The good news is that breast cancer patients are living longer. Treatment advances are making an impact and boosting survival for women with the disease.
But that progress has come at a cost — the disease may have more time to spread to the brain.
Breast cancer is one of several cancers that can spread to the brain. (Image by Mikael Häggström)
“With the introduction of personalized medicines such as Herceptin, and many more on the way, women are living longer with breast cancer,” said Rahul Jandial, M.D., Ph.D., assistant professor in City of Hope’s Division of Neurosurgery. But this leaves doctors and patients wondering how to fight increasingly common breast cancer tumors that spread, or metastasize, to the brain.
Herceptin battles breast cancers that have a mutated HER2 gene. The drug has improved survival for thousands of women. Many patients, though, develop breast cancer metastases in the brain even though medication is controlling the breast cancer in the rest of their body, Jandial says, “and those patients are dying from their brain tumors.”
In one study, half of the breast cancer patients with a mutation to HER2 still developed brain metastases even though chemotherapy was suppressing cancer in the rest of the body. Of those diagnosed with brain metastases, half died from the brain tumors.
About 200,000 cancer patients in the U.S. each year get metastatic brain tumors. Jandial says that the metastatic brain tumors were not considered as immediate a concern for breast cancer patients in the past. That’s because the brain metastases occurred in the late stages of the disease, when breast cancer’s spread to other organs caused most of the complications and deaths.
Now, thanks to a $250,000 gift from an anonymous donor, neurosurgeon Jandial is taking on the role of breast cancer researcher to better understand what makes these brain-invading breast cancer cells tick.
He believes bringing knowledge from neuroscience and neurosurgery into the investigation “could offer a new source to develop targeted therapies for women with advanced breast cancer.”
While the initial focus of his study is on breast metastases to the brain, he says the findings have the potential to apply to other cancers that spread to the brain, as well.
“Brain tumor research has shown us that cancer, whether arising from the brain or spreading to the brain, is a uniquely frightening event that threatens both life and independence,” he added. “Our long-term goal is not only to add years to the lives of women with advanced breast cancer, but also to add quality of life to their years.”
When cancer goes viral
Cancer can spread from the place it first started to other places in the body. A tumor formed by these spreading cancer cells is called metastasis.
When cancer metastasizes to other parts of the body, it still has the same type of cancer cells as the first tumor. A cancer that started in the colon and spreads to the liver is still colon cancer, not liver cancer.
Almost all cancers can metastasize. Each kind of cancer tends to spread to certain locations. The most common places cancer spreads are the bones, liver and lungs, but it can also go to the brain and other organs.