In the final instalment in our series of 'Making the Last One a reality' blogs, our Research Communications team look at secondary breast cancer and how work our supporters are helping to fund is aiming to achieve our goal that, by 2050, no one who develops breast cancer will die from it.
Every 45 minutes we lose someone else to breast cancer.
That person will likely have seen their cancer spread from the breast to other parts of the body - what’s known as secondary, or metastatic, breast cancer. Secondary breast cancer is responsible for most breast cancer deaths.
Whilst there is no cure for secondary breast cancer yet, we are making progress in understating how and why cancer spreads. To speed up this progress, Breast Cancer Now is supporting secondary breast cancer research across the UK and Ireland, including projects like the LEGACY study.
To explain some of the challenges that we need to tackle in secondary breast cancer research we’ve collected some thoughts from leading experts in the field.
The basics: how does cancer spread and who’s at risk?
One of our teams focussing on secondary breast cancer is led by Professor Clare Isacke at our research centre in London. There are “two fundamental issues” that her team is investigating, she explains:
“One is how do breast cancer cells survive and grow in what for them is a very foreign environment like the brain or the lung, and the other is the question of why do some breast cancer cells essentially hide out in distant organs and then reappear, sometimes 10 years after the woman has had their first diagnosis.”
Another of our researchers tackling these issues is Professor Ingunn Holen at the University of Sheffield. She puts it like this:
“One of the biggest problems is that we don’t know who will get secondary breast cancer – we treat the same patients in exactly the same way, but in some cases their breast cancer spreads and in others it does not.
“To help with this, we need to understand the mechanisms of what actually happens when a cancer cell arrives into a secondary site, such as the bone, liver, lungs, and brain.”
Professor Holen’s research team is doing just this, by investigating molecules involved in the spread of breast cancer to the bones.
Improving treatments and how they’re used
By funding work, like Clare and Ingunn’s, to improve our understanding of secondary breast cancer we can improve how we treat the disease.
As a consultant oncologist, researcher and Trustee of Breast Cancer Now, Professor Rob Coleman is well aware of the need to improve treatments. He says:
“Once a patient gets secondary breast cancer we still don’t know the best order to use the treatments we have. We tend to treat patients in groups… we need to get better at tailoring the treatments for individual patients.”
One way to do this is to start doing looking at the molecules driving a tumour again once the cancer has spread, to check whether the tumour will still benefit from the same treatments. We’re helping researchers to do just that, by funding Dr Nick Turner to develop a test for breast cancer DNA in the blood, called a ‘liquid biopsy’.
Professor Coleman adds:
“The other priority area is to balance the benefits of treatments with their side-effects.”
Effective drugs that have fewer side effects are starting to appear. One is Kadcyla, which delivers chemotherapy molecules to cells driven by the molecule HER2, without some of the side effects usually associated with chemotherapy, and can give an average of six months more life than standard treatment. Developing drugs like this is a lengthy process.
However, we know that research is moving faster all the time and we believe a future is possible where many more drugs have fewer side effects.
Joined up thinking
Better treatments need a better healthcare system to deliver them and to achieve this we have been influencing policy to affect healthcare.
In the last year, we worked to make sure that secondary cancer was not forgotten in the Cancer Strategy for England 2015-2020.
Two of the key points we wanted to be recognised in the strategy were the improvement of services for secondary breast cancer patients and better data collection about secondary breast cancer.
Service improvements should include a clinical nurse specialists being made available to all secondary patients to guide them through the labyrinth of appointments, contacts and different services available to them.
To help and support secondary breast cancer patients in making informed choices about their care, Breast Cancer Now developed an online guide on the treatment and support they should expect.
The information in the guide can be tailored geographically and by type of treatment, helping people to understand their options and allowing them to have greater confidence in and control of their care.
Because of poor historic data collection, we can’t currently tell how many people in the UK have secondary breast cancer.
This just isn’t good enough when this data could be collected to help us answer some of the key questions we’ve mentioned here: how can we tailor treatment and plan and commission care to for people with secondary breast cancer, and are there trends to help us understand who gets secondary breast cancer?
We have also campaigned to try and make cheap, off-patent drugs, which can prevent the spread of cancer, more easily available, and expensive new drugs, like Kadcyla, accessible to everyone who needs them.
A future where secondary breast cancer doesn’t kill
Ultimately we all need to work together, to make all of the above happen and get us to a future where no one dies from secondary breast cancer.
Together we can turn secondary breast cancer from something to fear into a chronic but completely manageable condition.
As Professor Isacke puts it:
“I hope in the future that no-one dies needlessly from breast cancer, but for those women and men who do have breast cancer that they can live with the disease, with a high quality of life, rather than die from it.”
Read the other blogs in the series: