Breast Cancer is Recurrent, Not Chronic - And the Distinction Matters
By Christine Cupaiuolo — November 12, 2008
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Barbara A. Brenner
As everyone familiar with breast cancer knows, there is no available cure for metastatic breast cancer (breast cancer that has spread beyond the breast to life-sustaining organs). In fact, metastatic breast cancer will kill a woman who has it unless something else kills her first.
The good news is that some treatments can extend the lives of some women with metastatic disease, and additional treatments are available that may keep metastatic breast cancer from advancing, at least for a period of time. These treatments are not without side effects, however –- some of them devastating.
What I find most interesting about this moment is that advances in treatment have led the cancer industry — the oncology community, the pharmaceutical and biotech industries, and the big cancer charities — to begin to talk of breast cancer as a “chronic disease.” While this might be seen as a positive trend, reflecting the fact that some people with breast cancer are living longer, the use of the term “chronic” conveys a misguided attitude about the deadly disease.
The term “chronic” has many meanings. Consider how Wikipedia defines it:
A chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development. A chronic course is distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between.
By this definition, metastatic breast cancer is recurrent, not chronic. While this might seem like an academic dispute, it isn’t. Using the term chronic implies that breast cancer is a manageable disease, and downplays the reality that it is far too often fatal. It also diminishes the fact that we are in desperate need of better treatments.
Breast cancer is also sometimes referred to as a chronic disease because the risk of recurrence never completely disappears. Women with early stage disease are followed in medical care for long periods of time (sometimes for as long as they live, even though they may well live a long life and die without a breast cancer recurrence).
In this context, the push to view breast cancer as a chronic disease seems to be an effort by the cancer establishment to turn attention away from the fact that there are still millions of women diagnosed with breast cancer every year. Urging the public to accept the notion of early breast cancer as a chronic disease undermines the demand for true breast cancer prevention.
How we think and talk about breast cancer and other cancers clearly has implications for how we address the disease. We all need to move beyond accepting the notion of breast cancer as a chronic disease if we are to have any hope of truly ending the epidemic.
Barbara Brenner is the executive director of Breast Cancer Action. More on BCA’s view of cancer policy issues can be found here.