Understanding Metastatic Breast Cancer & Research

Guest post by Cheryl JerniganCPA, FACHE, Komen Scientific Advisory Board Member and Advocate in Science Steering Committee Member 

Komen Kansas City’s June 18th webinar offered both sobering and hopeful information, which was all too real for many of us.  Monday morning, we lost a dear friend, Lisa Covington, to metastatic breast cancer. Her inspiring, often painful 13-year battle with metastatic cancer fuels our determination to stop breast cancer, especially the “Big M!”

But as we learned from Komen Scholar Dr. Danny Welch, that’s far from easy.

I’ll start the story where Dr. Welch ended it…with a call to action!

Living with the “Big M” can feel lonely at times. People with metastases live like they are waiting for the other shoe to drop. Often, family, physicians, and employers treat them differently. Few people want to talk about the “Big M;” even fewer really understand it.

For the Lisa’s of the world, we need to tear down any stigma and bring metastatic cancer out of the dark ages, much like Betty Ford and Nancy Brinker have done for breast cancer!

Metastatic cancer causes over 90% of cancer deaths. Yet it is estimated that less than 5% of cancer funding focuses on metastasis.

The complex, evolving nature of metastatic cancer cells, drives part of this lack of funding.  Metastatic cells acquire and continually evolve characteristics they didn’t have before, allowing them to multiply, travel and set up camp in other parts of our body.

They are adaptive in breaking through, and sometimes even co-opting, our body’s many defensive systems in their quest to grow and travel.  Some will move in clusters, like a pack of teenagers, while some prefer to act alone. Others act like Houdini – able to squeeze through small spaces.  Then there are the Star Trek-like cells that pass through other cells, beaming themselves from one location to another.

What’s even more frightening is a tumor smaller than a pencil’s eraser will shed 1-4 million cells into our body every day, leading some to believe that once the horse is out of the barn, it’s virtually impossible to control it.

Fortunately, Dr. Welch and other dedicated researchers don’t believe that!

Scientists estimate that less than 0.01% of cancer cells become metastatic.  So millions of cancer cells invade and get into our blood stream.  BUT few survive!

The hallmarks of metastatic cells are their ability to:

-Invade the body (i.e., break away from the original tumor site(s), like the breast),

-Survive (i.e., avoid being killed by our body’s own natural defense systems and manmade treatments, and find resources to fuel its growth),

-Establish “camp” in other parts of the body, AND

-Colonize (i.e., grow a family of like-minded tumor cells that take over the “campsite(s)”, often in our bones, liver, brain, etc.).

The “good news” is that metastatic cancer cells have to be able to do ALL four, and that’s not easy.

Some genes have been found that promote, or won’t suppress, metastatic breast cancer.  Research is also looking for genes that will stop or halt cancer. For a cell to metastasize, all the critical genes must be present and their “expression” (i.e., functioning with each other) coordinated.  If we can knockout one of these key genes, it could halt metastasis’ deadly threat.

Dr. Welch’s research, funded in part by Komen, is exploring two excitingly hopeful avenues to halt metastasis and discover information to more precisely identify whose tumors and genetic factors put them at high risk for metastasis.  His research is focusing on:

-A gene (KISS1) that research indicates can block a tumor cell’s ability to “colonize.”

-Mitochondria (the structures within our cells that convert energy from food into a form cells can use to function and grow) and their role in enabling a cell’s metastasis.  This could potentially identify who is predisposed to developing metastatic cancer.

As Dr. Welch continues his important contributions to solving one of the most difficult puzzles in breast cancer, there are ways we can all take steps toward a future without breast cancer:

-Increase awareness and understanding about metastatic breast cancer.

-Invest in research to end metastatic cancer’s death toll. Komen has invested more than $91 million since 2006

Onsite at the webinar: Lori Maris, Managing Director, Komen Affiliate Network; Cheryl Jernigan, advocate member, Komen Scientific Advisory Board & Komen KC Board member; Danny Welch, Ph.D., Komen Scholar & The University of Kansas (KU) Cancer Center Chair, Dept. of Cancer Biology; Nikki Cheng, Ph.D., Komen-funded researcher & Assistant Professor, KU Division of Cancer and Developmental Biology; & Carli Good, Executive Director of Komen Kansas City.

-Collaborate with other organizations to ask the hard questions. Komen is proud to be a founding member of the Metastatic Breast Cancer Alliance – a group of 19 non-profit organizations and five pharmaceutical industry partners with the vision of transforming and improving the lives of women and men living with metastatic breast cancer.

Across the country, local programs funded by events like your local Race for the Cure, are helping women and men living with metastatic breast cancer – offering financial assistance, access to resources and, sometimes most importantly, support.

As a member of Komen’s Scientific Advisory Board, the Komen Advocates in Science Steering Committee, a long-time, passionate breast cancer advocate and a survivor, I am excited to be a part of an organization committed to ending ALL breast cancer. Komen will not shy away from this complicated question.  For the sake of those living with metastatic disease and everyone who has ever been touched by breast cancer, please join us in our mission to end this disease once and for all!

If you’d like to listen to the webinar or view the slides, click here.

About the author

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Susan G. Komen has written 281 articles for Susan G. Komen® | Blog

Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything in her power to end breast cancer forever. In 1982, that promise became Susan G. Komen and launched the global breast cancer movement. Today, Komen is the world’s largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure®, we have invested more than $1.9 billion to fulfill our promise, becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world.