Friday, March 23, 2007

Elizabeth Edwards and Her Cancer: A Controllable Disease

By Katherine Hobson.
US News & World Report

Although the breast cancer diagnosed and treated more than two years ago in Elizabeth Edwards has spread and can no longer be eradicated completely, its progression can often be managed, much as is done with other chronic diseases.

The cancer that has afflicted the wife of Democratic presidential candidate John Edwards is now lodged in a right rib bone.

"I always remind my patients that diabetes is not curable and hypertension is not curable," says Aman Buzdar, deputy chairman of the department of breast medical oncology at the M. D. Anderson Cancer Center in Houston, who isn't familiar with the specifics of Edwards's case. "But we can keep those diseases under control for a long period of time."

Edwards said at a press conference in North Carolina that she sought medical treatment for pain on her left side. That turned out to be a cracked rib she suffered while moving furniture in her new house, but the same X-ray that revealed the break also showed a suspicious spot on the opposite side of her ribcage. A bone study and other follow-up tests confirmed that there was cancer in a rib bone.

That's clearly disappointing but not surprising. When breast cancer does escape the confines of the breast and spreads to other organs, the bone is the most common site for it to take root. Because the cancer has spread to another organ, it is automatically classified as late stage, or stage IV.

Survival will hinge on many factors, including the number of areas affected by cancer and how big the tumors are, doctors say. Edwards's tumor is small, and a CT scan showed very little presence of the disease in soft tissues beyond the bone.

Treatment options for breast cancer that has spread to bone break down into two categories, says Harold Burstein, medical oncologist at Dana-Farber Cancer Institute in Boston and an assistant professor of medicine at Harvard Medical School. A group of drugs called bisphosphonates are used to strengthen and heal the bone. The drugs, Zometa and Aredia, are similar to drugs taken to combat osteoporosis but are more powerful and are given intravenously rather than orally.

"Doctors may also start specific treatment against the tumor," says Burstein. That may include drugs that block estrogen, if the tumor is fueled by that hormone, or chemotherapy. (Looking to the future, a monoclonal antibody called denosumab is currently in clinical trials for use against both bone metastasis and osteoporosis.)

True, the treatments now available can only delay the progression of the cancer and alleviate symptoms; the tumor may become resistant to one treatment over time, forcing a switch to something else. But Buzdar says this can extend the life of even a late-stage cancer patient for years.

"There is hope," he says. "A recurrence of cancer does not mean there's no hope, and people can live a very productive, comfortable life."

Related News
Defying Reports, John Edwards Stays In.
In-Depth Breast Cancer Information & Resources.
Video: Edwardses' Press Conference.
Cancer Prevention Tips.
Living Beyond Cancer.
More From Politics.
More From Health.

I would just like to add my own two cents right here. I pray for Elizabeth and her family as she continues in her struggles and hopes. I pray she is well taken of by her husband, her doctors and our Lord. Hang in there, Mrs. Edwards. We are praying for your health and you...all politics aside.

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