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Stage 4 Cancer

Stage 4, Stage IV metastatic cancer

“Metastases cancer” or stage 4 cancer, is the medical term for describing a condition where a tumor originating in a certain organ, “primary tumor”, is identified in another organ or in a distant location from the original organ, e.g., metastases of breast cancer can be found in the lungs, brain, bones and liver.

It is important to note, metastases are the same type of the original primary tumor, even if its location is in distant organs and so are the treatments regarded as such, for example, a treatment for a metastatic lung cancer that has spread to the liver, is determined by the treatment for metastatic lung cancer and not by the treatment for liver cancer.

Metastases formation

Cancer cells of the primary tumor can be released into the bloodstream and lymphatic system and circulate to distant organs or adjacent organs and tissues to the primary tumor and “settle” in them and grow.

There are different types of cancer which is known where metastases can be formed, for example,

  • Breast cancer can spread to the bones, brain, liver and lungs
  • Lung cancer can spread to the brain, bones, liver and kidney
  • Prostate cancer can spread to the bones
  • Colon cancer, rectal cancer, colorectal cancer can spread to the liver and lungs
Breast cancer can spread to the bones, brain, liver and lungs
Breast cancer can spread to the bones, brain, liver and lungs

Stage IV metastatic cancer and recovery

In the vast majority of the metastatic cases, the treatments do not cure. Treatment goals are slowing tumor growth rate, prolonging life and reducing the symptoms of the disease, improving the quality of life of the patient.

The efficacy of the treatments is affected by many factors, among them are the type of cancer, number of metastases (also called “lesions”) and their location, how much cancer the patient has in his or her body, growth rate of the tumor lesions, medical history of the patient, background diseases, microenvironment between the tumor cells themselves, resistance the tumor has developed to previous treatments and other.

Advanced treatments and clinical trials for stage 4

The National Cancer Institute (NCI) highlights the fact that for a certain group of metastatic cancer patients, the best treatment option is to join one of the many clinical trials existing worldwide aiming to increase their chances of therapeutic success.

This is also recommended by the USA national comprehensive cancer network, NCCN,  (USA national comprehensive cancer network)

“Patients with cancer should be encouraged to participate in clinical trials during all aspects of their diagnosis and treatment”

Currently, every patient will be offered the standard protocols described above. Sometimes the oncologist may suggest integrating these therapies with trials carried out in the Institute.

Advances in cancer therapies may be found in clinical trials prescribing cutting edge, interesting drugs, some of which have already been recognized by the FDA (US Food & Drug Administration) as “breakthrough treatments” and require further information input before being finally and fully approved.

An entire world of clinical trials and compassionate drugs and treatments are open and available worldwide. It is important to know which cutting edge treatments exist which patients can gain far more from them than the standard care offered.

For most patients with stage 4 metastatic cancer, current treatments are insufficiently effective. This gives rise to the need for innovative strategies with greater efficacy in fighting the disease.

Read our publications on innovative treatments for stage 4 metastatic cancer:

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Faslodex + Capivasertib vs Placebo in Metastatic, ER positive Breast Cancer

Published February 5, 2020

Background

Capivasertib (AZD5363) is an oral inhibitor of AKT and by that it influences cell division, apoptosis and cell metabolism. The FAKTION study investigated whether the addition of Capivasertib to Faslodex prolonged the time until disease progression in metastatic or locally advanced inoperable breast cancer patients who failed and developed resistant to Aromatase Inhibitors, such as Arimidex, Femara and Tamoxifen.

Methods

This clinical trial, The FAKTION study, was a Phase II trial and recruited breast cancer patients from 19 hospitals in the UK. Enrolled participants were randomly assigned (1:1) to receive Faslodex with either Capivasertib or Placebo, orally twice daily.

Findings

Median time until disease progression was 10·3 months in the Capivasertib group versus 4·8 months in the placebo group and the risk of disease progression had decreased by 42% in the Capivasertib group.

Adverse Events

The most common adverse events in the Capivasertib group were hypertension, diarrhoea, rash, infection and fatigu.

Serious adverse reactions occurred only in the Capivasertib group and were acute kidney injury, diarrhoea, rash, hyperglycaemia, loss of consciousness, sepsis and vomiting. One death, due to atypical pulmonary infection, was assessed as possibly related to Capivasertib treatment. One further death in the Capivasertib group had an unknown cause.

Conclusion

The addition of Capivasertib to Faslodexwas associated with a significant median prolongation of the time until the disease had progressed 10.3 vs 4.8 months compared with Faslodex alone.

The best treatment for a cancer patient is to get the most advanced cancer drugs in advanced stages of development. There, the hope and the chance to extend life go far beyond the standard protocols.

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About Breast Cancer

One out of seven women will develop breast cancer sometime throughout her life. Approx. 1% of all breast cancer cases appear in men.

Breast cancer is diagnosed following taking a biopsy or removal of cells from the afflicted tissue during surgery and diagnostic analysis.

Early detection affects the disease treatment plan and also treatment success.

The existing therapies used for stage 4 metastatic breast cancer are not curative, and this is a source of the need for innovative and effective treatment strategies in order to fight the disease.

The National Cancer Institute, NCI, highlights the fact that for a certain group of breast cancer patients, the best treatment option is to join one of the many clinical trials existing worldwide aiming to increase their chances of therapeutic success.

Classification

The disease is classified according to the breast cells from which it develops. In most cases the source is the epithelial cells in the breast tissue, thus the disease is called “Adenoarcinoma”.

In some cases, the disease develops in the milk ducts which transfer milk from the glands to the nipples (milk ducts or the milk ducts that produce milk, lobules).

The disease can be local, locally spread or metastatic, which is also called “Stage 4”.

Types of breast cancer

Breast cancer is classified according to the type of receptors found on the cell. A “receptor” is a molecule located on the external shell of the cancerous cell to which ligands bind. A “ligand” is a molecule smaller than the receptor that triggers intracellular biological processes including proliferation and survival processes of the cancerous cells.

  • HER2 positive
  • Hormone positive
  • Triple Negative Breast Cancer
  • Triple Positive Breast Cancer
  • Inflammatory breast cancer
  • Metaplastic breast cancer
  • Breast cancer among men
  • Stage 4 metastatic breast cancer

Stage 4 breast cancer

Stage 4 metastatic breast cancer is a cancer that started in the breast and its cells have spread to other body organs, distant from the breast, and created new lesions. These lesions are called “metastases” and are made of breast cancer cells.

Breast cancer metastases may appear in the bones, liver, lungs and brain. The formation of metastases constitutes a threat on life.

Even though the cancer has spread to other organs, it is still defined as a breast cancer and is treated as breast cancer. In this manner for example, a lesion in the lung that is a metastasis of breast cancer shall be treated with breast cancer drugs and not lung cancer drugs.

Breast cancer metastases may appear in the bones, liver, lungs and brain

Symptoms

  • A lump in the breast that is palpable
  • A swelling of the breast or the armpit area
  • A change in the breast appearance or a drop of the breast
  • Reddish, inflamed and rough looking (“orange peel” texture) or irritated breast skin
  • The nipple is enlarged, bleeding, swollen, inflamed or retreating in

Facts

The existing therapies used on stage 4 metastatic breast cancer are not curative, and this is a source to the need for innovative and effective treatment strategies in order to fight the disease.

The National Cancer Institute, NCI, highlights the fact that for a certain group of breast cancer patients, the best treatment option is to join one of the many clinical trials existing worldwide aiming to increase their chances of therapeutic success.

Currently, every patient will be offered the standard protocols described above. Sometimes the oncologist may suggest integrating these therapies with trials carried out in the institute.

 

#cancer #breastcancer

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