The recurrence of Elizabeth Edwards' breast cancer years after treatment is a serious setback, but probably one she can live with for five to 10 years, perhaps even longer, experts said Thursday.
Still, she will have to take medications for the cancer for the rest of her life.
Such recurrences are not unusual. About a third of breast cancer patients have a disease that has metastasized, or spread from the original location, typically to bones.
For The Record
Los Angeles Times Tuesday April 03, 2007 Home Edition Main News Part A Page 2 National Desk 0 inches; 26 words Type of Material: Correction
Elizabeth Edwards: A March 23 article in Section A about Elizabeth Edwards' breast cancer misspelled the name of Premiere Oncology in Santa Monica as Premier Oncology.
If the disease has spread, "we do not feel that it is curable, but it is treatable," said Dr. Linnea Chap, a breast cancer specialist at Premier Oncology in Santa Monica, which is affiliated with St. John's Health Center.
"We have very good treatments that can allow patients to live with breast cancer for many years with a good quality of life."
Cancer metastases are so difficult to cure because surgery is no longer an option once the disease has spread beyond its original confined location, said Dr. Marisa Weiss, president of breastcancer.org and a cancer specialist at Lankenau Hospital in the Philadelphia area. Drugs also become less effective because the metastasized cells "get into hiding spots that the drugs can't get into as easily."
Experts cautioned that it was difficult to predict treatment and outcome for Edwards because the details of her tumor had not been made public.
The treatment is individualized, depending on the characteristics of a patient's cancer. The approach can be as minimal as a pill to block estrogen, which contributes to the growth of many breast cancers. "That is taken daily and is very well tolerated," Chap said.
If the cancer has spread more widely, her physician will probably be more aggressive, using drugs such as Xeloda -- an oral drug that blocks an enzyme needed by tumors -- or one of the taxane drugs, such as paclitaxel or docetaxel. Those drugs must be given intravenously, and have stronger side effects.
Either might be given in combination with Avastin, which blocks the growth of blood vessels supplying nutrients to the tumors.
The patient also is typically given monthly doses of one of the bisphosphonate drugs, such as Actonel or Fosamax. These drugs do not attack the tumor directly, but strengthen the bone, making it more resistant to fractures. They have also been shown to reduce bone pain in the metastases.
If the cancer has spread to organs other than the bones, as Edwards' physician has hinted, then the initial therapy would be more aggressive, using the strongest of those drugs.
"If it is just in the bones, then the outlook is more favorable than for cancer that has gone to the liver," Weiss said.