Both Edwards and her husband were upbeat and said they would continue campaigning. She said she is "completely symptom-free." He likened her cancer to diabetes -- an incurable but treatable disease.In the Edwards's news conference, Elizabeth did as one might expect someone in her situation to do, which is to bank on being among the minority who survive many years with breast cancer that has, according to reports, spread not just to her bones but possibly to her lungs, as well. The couple's optimism and grace before the cameras while laying out the new diagnosis were admirable and will likely serve as an inspiration to others facing similar conditions for years to come. And of course there are medicines that can help stem the growth of the cancer, strengthen her bones, and otherwise relieve symptoms. Historical statistics can't take the impact of those new medicines into account, and population statistics can tell us nothing about an individual's prognosis. But still, Washington Post writer Brown, assigned the task of offering an objective clinical report on what the condition is, has offered the only piece I've seen that's simply laid out the facts for readers, rather than tread delicately around the situation. Any commenter who says they can lay out a specific prognosis for Edwards based on the incomplete picture of her condition presented -- she's still undergoing tests, after all -- is just speculating, but papers owe it to their readers to provide them with a clear picture of what stage IV breast cancer is, however disheartening the facts may be.Data suggest, however, that her long-term prognosis is considerably graver than for people with diabetes and other chronic diseases.
A study published last year in the European Journal of Surgical Oncology reviewed the experience of 2,500 women treated at a large hospital in Sydney between 1989 and 2002. Of that group, 18 percent had a recurrence of their breast cancer, and the average time to recurrence was 2.3 years, slightly shorter than Edwards's. The most common site of relapse was bone, as was hers.
Among women with recurrences outside the originally affected breast or its nearby lymph nodes, only 13 percent survived five years or more. Women whose tumor reappeared in bone had a median survival of 2.4 years, longer than those in whom the tumor came back in either the lungs or liver....
A statement by Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said survival statistics for women whose cancer was widely spread at the time of original diagnosis "has no meaning in Ms. Edwards' case and should not be interpreted as a suggestion of her survival chances."
However, it is unlikely her prognosis would be better than those women, among whom 24 percent were alive five years after original diagnosis, and 13 percent were alive after 10 years.
Also, from a purely medical perspective, anything that helps a woman with breast cancer stave off depression and feel socially connected and valuable and alive is beneficial for her survival, since depression and social isolation have been pretty well documented to hasten disease progression. Given their temperaments, it appears that staying in the race is clearly the best way forward for Edwardses during this difficult time. To give up their dreams now would be a concession to the disease, instead of an effort to fight against it, and to live with it, as long as Elizabeth can. Andrew Sullivan, who knows what it means to live with an incurable but treatable condition, writes, "One key to surviving serious illness is to live positively and candidly while you treat it." Many women with breast cancer have stayed active, productive, engaged members of their professions until the bitter end, and there's not reason Edwards can't, too. The much missed Molly Ivins, for example, was diagnosed with breast cancer in 1999 and had two recurrences of the disease before passing away this January. It doesn't make any more sense to suggest that Elizabeth give up her work as her husband's political adviser -- or that he give up what are clearly their joint ambitions for his future -- than it would be to say that Ivins should have stopped writing and fighting four years ago, when she had her first recurrence. Ivins raised hell and made a difference even after being terribly weakened by her second recurrence, and there's no reason Edwards can't do so, too.
--Garance Franke-Ruta
