The Importance of Maintenance for Breast Cancer
- Actress and breast cancer warrior Shannen Doherty, 50, recently shared a photo of herself at an early-morning doctor's visit for scans, highlighting the importance of maintenance for fellow cancer warriors and survivors.
- As someone with stage 4, or metastatic, breast cancer, Doherty needs to have scans every few months to monitor her disease and make sure it doesn't spread further than it already has.
- Regardless of the type of breast cancer you have, the National Comprehensive Cancer Network recommends routine monitoring for all metastatic breast cancer patients.
- Monitoring includes physical exams, blood tests, imaging scans and tumor testing, if needed. These monitoring methods are used to see if a patient's cancer is responding to treatment, is stable or is progressing.
"Early morning doctors visit for scans," she posted to Instagram on Friday. "Blurry eyed. Hair askew but the new bandage wraps made me smile! #cancerslayer."
Read MoreView this post on Instagram
Stage 4, or metastatic, cancers have spread beyond the breast and nearby lymph nodes to other parts of the body. When breast cancer spreads, it most commonly goes to the bones, liver and lungs. It may also spread to the brain or other organs. It remains unknown where exactly in Doherty's body her breast cancer may have spread.
However, Dr. Julie Nangia, an assistant professor of medicine at Baylor College of Medicine and the director of the Breast Cancer Prevention High-Risk Clinic, previously told SurvivorNet: "When breast cancer comes back, the most common place for breast cancer to come back is in the bones, and the most common symptom women have is either pain or a fracture when that happens."
Doherty explained that before receiving her metastasis breast cancer diagnosis (after she had already gone into remission for breast cancer in 2017), she "started feeling some very odd aches."
The Importance of Maintenance for Breast Cancer
Whether you're a cancer warrior (still fighting) like Shannen Doherty or a survivor, keeping up with routine monitoring is extremely important.
Regardless of the type of breast cancer you have (it remains unknown what type Doherty's cancer is), the National Comprehensive Cancer Network recommends routine monitoring for all metastatic breast cancer patients. (NCCN is an alliance of 31 cancer centers in the United States, most of which the National Cancer Institute has designated as comprehensive cancer centers.)
Monitoring includes physical exams, blood tests, imaging scans and tumor testing, if needed. These monitoring methods are used to see if a patient's cancer is responding to treatment, is stable or is progressing.
NCCN doesn't specify how often patients should get scans; that decision is made in collaboration with the patient's doctor, however, routine monitoring check-ups are typically done every three to six months. This is something SurvivorNet experts recommend, as well.
As previously mentioned, the most common place for breast cancer to come back is in the bones. To monitor bone metastasis is "actually pretty difficult on imaging," Dr. Nangia explained.
When Breast Cancer Spreads to the Bones
"So you can get serial bone scans every three months along with CT scans," she continued. "But the number one symptom that has really been shown to show if bone metastases are growing or not is how the patient feels. So if a woman is developing new pain (like Doherty) in their bones, it could be a sign that the cancer is starting to grow."
Dr. Nangia told SurvivorNet that the question she gets asked the most once patients finish treatment is: "Now what?"
"When we watch women after their treatments to look for if the cancer comes back or not, we don't do any type of specific scans," she explained. "So CT scans, bone scans, tumor markers they're not indicated for looking for recurrence in breast cancer. What we're looking for are new symptoms that last for two weeks or more."
"The reason we picked that timeline is (because) normal things happen to normal people," Dr. Nangia added.
She said she isn't talking about someone lifting a body and straining a muscle in their back that's normal pain.
"But most normal things will be getting better by two weeks," she said. "So if you have had a history of breast cancer and you have new symptoms, whatever they may be, if they've lasted more than two weeks, you really need to go to your regular doctor to see if that's something you should be concerned about or need extra tests to work up."
Shannen Doherty's Cancer Battle
Shannen Doherty's battle with breast cancer dates back to 2015, which is when she was first diagnosed with the disease; a lump was found in her breast, and it turned out to be malignant (cancerous).
Metastatic Breast Cancer: You Are Not a Statistic
To fight the cancer, she underwent hormone therapy, but the treatments were ineffective; the cancer had spread to her lymph nodes.
In May 2016, the actress underwent a single mastectomy surgery to remove a breast; she also had chemotherapy and radiation treatments. Then, about a year after she finished radiation treatment, Doherty underwent breast reconstructive surgery.
Then, in 2017, Doherty shared that her cancer had gone into remission.
View this post on Instagram
"What does remission mean? I heard that word and have no idea how to react. Good news? YES. Overwhelming. YES. Now more waiting," she posted to Instagram in April 2017. "As every single one of my fellow cancer family knows, the next five years is crucial. Recurrences happen all the time."
Unfortunately, that's exactly what happened to Shannen Doherty. In February 2020, she announced that her cancer had returned, and it had spread to other parts of her body. This is stage 4 cancer, also known as metastatic disease. The cancer had come back the year prior, in 2019, but she wasn't ready to share the news at the time.
After @DohertyShannen revealed her battle with stage four breast cancer, the actress explained in an exclusive interview with @arobach why she waited so long to tell the world. https://t.co/eWEIxwNTJO pic.twitter.com/tSltB2OCyl
Good Morning America (@GMA) February 5, 2020
Once the world knew of her metastatic breast cancer diagnosis, she told fellow breast cancer survivor and ABC's Good Morning America host Amy Robach: "I don't think I've processed it. It's a bitter pill to swallow in a lot of ways."
But since her breast cancer recurrence, Doherty has made it a point to stay positive and be a "beacon of light" for everyone, especially those fighting breast cancer alongside her.
Learn more about SurvivorNet's rigorous medical review process.
