October 2, 2017

As new treatments are approved, fewer women are dying from metastatic breast cancer every year and more are living with it.


Cheerful pink ribbons are everywhere, and the word “cure” is front and center.

October can be a conflicting time for women with stage IV metastatic breast cancer, many of whom know their cancers are not curable. They, instead, are living with cancer.

The most common misperception people have about stage IV metastatic breast cancer is that life is over, says Vandana G. Abramson, M.D., a medical oncologist for the Vanderbilt Breast Center. She shares a different picture.

“These are women living very normal, fulfilling lives. They run marathons, they travel, they write books,” Abramson said. “Certainly, there are some aggressive cases, but people now commonly live with metastatic breast cancer. With newer therapies and a better understanding of the disease, we are able to focus on making it more like a chronic disease, like diabetes, so people can live normal lives and not be limited. The goal is to get treatment and carry on with normal life.”

More treatments every year

Breast cancer research has historically been well funded and well supported, and advances in precision medicine now allow oncologists to study tumors’ DNA to better understand what makes them grow.

The result, the hope Abramson would like people to keep in mind, is a strong decline in deaths.

Breast cancer deaths among women have dropped from 30.1 per 100,000 population in 1930 to 20.5 per 100,000 in 2014, according to the American Cancer Society’s Cancer Statistics Center.

“More than ever, we have so many different treatments available. Almost every year, we have a new treatment available, which is just remarkable. Many of these can prolong life significantly,” said Abramson, who splits her time between patient care, research and teaching. “Most of these treatments are targeted to some degree. They actually have less toxicity than ever before, which allows people to live more normal lives.”

Clinical trials not a ‘last resort’

Those diagnosed with metastatic breast cancer should immediately begin asking questions about precision medicine. Understanding a tumor’s DNA and what is making it grow leads to more targeted care. That prompts another important question: What clinical trials can a patient join to learn what might be fueling that cancer? At Vanderbilt, Abramson is the principal investigator in 20 clinical trials and the national leader spearheading four of those studies.

“People think about clinical trials as something you explore as a last resort, but we have clinical trials available as a first line of treatment,” Abramson said. “Those are options that should be talked about from the start.”

More options exist than ever, Abramson says, in October and the rest of the year.

“It’s hard living with cancer. The biggest hope I can offer is that the cure is around the corner. People feel like cancer is everywhere, but fewer and fewer women are dying from this disease every year. There’s so much research and so many new treatments in clinical trials, we know one day there’s going to be a cure for all stages of the disease,” Abramson said. “October is a celebration of how far we have come.”

The Vanderbilt Breast Center at One Hundred Oaks provides the most complete range of services for breast health in Middle Tennessee. The center offers screening, imaging, genetic testing and breast cancer care. To make an appointment, call 615-322-2064.