Elizabeth Edwards told not to treat spreading cancer

December 7th, 2010 by Staff

By Liz Szabo, USA TODAY — Elizabeth Edwards announced Monday that her cancer has taken a turn for the worse and has now spread to her liver.
Edwards, 61, the estranged wife of former presidential candidate John Edwards, was first diagnosed with breast cancer in 2004. Now, with cancer in her liver, her doctors have advised her not to undergo any more anti-cancer treatments, according to a family statement.

“For them to say that she is not strong enough to benefit from further treatment, that says to me that her disease is far advanced and she is facing the end of her life,” says Ira Byock, director of palliative medicine at the Dartmouth-Hitchcock Medical Center, who has no personal knowledge of Edwards’ case.

Doctors say it’s hard to predict how long someone in Edwards’ situation will survive, especially without knowing details of her case.

But patients in this condition rarely live past six to 12 months, says Hal Burstein, of the Dana-Farber Cancer Institute in Boston.

On average, breast cancer patients survive about three to four years after their cancer first metastasizes, Burstein says. It has been three years since Edwards revealed that her breast cancer has spread to her bones, in 2007.

Although early breast tumors are usually curable, and doctors have made great strides in prolonging the lives of women with advanced disease, metastatic breast cancer is not considered curable, Burstein says.

Chemotherapy can keep the disease at bay for a long time, though. Most women with advanced breast cancers undergo five or six different lines of chemotherapy, Burstein says.

Doctors also can treat liver metastases with chemo, which can keep cancer under control for some time, says breast cancer expert Sandra Swain, medical director of the Washington Cancer Institute at Washington Hospital Center.

Eventually, however, women may become so weakened by disease that chemo is no longer likely to help, Byock says.

In many cases, patients actually live longer if they stop actively treating their cancer and focus on palliative care to relieve symptoms, Byock says, because chemo takes such a heavy toll on the body.

“There are lots of chemotherapies and late-stage treatments,” Byock says. “But people have to be strong enough to benefit from them.. .. If a person is just weak from the ravages of an illness, it makes no sense to put them through those invasive procedures.”

Edwards “may well live longer by conserving her energy and celebrating her very full and remarkable life,” Byock says.

Thanks to pain relievers, living — or even dying — with a liver metastasis isn’t necessarily painful, says Charles Loprinzi, an expert in breast cancer at the Mayo Clinic in Minnesota. “With proper care and attention, it shouldn’t be a painful process,” Loprinzi says.

Around the country, many cancer survivors say they sympathize with Edwards’ plight and have appreciated her courage and grace.

“I hope she enjoys the best possible life in the time she has,” says Jody Schoger, a breast cancer survivor in The Woodlands, Texas. “When someone in the breast cancer community relapses, we all feel it. I’m seeing many survivors responding on Twitter to the news. I feel terrible for her children and hope they are surrounded with love and caring by their friends and family.”

Byock, who says he met Edwards briefly in 2007, when she and her husband visited Dartmouth, describes her as “a class act.”

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