Living for years with late-stage breast cancer

For decades, a diagnosis of “late-stage breast cancer” meant two things: few options for treatments and death.

So, 10 years ago, when 37-year-old Cooper City resident Suzie Silverman felt a painful lump, which she likened to a bra’s underwire poking out of the fabric, the doctor’s findings of stage four cancer left her in shaken disbelief. She imagined little time left with her two boys, then 4 and 8.

Then, more bad news: Scans showed the cancer had spread to her liver and bones, and eventually, her brain.

“Suzie was in trouble,” said Dr. Alejandra Perez, breast program director at Sylvester Comprehensive Cancer Center in Plantation, part of the University of Miami.

“Her cancer was very advanced,” said Perez, who has been with Silverman since her diagnosis.

Now, 47, Silverman just celebrated her “cancerversary” — 10 years cancer-free. She isn’t “cured,” she and Perez pointed out, but, rather, “stable.” It’s the best diagnosis someone with metastatic cancer can receive.

And it’s happening more and more. Thanks to a variety of treatment options for advanced-stage and high-risk cancer patients, in many cases, late-stage cancer can be considered a “chronic disease” that people live with for decades.

From 2003 to 2013, the last year for which data are available, the death rate in women from breast cancer decreased by 1.9 percent per year, according to the Centers for Disease Control & Prevention. In 2013, 230,815 women and 2,109 men in the United States were diagnosed with the disease; 40,860 women and 464 men died from it.

Silverman referred to herself as a “lifer” — she will always be taking some kind of medicine. She ingests oral chemotherapy pills and, through a port that will stay in her body forever, she receives infusions every three weeks.

It was the breast implants Silverman had had put in two years prior to her diagnosis that ended up saving her life. She has no history of cancer in her family and later tested negative for the BRCA gene mutation, which increases your risk of contracting breast cancer. So on a vacation to Georgia, when she felt the painful lump, Silverman’s first thought was an implant-related issue. And when doctors found a tumor pushing out of her breast, she assumed the implants would have to come out. Turns out, they did not, nor did Silverman have to undergo a mastectomy.

The then fourth-grade teacher participated in a clinical trial run by Perez and underwent brain radiation and three brain surgeries. Silverman, who focused on remaining positive — even ending her marriage during the course of her treatment because she did not find her husband supportive — said she felt like she had angels sitting on her shoulders.

Twenty years ago, doctors were able to cure about 60 percent of breast cancer cases. Today, it’s 80 percent, Perez said.

“We know that research is the only way to find a cure, so I am very passionate about research. Every drug approved is progress in the field. I’m very hopeful that a cure will be found,” she said.

At Memorial Cancer Institute, part of the Broward-based Memorial Healthcare System, high-risk patients who may or may not have been diagnosed with cancer are participating in a new one-on-one program led by Dr. Sayeh Lavasani, an oncology and hematology specialist.

One way of calculating the patient’s risk is by looking through a person’s family history. If the risk is higher, they are referred for genetic testing for mutations and abnormalities.

It is key that patients be cognizant of any cancers in their biological family members, Lavasani said.

“Patients need to pay attention to the available resources out there and take advantage of them. Some don’t follow through, and not everyone is interested.

“The bottom line is early detection can save lives, reduce surgeries and improve patient outcomes,” Lavasani said.

Regarding Silverman, Perez said her body’s positive reaction to treatment research options is the kind of story that motivates oncologists. Silverman just sent her 18-year-old son, Logan, off to college, and Perez said she feels very much a part of that rewarding experience.

Silverman hasn’t been able to return to the classroom, as an elementary teacher’s schedule is rigid in terms of being able to leave the students for bathroom breaks and meal times. Incessant germs lurking about school campuses are also something that can compromise her body.

Still, she’s grateful for every sunrise.

“As long as I’m looking at life from this side of the ground, it’s a great day. No matter what happens, we get through it and get through it as a family,” she said of her sons, Ethan, 14, and Logan.

This story was originally published October 10, 2016 at 10:03 PM with the headline "Living for years with late-stage breast cancer."