Stage Four Breast Cancer Treatment, Surgeons Perspective – Dr. Jay K. Harness

Stage Four Breast Cancer Treatment, Surgeons Perspective – Dr. Jay K. Harness


Dr Jay K. Harness:>>>I see a lot of patients
back as part of my routine followup of them for treatment of breast cancer. Typically,
I see patients twice a year roughly every six months and I always wanted to see them
when they are back for their annual mammograms. Now obviously as I am following patients over
a long period of time, there are going to be patients of mine who are going to progress
on to stage IV breast cancer. Stage IV breast cancer is unfortunately not curable however,
that does not mean that it is not treatable and so from my perspective as a surgeon, what
are the goals here? What do I want to see happen to my patients who have now progressed
on to stage IV? Clearly I am going to be working with my team and I will be working with my
medical oncologists and my radiation therapist. It depends at what point and where they are,
what is the definition of stage IV? Is it spread to the bone? Is it spread to lungs,
liver, and brain and so our goals clearly are to deal with the specifics of the progression
of a cancer on the stage IV. The goal of here is to slow the process down.
This is not a process that I would consider to be completely hopeless and we are towel
on because I will share with you, I had many patients over the years who have had quite
stable stage IV disease. Typically this is stage IV disease that is limited, let say
as an example to a thoracic spine, one spot to a pelvis or things of that sort and the
medical oncologist know exactly what they are doing as far as the need of antiestrogen
therapy or drugs like Zometa or the other they can do. Now part of our goal in the treatment of stage
IV breast cancer is clearly to relieve the pain and to relieve symptoms that affect quality
of life, obviously are life threatening for that matter. So radiation therapy may be needed
to isolated areas of bony metastases. A single metastasis to the brain surgically is typically
removed followed by either focussed or whole brain radiation therapy. There are instances where we have a single
metastasis to the liver that can be treated by an ablative therapy, so the circumstances
are highly variable. The goal here is always pain relief, the goal is to get the stage
IV disease under control, the goal is to try and make it a chronic state. One of the things that I envisioning in the
future and now in the treatment of breast cancer is if we go to stage IV that we put
the patient into the chronic disease state, like we do with diabetes or other diseases
so that things can be followed over a longer period of time. We obviously want to maximise what we know
today because who knows what is down the road in the future treatment of stage IV breast
cancer. So the bottom-line is here, please be working with your multidisciplinary team,
please be asking questions about are there new protocols out. Please be asking for the
state‑of‑the-art treatment as we know it today, but hang in there, new things are
coming, let us work together on the treatment of your stage IV disease. Hi, I am Dr. Jay Harness and I want to share
with you an important information that I believe that every newly diagnosed patient with breast
cancer needs to know. Susan Denver: I am a breast cancer survivor. Katherine Stockton: I am a breast cancer survivor. Coree: I am a breast cancer survivor. Susan Denver: And I want every woman to know… Katherine Stockton: …about personalized
breast cancer treatment… Susan Denver: …and the Genomic Test. Coree: A test that helps guide a woman and
her doctor… Katherine Stockton: …to the best treatment
options for her. Susan Denver: Pass it on!

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