As we wrap up Breast Cancer Awareness month, it’s worth noting that during our grandmothers’ lifetimes, real, significant progress has been made against this group of diseases: it’s no longer the death sentence it once was.
An MD Anderson Cancer Center study of more than 12,000 women demonstrated that in the past sixty years, the number of women who survive ten years after a breast cancer diagnosis has tripled, from just 25 percent in 1944-1954 to more than 76 percent in 2004.
And because of the increase in early screening and routine mammography, as well as astonishing breakthroughs in genetic testing and novel therapies that are using the immune system and other targeted treatments to take down even late-stage cancers, today’s news is even better. A 2014 study of more than 189,000 women who had been diagnosed with early-stage breast cancer (the kind most commonly detected on routine mammograms) found an average ten-year survival rate between 79.9 percent and 83.2 percent; there was no statistically significant difference in outcomes among women who had chosen lumpectomy and radiation, single mastectomy, or double-mastectomy as their initial cancer treatment.
Living with Breast Cancer: What to Expect
But—and this is a critical but—nobody is a statistic.
And no two women (or men, for that matter) have the same experience of breast cancer.
A breast cancer diagnosis, like all serious illnesses, is a sudden, reality-shifting and often isolating moment. The day before, life was full of taxing but normal challenges—everyday stresses like work and family demands, keeping up with social commitments, juggling competing priorities and financial issues. Then there’s the abnormal mammogram, and an initial biopsy, and in a matter of seconds, everything’s changed.
Suddenly you’re faced with a world of unfamiliar medical terminology and a confusing, dizzying array of options and decisions to be made. You may learn for the very first time that there isn’t just one type of breast cancer; there are non-invasive and invasive forms, and cancers that start in the milk ducts or the lobules of the breast. You discover there aren’t just different stages of breast cancer, but different grades of cancer cells, as well. If your surgery is operable, you’ll become conversant in the language of pathology reports—how to interpret what they say about surgical margins, and the presence or absence of cancer cells in lymph nodes and blood vessels.
Most of all, as you wait for the full diagnostic picture to emerge and continue to work with your team of medical professionals, you’ll discover that nobody except you is the best, final expert about what you’re going through—physically, spiritually, and emotionally. Even before traditional treatments like chemotherapy or radiation start, patients may find medical cannabis helpful for managing anxiety, stress, and insomnia during weeks of uncertainty as biopsies, lab test results, and pathology reports trickle in.
The Physical, Emotional and Psychological Aspects of Living with Breast Cancer
The vocabulary of living with and through breast cancer (to “survivorship,”) often sounds as if it were ripped straight out of a Spaghetti Western script—fights, battles, survivors, winning, heroes.
But such language doesn’t necessarily sit well with everybody who’s gone through a cancer journey. The Dana-Farber Institute asked a focus group of young people to sound off about this and got thoughtful, complex replies:
“I feel like the term survivor is so confusing,” remarked one young adult. “Dying isn’t losing; cancer isn’t a game.”
These terms become even more complicated for those with cancers considered to be chronic, or for individuals whose cancer was cured or has gone into remission, but who still feel the emotional impact of the cancer experience.
Mary Elizabeth Williams, whose recovery from Stage IV melanoma was highlighted in our blog about the Cancer Moonshot, is frank in a post-treatment blog about the fact that cancer is, psychologically and emotionally speaking, the gift that keeps on giving, even after all physical traces have disappeared. And she’s among those uncomfortable with the finite language of “survivorship” to describe a disease that never really goes away.
Cancer is so often served up as a thing to be “survived,” through pluck and positivity, that the difficult and long-term effects of it are conspicuously shushed. “Survivors” are supposed to be happy and hopeful and physically strong…Yet I often feel like a fraud when I’m included in “survivor” events, because with cancer, it’s hard to ever stop waiting for the other shoe to drop…It’s tough. So I cringe when people in the media automatically call people who’ve gone through cancer “brave” or “strong,” because while that’s nice, plenty of us have simply been doing what we’ve had to to live, with no particular nobility attached to showing up for doctor appointments…I am emotionally and physically wrung out…We can be hopeful while being afraid of recurrence. And we can live every day knowing that…“The disease doesn’t go away after it’s cured.”
Even months and years after treatment, life after cancer is never the same as life before cancer. There may be physical changes to deal with, such as fatigue, pain, and neuropathy. During and after treatment, these symptoms may require palliative care. And then there are very real, potentially long-lasting psychological and emotional reactions, ranging from depression and ongoing anxiety about a recurrence to full-blown medical PTSD related to the cancer experience. And the evidence is clear: medical cannabis can help those who are living with cancer, or survivors (whichever term they want to use) manage these conditions.
But Can Cannabis Actually Treat Breast Cancer?
Beyond the irrefutable evidence for symptom abatement and management, Cannabinoids: A New Hope for Breast Cancer Therapy? offers an intriguing and comprehensive review of preclinical basic and animal research. The overall conclusion supports the reasonable inclusion of medical cannabis in the Cancer Moonshot: cannabinoid-based medicines may eventually become an additional safe and effective treatment for most breast tumor subtypes.
CBD’s properties which suggest its potential effectiveness as a treatment, not simply a symptom-relief aid, are:
- Anti-proliferative: CBD to reduce the number of active tumor cells.
- Pro-apoptotic: Apoptosis is the normal “programmed self-destruction” of cells with damaged DNA—like cancer cells. CBD appears to spur this activity.
- Anti-migratory: In early research, CBD seems to inhibit the spread of cancer cells from the primary tumor site to form metastases.
- Anti-invasive: Research in mice has suggested CBD limits the rate and extent of invasion of cancer cells from the primary tumor into surrounding healthy cells.
- Anti-angiogenetic: Simply put, CBDs seem to inhibit the growth of blood vessels that feed tumors—by multiple
- Anti-metastatic: CBD has shown promise in reducing the spread of cancer to other parts of the body—metastases.
As the Cancer Moonshot should open the door for unbiased science to study the anti-cancer properties of not only CBD, but also TCH (and perhaps even compounds in cannabis that have not yet been isolated), we remain optimistic.
Overall, as we bid farewell to another Breast Cancer Awareness Month, our message to patients, their friends and families is one of hope. Know your options; be your own, best advocate; understand your journey in the terms that make you feel the most comfortable and powerful; embrace all the treatments, therapies, and support you need to help you keep walking forward, from the day of your diagnosis through every day afterward.