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Is Sonali Bendre's cancer curable?

Last updated on: July 25, 2018 14:44 IST

Making healthy alterations to your diet will help starve cancer cells, suggests oncologist Dr Rakesh Bhade.

Is Sonali Bendre's cancer curable?

Photograph*: Kind courtesy Sonali Bendre*/Instagram

The National Institute of Cancer Prevention and Research, a premier institute under ICMR has estimated that the number of people living with cancer in India is around 2.5 million.

New cancer patients being registered every year is over 7 lakh and cancer-related deaths 5,56,400.

Metastasis is the process by which cancer cells migrate throughout the body.

When this occurs, doctors say the cancer has 'metastasized.' Other names for metastasis are -- metastatic cancer and stage 4 cancer.

It means cancer that has spread to nearby tissues or lymph nodes but not to the entire body.

Causes

Metastasis progresses when cancer cells break away from the main tumor and enter the bloodstream / lymphatic system.

When this occurs the cancer cells can travel away from the original tumor and create more tumors when they settle and grow in a different part of the body.

Any type of cancer can metastasize (spread). This depends on several factors which include:

  • The type of cancer
  • How aggressive it is
  • The duration one has had it before treatment

Cancer in India vs the world

India’s cancer incidence is far lower than developed nations.

For instance, if cancer strikes over 300 out of every 100,000 population in US, the corresponding number in India is around 80.

Cancer manages to get the upper hand in almost 70 per cent of cases in India.

A study in a medical journal, The Lancet, in 2014 indicated only 30 per cent of India's cancer patients survive for over five years.

How is metastasis diagnosed?

If one has had treatment for non-metastatic cancer, there is usually a follow-up care plan for regular tests.

One of the reasons for these tests is to look for any evidence of metastasis.

Cancer may or may not cause symptoms, such as pain or shortness of breath. These symptoms lead a doctor to perform tests to diagnose the presence of metastasis.

Preventing Metastatic Cancer

The spread of cancer is complex and comprises a domino effect of influences which promote an environment for cancer cells to increase.

The four key factors that cause cancer metastasis in the body are:

  • Chronic Inflammation
  • Modified Nrf2 Signaling
  • Secretion of Connective Tissue-Dissolving Enzymes
  • Angiogenesis

The following approaches will help prevent the formation, growth and spread of cancer tumors:

  • Consumption of dietary compounds that inhibit MMP activity and promote detoxification in the body including EGCG found in green tea, resveratrol in dark grapes and berries and turmeric; quercetin found in citrus fruits and apples; sulforaphane concentrated in broccoli and cruciferous veggies.
  • Consumption of nutrients that inhibit inflammatory enzymes and suppress carcinogenic activity such as berberine, luteolin, curcumin, kaempferol, quercetin and apigenin
  • Strengthening the anti-inflammatory mechanisms regulated by Nrf2 signaling with curcumin, resveratrol, green tea extract and sulforaphane.

Conservative cancer screening methods can expose patients to unnecessary radiation and even promote cancer metastasis.

A safer and more accurate form of identifying cancer growth in the body is thermography testing.

The key to preventing chronic inflammation and suppressing cancer growth is to limit foods high in sugar and starch.

Genetically modified grains have flooded the marketplace and fuel cancer growth by supplying a steady flow of glucose.

Rather than feeding cancer, starve it by consuming foods that help maintain low blood sugar levels. These foods include 100 per cent grass-fed meat and raw cheese variants and organic pasture-raised poultry.

Adding low-carb fermented foods and beverages to the diet will help provide an alkalizing environment in your tissue and organs inhibiting the development and spread of cancer.

Metastatic cancer in men

Male breast cancer is very rare. Less than one percent of all breast cancer cases develop in men and only one in a thousand men will ever be diagnosed with breast cancer.

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola.

Stage IV 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.

Treatment for metastasis depends on:

  • Where the original cancer started
  • How much the cancer has spread and where it is located
  • Age and health of the patient

Usually doctors might try one type of chemotherapy, and then shift to another when it no longer works. Alternately there might be a combination of treatments ― chemotherapy, radiation, surgery to remove the metastases.

Treatment options

The main treatments for metastasis include the following:

Treatment that affects the entire body and that includes chemotherapy and other medications, such as targeted therapy, hormone therapy and biologic treatment.

Treatment for the area with cancer is called ‘local’ therapy and it includes surgery and radiation therapy.

Hormone receptor-positive cancers:

Women with hormone receptor-positive (ER-positive or PR-positive) cancers are often treated first with hormone therapy (tamoxifen or an aromatase inhibitor).

This may be combined with a targeted drug such as palbociclib (Ibrance), ribociclib (Kisqali), abemaciclib (Verzenio), or everolimus (Afinitor).

Hormone receptor-negative cancers:

Chemo is the main treatment for women with hormone receptor-negative (ER-negative and PR-negative) cancers, as hormone therapy isn’t helpful for these cancers.

HER2-positive cancers:

Trastuzumab (Herceptin) may help women with HER2-positive cancers live longer if it’s given along with chemo or with other medications such as hormonal therapy or other anti-HER2 drugs.

Pertuzumab (Perjeta), another targeted drug, might be added as well. Another option is the targeted drug ado-trastuzumab emtansine (Kadcyla), which is given alone or with lapatinib.

HER2-negative cancers in women with a BRCA gene mutation:

These women are typically treated with chemotherapy (and hormone therapy, if the cancer is hormone receptor-positive).

An option after getting chemo is treatment with a targeted drug called a PARP inhibitor, such as olaparib (Lynparza).

Treatment often continues until the cancer starts growing again or until side effects become unacceptable. If this happens, other drugs might be tried.

Local or regional treatments for stage IV breast cancer:

Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well.

These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.

Radiation therapy and/or surgery may also be used in certain situations, such as:

  • When the breast tumor is causing an open wound in the breast (or chest)
  • To treat a small number of metastases in a certain area, such as the brain
  • To help prevent bone fractures
  • When an area of cancer spread is pressing on the spinal cord
  • To treat a blood vessel blockage in the liver
  • To provide relief of pain or other symptoms

In some cases, regional chemo (where drugs are delivered directly into a certain area, such as into the fluid around the brain and spinal cord) may be useful as well.

Relieving symptoms of advanced breast cancer

Treatment to relieve symptoms depends on where the cancer has spread.

For example, pain from bone metastases may be treated with radiation therapy, drugs called bisphosphonates such as pamidronate (Aredia) or zoledronic acid (Zometa), or the drug denosumab (Xgeva).

In the past, people who were diagnosed with metastatic cancer did not live long.

Even with today's better treatments, recovery is not always possible, nor guaranteed.

But doctors can often treat cancer even if they cannot completely cure it. A good quality of life is possible for months or even years.

Lead image used for representational purposes only.

The author Dr Rakesh Bhade is oncologist surgeon at K J Somaiya Super Specialty Hospital, Mumbai.

Dr Rakesh Bhade