Dr Jay K. Harness:>>> I see a lot of patients back as part of my routine followup of them
for treatment of breast cancer.
Typically, I see patients twice a year roughly every six months and I always wanted to see
them when they are back for their annual mammograms.
Now obviously as I am following patients over a long period of time, there are going to
be patients of mine who are going to progress on to stage IV breast cancer.
Stage IV breast cancer is unfortunately not curable however, that does not mean that it
is not treatable and so from my perspective as a surgeon, what are the goals here?
What do I want to see happen to my patients who have now progressed on to stage IV?
Clearly I am going to be working with my team and I will be working with my medical oncologists
and my radiation therapist.
It depends at what point and where they are, what is the definition of stage IV?
Is it spread to the bone?
Is it spread to lungs, liver, and brain and so our goals clearly are to deal with the
specifics of the progression of a cancer on the stage IV.
The goal of here is to slow the process down.
This is not a process that I would consider to be completely hopeless and we are towel
on because I will share with you, I had many patients over the years who have had quite
stable stage IV disease.
Typically this is stage IV disease that is limited, let say as an example to a thoracic
spine, one spot to a pelvis or things of that sort and the medical oncologist know exactly
what they are doing as far as the need of antiestrogen therapy or drugs like Zometa
or the other they can do.
Now part of our goal in the treatment of stage IV breast cancer is clearly to relieve the
pain and to relieve symptoms that affect quality of life, obviously are life threatening for
that matter.
So radiation therapy may be needed to isolated areas of bony metastases.
A single metastasis to the brain surgically is typically removed followed by either focussed
or whole brain radiation therapy.
There are instances where we have a single metastasis to the liver that can be treated
by an ablative therapy, so the circumstances are highly variable.
The goal here is always pain relief, the goal is to get the stage IV disease under control,
the goal is to try and make it a chronic state.
One of the things that I envisioning in the future and now in the treatment of breast
cancer is if we go to stage IV that we put the patient into the chronic disease state,
like we do with diabetes or other diseases so that things can be followed over a longer
period of time.
We obviously want to maximise what we know today because who knows what is down the road
in the future treatment of stage IV breast cancer.
So the bottom-line is here, please be working with your multidisciplinary team, please be
asking questions about are there new protocols out.
Please be asking for the state‑of‑the-art treatment as we know it today, but hang in
there, new things are coming, let us work together on the treatment of your stage IV
disease.
Hi, I am Dr. Jay Harness and I want to share with you an important information that I believe
that every newly diagnosed patient with breast cancer needs to know.
Susan Denver: I am a breast cancer survivor.
Katherine Stockton: I am a breast cancer survivor.
Coree: I am a breast cancer survivor.
Susan Denver: And I want every woman to know…
Katherine Stockton: …about personalized breast cancer treatment…
Susan Denver: …and the Genomic Test.
Coree: A test that helps guide a woman and her doctor…
Katherine Stockton: …to the best treatment options for her.
Susan Denver: Pass it on!