Elizabeth Edwards diagnosis not a death sentence

WASHINGTON (Reuters) - Elizabeth Edwards is facing the worst news any cancer patient can hear -- once cancer comes back, it can almost never be cured.

But treatment can keep patients alive, sometimes for decades, doctors agreed. And many new drugs in the pipeline offer even more hope to breast cancer patients.

Edwards, 57, wife of presidential candidate and former North Carolina Democratic Sen. John Edwards, announced on Thursday that the breast cancer she was treated for in 2004 has come back.

It was discovered when Edwards broke a rib and got an X-ray. The cancer is in her bones.

"This is what happens to every cancer survivor. Not that you ultimately get a bad diagnosis, but every time you get something suspicious, you go into alarm mode," Edwards told a news conference.

"And every cancer survivor that you know personally has exactly that experience of knowing that that pain they feel in their side, the ache they feel someplace could be the sign of something worse."

Edwards, who lost her 16-year-old son Wade in a car accident in 1996, said she would weather this tragedy, too.

"We're actually encouraged as we got more and more test results. And right now we feel incredibly optimistic," she said.

While Edwards has been open about her diagnosis in 2004 and her months of chemotherapy, radiation and surgery, she has not given precise details of what kind of breast cancer she has.

Treatments for breast cancer vary by type -- hormone-receptor positive cancers can be treated with tamoxifen or a new class of drugs called aromatase inhibitors. Patients with these cancers can live for decades, said Dr. Julie Gralow of the University of Washington and a spokeswoman on breast cancer for the American Society of Clinical Oncology.

"We generally tell patients once it is in the bone or the liver or the lungs or someplace else beyond the breast that it is incurable, but we also hasten to add that it is generally treatable," Gralow said in a telephone interview.

"Patients can live many years. With bone disease they can live decades," she said.

OPTIONS

A second type of breast cancer is called her-2 positive breast cancer. It can be treated with Herceptin, a targeted therapy made by Roche and Genentech, or a new once-a-day pill called Tykerb and made by GlaxoSmithKline.

But Edwards could have a third type of cancer, called triple-negative cancer, said Dr. Christy Russell of the University of Southern California, who is chair of breast cancer advocacy for the American Cancer Society.

"Her options would be only for chemotherapy," Russell said in a telephone interview.

"Her outlook would be more related to all the areas where the metastases are. Women with only bone metastases tend to live much longer and do much better than women, for instance, with lung or liver metastases."

Edwards joked that her three remaining children were disappointed that she would not lose her hair this time, as she did in 2004.

One study suggests that close family bonds may help.

Candyce Kroenke of the University of California, San Francisco found last March that breast cancer patients who have close relationships with family members and friends are more likely to survive the disease.

"I don't look sickly, I don't feel sickly," Edwards said.

Breast cancer is the second-leading cause of cancer death among U.S. women, after lung cancer. More than 200,000 people are diagnosed and another roughly 40,000 die from it each year, according to the American Cancer Society.