“Why did this happen to me?” he asked himself almost every day when it all started. Is oncology patient for 31 years. He had his first breast cancer with only 32. After a disease-free period of 17 years, had a relapse: a tumor in the other breast. Afterwards, she was “free” for another 11 years. But it wasn’t going to stop there: she has been fighting metastasis for seven years. “I am one of those people who has surpassed the average of five years of life”she says proudly Pilar Fernandezpresident of the Spanish Association Metastatic Breast Cancer (AECMM). But not all suffer the same fate. For this reason, he quickly answered the question at the beginning: “It’s your turn, because it’s up to a lot of people, even though you think it will never happen to you.” In 2023, more than 6,500 women died for this disease, on which he wants the focus to be placed, believing that it is relegated to the background.
“If the word cancer produces fear, the word metastasis It is always linked to death, and people tend not to talk too much about things they don’t like,” laments Fernández. He reproaches that attention is always paid to “positive part” of the disease, to healing, and “it has been sweetened a lot.” But the truth is that “having a metastatic breast cancer can make you live many years, it does not have to entail a negative outcome”, says Dr. Soraya Casla, specialist in oncological exercise and director of the Exercise and Cancer centers.
Of the 36,395 new cases of breast cancer which are estimated to be detected in Spain by 2024, close to the 5% will be metastatic, according to the Spanish Society of Medical Oncology. Despite being an incurable disease, medical advances have allowed the average five-year life expectancy to improve, going from 20% to 38% who manage to achieve it. The doctor guarantees that the women she works with usually have a perspective in which “they want to take care of themselves to live as long as possiblein the best possible way.”
At first, it was difficult for him to accept it. “If in addition to having cancer, they tell you that it is metastasis, it is a shockhe emotional impact It is tremendous, above the physical,” says the president of the AECMM. He had to do an intense acceptance exercise for a long time: he knows that he suffers from a incurable illness. It is a continuous management learning: “You get used to living with it, but at first you are disconcerted and very afraid.” Still, he emphasizes that patients should keep in mind that “the word metastasis It is no longer always associated with death”.
And the first phase of accepting that metastatic breast cancer is becoming chronic is followed by keep hope alive and, finally, seek support among equals, so as not to feel alone. “They have to learn to integrate health recommendations and medical monitoringlike other people with chronic diseases that can also be very serious,” explains Casla.
Fernández’s tumor is hormonal, so it is treated every 28 years with a estrogen inhibitor. “I am one of the lucky ones for whom the treatment is lasting a long time,” she says. She lives with the uncertainty of knowing if Is it going to work or not?, or what side effects it will generate. This causes you to “never go back to your normal life because you can’t do the same thing you did.”
This is where the physical exercise. “There are people who now have more treatment than before, but physically they feel better”, emphasizes Dr. Casla. This also has an impact, in her opinion, on an improvement in social and work relationships, given that being and feeling strong helps to cope with the situation. And that’s not all: “We have patients who, thanks to their good physical health, have been able to enter new lines of treatment”, he indicates.
October 18 is Breast Cancer Awareness Day. Just a few days before, October 13, is the Day to Fight Metastatic Breast Cancer. The first is world famous. The second is a victim, in most cases, of ignorance. And this silence endangers the disease awareness and, with this, something that is key to “being able to stop cancer in time and for probability of survival is higher”, assures Casla: early detection and screening. Hence, she considers it important to “remove the fear of the population”, so that, if a woman feels a lump, she goes to the doctor first: “We have to give her a vision.”nothing happens, this is over””.
But the truth is that the B side of breast cancer is not given the attention it deserves. For the doctor, “sometimes the blows are harder because talk about topics you don’t like It is more complicated and social awareness is less.” However, he believes that more and more reference is made to this situation due, above all, to the fact that survival has increased. “It is incurable”says Fernández with integrity. He is aware of it. But also that “thanks to innovation and therapies aimed at precision oncologythe life of metastatic patients is being prolonged well above the average.”
From the AECMM, they ask that research into metastatic breast cancer and innovation in drugs that reduce the harshness of its effects. “We live in the hope that new therapies will appear that allow us to continue living,” they claim. Precisely, a few days ago, hopeful news hit the media: a drug, Trastuzumab deruxtecanwhich works like a Troy Horsehad achieved that more than 67% of patients with metastatic or inoperable breast cancer still alive after three years of treatment.
The treatment of patients with metastatic breast cancer is very diverse, since it is individualized depending on the type of tumor. But it always has something in common, given that it is “very complex” and that, in all cases, the side effects are a reality: fatigue and fat increase, loss of muscle mass, inflammation, the immune system can be reduced, cardiovascular capacity, strength, mobility decrease…
“The illness has changed me in everything,” Fernández confesses. “When cancer enters a house, It destroys everything and does not only affect the patient“, Add. To the treatment of one or two years, we must add the aesthetic reconstruction and the return to normal life, although the process continues for a few years. But this only happens “when you have a normal cancer and you are cured.” The same does not happen with the metastatic. “This is another absolutely different reality, you will never be cured and even the society sees you differently”, laments the president of the AECMM. His life is linked to the hospital. In fact, it has reviews every three months. And for years she has lived with a broken collarbone, she has an immovable arm, pain… Physically, she is more limited.
As it could not be otherwise, this leaves its mark on the patient economysince it can completely affect your career. On many occasions, they are forced to take sick leave or reduce their working hours, or need an adaptation to their job. Fernández was dedicated to the field of labor relations and human resources, but Social Security granted him a inabilityalthough she claims that this should be total: “Many colleagues, in addition to fighting against the disease, have to fight against the administration to obtain the disability”.
Another of the big problems is that “the treatments last longer and longer and, if the side effects are not reduced, they can lead to other diseases,” such as obesity, cardiovascular problems, nervous disorders… Therefore, oncology exercise is fundamental and has a clear objective: “First of all, healing and, if it is not possible, increase survival and make the disease chronic,” argues Casla. This is exactly what manages to reduce side effects, Improve Life Quality of women, and their reintegration and incorporation into family and work life in a “much healthier” way.
The Exercise and Cancer centers give workshops and organize events in different cities in Spain, such as the Women’s Race, with the presence of the #laMquefalta movement, an initiative of the AECMM in collaboration with the Daiichi Sankyo Alliance and AstraZeneca. The purpose is to give visibility to the importance of exercise in physical and mental health of the patients, as well as giving them guidelines so that they can carry out the sports practices in your day to day life. “You have to do sports no matter what, at least move. It is proven that the relationship between this and cancer is fundamental,” says Fernández.
And the main goal of the president of the AECMM remains the same as when she was diagnosed with breast cancer more than three decades ago: “Survive the disease“If I can, for quite a few years.” But it is not about doing it at any price, he wants this to be “with a good quality of life.” For this, it is necessary to invest enough in research and awareness. And, of course, don’t forget that metastasis also exists in breast cancer.