast cancer most commonly occurs in the milk ducts (ductal carcinoma), although it can also occur in the milk glands (lobular carcinoma). Cancers are staged 0 through 4. A stage 0 cancer is non-invasive, commonly known as cancer in situ. From there, a combination of tumor size and spread of the cancer is used to determine staging. This, in turn, factors into treatment protocols. Stage 4 cancer is also known as metastatic cancer. That means that the breast cancer has spread beyond the breast and the local lymph nodes. It takes up residence in distant organs like the lungs and the liver, or in the brain, or in the bones.
Here’s the thing. Breast cancer that stays in the breast will not kill you. Breast cancer has to spread beyond the breast and beyond the lymph nodes before it becomes an existential threat. Stage 4 breast cancer, metastatic disease, currently has no cure.
Here’s the other thing. It seems to make intuitive sense that breast cancers start as stage 0 and march their way on to stage 4 if not treated. Therefore, if we can catch it at stage 0 or stage 1, we can slam the door closed on it. In fact, that was the common wisdom for years, and the theory behind the notion that “early detection saves lives.”
But it’s not true, or more precisely, it’s not complete.
Yes, some versions of breast cancer work that way. Some don’t. Some estimates say that up to 30% of all breast cancers will metastasize, regardless of the initial stage. Could it be that the seeds are planted before the original cancer is discovered?
And some cancers won’t progress at all. They may even resolve on their own.
Here’s the real kicker — we don’t have any way to reliably test which one is which. And if it is the kind that will end in metastases, we don’t have a way to cure it.
This gets to the problem with the pink. We’re busy pooping, shooting, frying, or drinking our way to a cure, latching on to these simplistic and fun messages. It’s so loud that it’s drowning out the complex and disturbing truths about this disease.
Where in this do you see these breast cancer realities?
So is it a good cancer? Well, it gets a lot of attention, yes. And millions of people are willing to shower those of us affected by the disease with love and goodwill. A lot of money is donated. And, yes, there is more known about this disease than other diseases. “Good” however, is a word I’d never use in conjunction with cancer.