What had you heard about Suzanne Somers’s breast cancer experience prior to her death on October 15?
I was only aware that she was diagnosed with breast cancer because she created some controversy when she wrote a book about walking away from conventional treatment and choosing alternative and complementary treatments. She may be an influential celebrity who’s written books about healthy eating, and getting chemicals out of your life, and “this is how I’ve treated my cancer,” but we want to be careful to educate women that while there may be a role for some of these alternative and complementary therapies in managing symptoms, they haven’t been rigorously tested or subject to peer review as cancer therapies. They haven’t gone through the randomized clinical trials we depend on to demonstrate oncologic benefit.
Is there any benefit to the healthy lifestyle that Somers talked about?
We do talk to patients about what we know about what lifestyle modifications can help reduce risk of cancer or risk of recurrence. But I always tell my patients there is no diet or specific lifestyle that prevents all cancers or treats a cancer. Even people who exercise regularly, never smoke, and try to eat the most healthy organic food possible can still get cancer. Healthy eating and healthy living are important, but they aren’t a substitute for tested therapies that have undergone randomized trials and peer review.
Somers said she had skin cancer prior to being diagnosed with breast cancer. Could those be related, or are they two completely separate incidences?
In 2000, when she first was diagnosed with breast cancer, connecting these two primary cancers might not have been on anyone’s radar. Currently, when someone has multiple primary cancers — in her case, melanoma, then breast — we would recommend genetic counseling and genetic testing to look for a hereditary cancer syndrome. The testing is informative if we get a positive result. It explains why someone would develop multiple types of cancer. Particularly in breast cancer, certain gene mutations like BRCA1 and BRCA2 help us identify specific drugs that will be effective to treat that cancer. Genetic testing has implications for the family, too — if there is a positive result, we would typically test siblings, children, and any other blood relatives to look for the same mutation. If a mutation is found in a person without cancer, they can take steps to prevent cancer.
Somers’s experience with breast cancer lasted more than 20 years. Is that fairly common, or is that unusual?
It depends on the type of breast cancer someone has, but some breast cancers are known to have a risk of late recurrence. Her story is not out of the ordinary. Women we think we’ve treated for cure can develop recurrences 10 or more years later. That’s what’s really scary about breast cancer. Some types of breast cancer are more likely to recur early, but some types can recur very far out after what we feel is curative treatment.
How is metastatic breast cancer managed?
For metastatic breast cancer, our goal is to manage the cancer as long as possible with treatments that are the least toxic to maintain quality of life. Treatment is likely going to be necessary indefinitely. Metastatic cancer is diagnosed either because someone has symptoms that prompt their oncologist to order testing, or they’re getting a routine scan that detects metastasis. Metastatic cancer is monitored with follow-up scans, typically every three months, at least initially, so we can understand their disease trajectory. Is it spreading to additional sites? Is the treatment keeping it under control? The initial therapy will keep disease under control for a period of time, but the cancer may progress, which requires a change in therapy.
Somers died at age 76. Is that considered young or old to die of cancer?
There is no standard. The fact that she dealt with breast cancer for 23 years is a clinical course we see in our daily practices. There are many women living with metastatic cancer who have a very high quality of life because our therapies are getting more targeted and often less toxic. Some patients with metastatic breast cancer continue to work and spend quality time with their family.