Treating certain metastatic tumors may prevent the spread of breast, other cancers

Cancer that has spread from the site of an original tumor to other places in the body is often viewed as a death sentence. But if there are just a few of those secondary tumors, called metastases, some patients have a good chance of survival if treated with a type of radiation that precisely targets small tumors, researchers at the UF Shands Cancer Center and the University of Rochester have reported in the International Journal of Radiation Oncology, Biology, Physics.

“The dogma is that this type of disease is incurable and that if there’s a metastatic tumor in one organ, then others must be present throughout the body,” said investigator Paul Okunieff, M.D., director of the UF Shands Cancer Center and chair of the UF College of Medicine department of radiation oncology. “It’s considered an all-or-none phenomenon, but the fact is this view is probably not correct. We need to think about metastasis like we think about the primary tumor: determine how much it has spread, then decide whether it’s treatable based on existing technology.”

Nearly 1.6 million Americans were diagnosed with cancer last year, and nearly 600,000 died from the disease, according to the National Cancer Institute. Experts estimate that up to 90 percent of those deaths were from metastases.

The researchers studied 121 patients who had fi ve or fewer tumors that spread from areas such as the breast, colon or lung, to as many as three additional organs. Tumors were treated with a one- to two-week radiation course strong enough to kill them and prevent their recurrence while sparing healthy tissue. In 20 percent of the patients, long-term follow-up revealed that the treated tumors did not return, nor did new ones pop up elsewhere. Very few regrowths occurred among patients who made it to three years.

Breast cancer patients fared even better, with one-third of patients being free of tumor regrowth after three years. Six years after treatment, almost half of breast cancer patients in the study were still alive — five times the survival rate of people with forms of metastatic cancer other than breast cancer.

“Our results suggest that patients with metastases that are limited in number and extent should be considered for potentially curative radiotherapy,” said investigator Michael Milano, M.D., Ph.D., an associate professor of radiation oncology at the University of Rochester. “Further studies are needed to ascertain which patients are most likely to benefit, either through prolonged survival or, perhaps, a cure. We need a better understanding of the biology of cancer and what makes one person’s cancer behave so differently from another’s.”

— Lindy Brounley

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Summer 2012

From the director’s desk

They’re our patients’ bridge over troubled water … when you’re feeling weary and there’s darkness all around, they will comfort you.

Audrey’s journey across the world

Six-year-old from Australia comes to UF Proton Therapy Center for brain tumor treatment. “More happiness came out of the center than pain,” Anderson said.

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Cancer is a scary diagnosis, by itself. Add in the need for appointments with surgeons, medical oncologists, genetics counselors and other specialists plus a slew of tests and the mind boggles. Nurse navigators guide patients through their cancer journeys.

Targeting tumors

Cancer that has spread from the site of an original tumor to other places in the body is often viewed as a death sentence. But if there are just a few of those secondary tumors, called metastases, some patients have a good chance of survival.

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