What Breast-Cancer Survivors Can Expect

Last fall, Elizabeth Edwards was the guest speaker at a conference sponsored by NEWSWEEK and Harvard Medical School. Although she spoke about the sorrows in her life, she conveyed an inspiring optimism. Now she faces another tough fight. To learn more about what Mrs. Edwards and other breast-cancer survivors might expect, Barbara Kantrowitz interviewed Dr. Jo Anne Zujewski of the National Cancer Institute (NCI).

Let's start by defining metastatic breast cancer.
The most important distinction is whether the breast-cancer cells are confined to the breast and lymph nodes (this is sometimes referred to as early-stage breast cancer) or if they are in distant sites—such as the bone, liver, lungs. Patients who have breast-cancer cells in distant sites are said to have advanced breast cancer, whether or not the cancer was detected at the distant sites at first diagnosis or later.

What are the survival prospects when breast cancer has spread to the bones?
Metastatic cancer carries a poorer prognosis than early-stage breast cancer, regardless of where it has spread.

How would chemotherapy affect a patient's ability to maintain a hectic schedule?
Every patient reacts differently. Fatigue—feeling tired and lacking energy—is the most common symptom reported by cancer patients, which can be due to a variety of factors. Experts suggest taking frequent naps or saving energy for only the most important activities.

Would a rigorous schedule increase the risk of infection?
Chemotherapy can increase the risk of infections because anti-cancer drugs can affect the bone marrow. This makes it more difficult to produce white blood cells, which fight off infection. Experts advise patients to be vigilant about preventive measures like hand washing to kill germs, as well as avoiding large crowds when possible.

Nearly 200,000 American women will be diagnosed with invasive breast cancer this year. After the scary news about Mrs. Edwards, what can you say to reassure them?
Most women who get treated for breast cancer will not have a recurrence. We have excellent treatments that are getting better all the time. Mortality is down.