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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Prognosis seems bleak, but survival rates vary

David Brown Washington Post

WASHINGTON – Elizabeth Edwards’ chance of surviving five years is well below 50 percent if her experience is similar to that of other women whose breast cancer has returned within five years of its original discovery and treatment.

That is the conclusion of numerous studies as well as clinical observations by oncologists. The pessimistic prognosis, however, is partly undercut by two caveats. Survival varies greatly for women with Edwards’ diagnosis, and new drugs are helping extend their lives even when the disease is no longer curable.

The 57-year-old wife of John Edwards, a former senator from North Carolina seeking the Democratic nomination for president, Elizabeth Edwards announced Thursday that breast cancer cells had been found in a rib on the right side of her chest, as well as in other unspecified parts of her skeleton. Her physician, Lisa Carey, an oncologist at the University of North Carolina, said “it is possible” the cancer has spread to one of her lungs.

Surgery is not a treatment for “metastatic,” or widely spread, cancer. In the coming months she is likely to undergo new rounds of chemotherapy.

A study published last year in the European Journal of Surgical Oncology reviewed the experience of 2,500 women treated at a large hospital in Sydney, Australia, between 1989 and 2002. Of that group, 18 percent had a recurrence of their breast cancer, and the average time to recurrence was 2.3 years, slightly shorter than that of Edwards.

Among women with recurrences outside the originally affected breast or its nearby lymph nodes, only 13 percent survived five years or more. Women whose tumor reappeared in bone, as opposed to the lymph nodes or “distant” organs such as the liver and brain, had the best prognosis, with a median survival of 2.4 years.

Many experts Thursday emphasized the relative scarcity of data on survival of women whose breast cancer returns, as well as the range of biological responses when they undergo treatment.