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Cancer – Stage 4

February 1, 2021


“Now stage four is considered a metastatic cancer. And that usually means that, and I say usually because the rules are a little different when it comes to blood cancers, but in solid cancers, meaning pancreas, lung, and breast, stage four means it has left the primary site where it originated. So if it originated in the breast, it originated in the colon, it has now gone to a different organ. And in this case it could be the liver or the lungs or the bone. And when that happens, say a breast cancer went to the bone, you don’t have bone cancer. Now you just have breast cancer that went to the bone. And that’s an important distinction. Now, before, we used to consider stage four just pretty much blankly incurable. This is not something that can be cured. What we’ve found over the last several years is even though it is stage four and it’s spread, we cross our fingers.

And in not a small amount of instances, people do seem to have long survivals, and in some cases be technically cured. And it just depends on how many places it’s gone, the cancer type that it is and were those able to be removed. So in colon cancer, we’re finding pretty high survival rates. Even if the cancer has gone to the liver, say in one place, by cutting out that part of the liver as well, as well as the colon. And up to 40% of people five years out still have no disease. So one thing I see in Louisiana is when somebody says, oh, dad or mom has stage four cancer, or it’s spread to the other parts, it’s incurable. Sometimes a reflex feeling is to say, well, then why biopsy and why treat if they won’t be cured of it.

And with how we have treatments and therapies now, it’s just too complex to be able to at least not have a conversation with your oncologist, because depending on the tumor type, you can have survivals of years with little disease in a stage four setting, as well as curative. One example of a curative stage four setting is sometimes we consider in certain cancers, brain mets, or brain metastases, has still abled to pursue curative measures, say in lung cancer. If you have one spot in your brain that they can deliver radiation with minimal side effects, we can still undergo curative measures for that place in your lung that the cancer is. Because the studies show people still have long survivals. So stage four means different things to different people. And it’s definitely worth having a conversation to know how treatable it is.”

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