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Secondary Breast Cancer Symptoms And Treatment Explained, In Light Of Olivia Newton-John's Diagnosis

The singer's cancer has returned, 25 years after her first diagnosis.

31/05/2017 8:51 PM AEST | Updated 31/05/2017 11:39 PM AEST

Olivia Newton-John has revealed that her breast cancer has returned and spread to her lower back.

The 68-year-old Australian singer has been forced to cancel a series of forthcoming tour dates while she seeks treatment. 

She was originally diagnosed with breast cancer in 1992, when she was 43, and at the time underwent chemotherapy and a partial mastectomy.

After experiencing back pain more recently, originally thought to be sciatica, she revealed that tests showed it was actually “breast cancer that had metastasized to the sacrum” - also known as secondary breast cancer.

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What is secondary breast cancer?

“Sometimes, cancer cells - that can’t be seen with the naked eye or scans - are left behind after initial treatment,” Sue Green, Macmillan Cancer Support senior nurse told HuffPost UK.

“If this happens, the cancer may come back, sometimes even years later.

“Cancer that has come back in a different part of the body is known as metastatic or secondary cancer.”

It’s estimated that 11,500 women die from breast cancer each year in the UK - the vast majority will have seen their cancers spread to become secondary breast cancer.

According to Breast Cancer Now’s spokesperson Sally Greenbrook, “roughly five in every 100 people with breast cancer already have secondaries when their cancer is first diagnosed”.

It is also estimated that a further 35 out of every 100 people with primary breast cancer will develop secondary breast cancer within 10 years of their first breast cancer diagnosis.

Unfortunately once breast cancer spreads, it is incurable. But it can be treated and some women can live with it for many years.

Symptoms of secondary breast cancer

If you’ve had primary breast cancer, it’s important to be vigilant of any symptoms that are either new, don’t have an obvious cause or don’t go away.

This is because they could signal that the cancer has returned and spread. 

It’s difficult to list all of the signs of secondary breast cancer as there are many. However some of the more common symptoms include:  

:: Pain in your bones (for example in the back, hips or ribs) that doesn’t improve with pain relief or lasts for more than one to two weeks. Also, the pain may worsen at night.

:: Unexplained weight loss and a loss of appetite.

:: Constant nausea.

:: Discomfort or swelling under the ribs or across the upper abdomen.

:: Feeling constantly tired.

:: A dry cough or a feeling of breathlessness.

:: Severe or ongoing headaches.

:: Altered vision or speech.

Green added: “The symptoms of secondary breast cancer will depend on where in the body the cancer has spread to. For example, symptoms might include pain if the cancer has spread to the bones, or a cough or breathlessness if it has spread to the lungs.”

Treatment

When breast cancer spreads to the bone, it can make it difficult to treat, according to Dr Alan Worsley, Cancer Research UK’s science communications officer.

That said, there are treatment options available that can help slow the progress of the cancer and lower the chances of it spreading further.

“Specialist teams will help to work out the best treatment options for each patient depending on the characteristics of their breast cancer, where/how far it has spread, the treatment they’ve already had and their general health,” Breast Cancer Now’s Sally Greenbrook told HuffPost UK.

“Treatments they might be offered include hormone therapy, radiotherapy, chemotherapy, targeted therapy and surgery.”

Here is a brief breakdown of each treatment option:

Hormone Therapy

Oestrogen and progesterone can make some breast cancers grow faster. In cases like this, hormone therapy tablets such as tamoxifen and aromatase inhibitors (anastrozole, letrozole and exemestane) may help slow the cancer’s growth or spread.

They work by blocking the production or action of these hormones on breast cancer cells.

In other cases, the ovaries can be treated to prevent them from producing hormones if you have not been through the menopause. This treatment type is called ovarian ablation.

Radiotherapy

This form of treatment can help slow the growth of secondary breast cancers and relieve symptoms. 

Radiotherapy courses for secondary breast cancer are usually shorter than for primary breast cancer and some women experience milder side effects.

They are usually given at an outpatient clinic and require regular visits to hospital for a week or more, although they can sometimes be given as a single treatment.

Chemotherapy

Chemotherapy with one or more anti-cancer drugs may be used to treat secondary breast cancer, especially if hormone therapy is not working well or where tumours are in internal organs (such as the lung or liver).

Like radiotherapy, the treatment’s aim is to slow the growth of secondary tumours and to prevent them from spreading further.

Targeted Therapy

This form of therapy refers to drugs which attack breast cancer cells directly, helping to slow the growth and spread. Some targeted therapies can help relieve symptoms too.

One targeted therapy available on the NHS is called Herceptin. It works by attacking cancer cells that produce high levels of a protein called HER2 (known as HER2 positive breast cancers). 

Surgery

This treatment type is not often used to treat secondary breast cancers. That said, it is sometimes possible for small tumours in operable areas to be removed. 

Greenbrook concluded: “The aim of treatment is to minimise spread and give patients the best possible quality of life.

“Thanks to new treatments, some women can live relatively normal lives – including returning to work, spending time with their families and keeping active – and for some you wouldn’t necessarily be able to tell they are living with incurable cancer.”

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