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Shannen Doherty's Battle: A Spotlight on Metastatic Breast Cancer and Immunotherapy Advocacy

Chris Bates

Tuesday, August 6, 2024

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Introduction

Shannen Doherty, known for her roles in "Beverly Hills 90210" and "Charmed," bravely shared her battle with metastatic breast cancer, raising awareness and advocating for immunotherapy. Sadly, she recently passed away, leaving behind a legacy of strength and advocacy. This article explores her journey, the science behind immunotherapy, and its potential to transform cancer treatment.

Shannen Doherty's Story: A Catalyst for Awareness

Personal Journey Shannen Doherty’s battle with breast cancer began in March 2015 when she was first diagnosed. After undergoing chemotherapy, radiation, and surgery, Doherty went into remission in 2017. However, in February 2020, she announced that her cancer had returned as stage 4, also known as metastatic breast cancer, which means the cancer had spread to other parts of her body. In June 2023, Doherty revealed that her cancer had further metastasized to her brain, highlighting the aggressive nature of metastatic breast cancer. In January 2024, Doherty shared that she was undergoing a new cancer treatment that was successfully breaking through the blood–brain barrier, calling it a "miracle." Tragically, on July 13, 2024, Doherty died from cancer at her home in Malibu, California, at the age of 53. Throughout her journey, Doherty remained remarkably open, sharing her experiences with the public to shed light on the realities of living with cancer. Her down-to-earth and free spirit to discuss her bout with cancer went a long way to demystify the illness and motivated others to speak out. In an ABC News interview, Doherty emphasized her responsibility to educate about stage IV cancer, stating, "People with stage IV are very much alive and very active." Her openness has significantly reduced the stigma of metastatic breast cancer, encouraging others to live fully despite their diagnosis.

The Power of Advocacy

Doherty’s advocacy significantly amplified the conversation around metastatic breast cancer, highlighting the physical and emotional challenges patients and their families face. Her efforts drew attention to the need for better treatment options, increased research funding, and emotional support. Doherty’s campaign brought much attention to metastatic breast cancer. Through her narration, she explained not just the medical complications of the disease but also the psychological implications for both patients and their families. Through her advocacy, she ensured that people recognized the need for improved treatments, additional funding, and support for patients battling cancer. Additionally, Doherty occasionally informed her fans about her health status and posted materials to raise awareness for breast cancer tests and early diagnosis. In an Instagram post, she expressed her hope that women should support and urge each other and realize the importance of early detection. This campaign fostered a conversation that extended beyond her followers, helping to spread awareness (Doherty, 2020).

Metastatic Breast Cancer: Understanding the Challenge

What is Metastatic Breast Cancer?

Metastatic breast cancer, also known as stage 4 breast cancer, is when cancer cells spread beyond the breast and nearby lymph nodes to other parts of the body such as the bones, liver, lungs, or brain. It is estimated that approximately 20-30% of women diagnosed with early-stage breast cancer will eventually develop metastatic disease. Despite advancements in treatment, the five-year relative survival rate for women with metastatic breast cancer remains around 31%, highlighting the critical need for innovative therapies (Sources: SEER Cancer Statistics Review, 2024; National Cancer Institute, 2024). 1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. In 2024, an estimated 310,720 women and 2,800 men will be diagnosed with invasive breast cancer (Shockney, 2023).

Current Treatment Landscape

Current treatments for metastatic breast cancer include chemotherapy, radiation, hormone therapy, and targeted therapy. These methods aim to slow disease progression, alleviate symptoms, and improve quality of life, but they come with side effects and limitations (NIH, 2024). Chemotherapy uses drugs to destroy rapidly dividing cells, including cancer cells. However, it also affects healthy cells, leading to side effects like hair loss, fatigue, and increased infection risk. Radiation Therapy targets cancer cells with high-energy rays to relieve pain and symptoms caused by metastasis. Side effects may include skin irritation, fatigue, and damage to nearby tissues. Hormone Therapy is effective for hormone receptor-positive cancers. It works by blocking estrogen or using estrogen-mimicking drugs to kill cancer cells. Side effects can include hot flashes, osteoporosis, and an increased risk of other diseases. Targeted Therapy focuses on specific molecules involved in cancer growth. For example, HER2-positive breast cancer can be treated with drugs targeting the HER2 protein. Side effects vary by drug but can include heart issues, diarrhea, and liver problems. Immunotherapy aims to enhance the immune system's ability to fight cancer with fewer side effects. Checkpoint inhibitors, for instance, have shown promise in treating certain breast cancers, especially when combined with other treatments. However, it is not yet considered a standard treatment for all patients, and its use is still under investigation.

Immunotherapy: A Game-Changer in Cancer Care?

How Does Immunotherapy Work? Immunotherapy uses the body’s immune system to fight cancer, boosting its ability to detect and destroy cancer cells. It enhances the immune response and removes mechanisms that inhibit immune cells from attacking cancer. (National Cancer Institute, 2019).

Types of Immunotherapy

Checkpoint Inhibitors: These drugs work by blocking proteins that prevent immune cells from attacking cancer cells. Examples include drugs like pembrolizumab and nivolumab. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, regulate immune responses. Normally, when PD-L1 binds to PD-1, it prevents T cells from killing tumor cells (left panel). Immune checkpoint inhibitors (anti-PD-L1 or anti-PD-1) block this interaction, allowing T cells to destroy tumor cells (right panel). CAR-T cell therapy is a cancer treatment that involves modifying a patient's T cells to better recognize and kill cancer cells. This approach has shown promise in treating certain blood cancers and is being investigated for solid tumors like breast cancer. Specifically, CAR T-cell therapy involves collecting a patient's T cells and genetically engineering them in the lab to express a chimeric antigen receptor (CAR). This CAR allows the T cells to specifically target and destroy cancer cells (National Cancer Institute, 2022). Other promising therapies are emerging, such as cancer vaccines and oncolytic virus therapy, designed to stimulate the immune system to target and destroy cancer cells.

Immunotherapy for Metastatic Breast Cancer

Recent trials and studies have shown that immunotherapy can be particularly effective in treating metastatic breast cancer (Immunotherapy for Metastatic Cancer). For example, combining checkpoint inhibitors with other treatments has shown improved outcomes in some patients. This combination approach is an area of active research, exploring how immunotherapy can work alongside other treatments to enhance effectiveness. Additionally, there is emerging research on the potential for immunotherapy to be used as a preventative measure for high-risk individuals. However, the benefits of Immunotherapy for Metastatic Cancer can vary, and more research is needed to fully understand which patients are most likely to respond to these therapies. Triple-negative breast cancer can at times be treated using immunotherapy especially when the cancer is locally advanced or has metastasized. Checkpoint inhibitors are specifically directed immunotherapies that target the molecules on immune cells, which bring about immune evasion, to enhance the immune response against the breast cancer cells. Pembrolizumab (Keytruda) is a very common immune checkpoint inhibitor that is used to target the PD-1 protein. It could be administered alongside chemotherapy to manage stage 2-3 triple-negative BC before or after the surgery or stage 4 cancer that cannot be surgically removed or metastatic disease. It is administered intravenously and usually the treatment cycle is every 3-6 weeks. Sometimes, PD-L1 protein is tested on cancer cells to know whether the cancer is likely to benefit from the treatment by pembrolizumab or not.

Navigating the Immunotherapy Landscape: Hope and Hurdles

Promising Outcomes Case studies and clinical trials show that immunotherapy can significantly benefit metastatic breast cancer patients, providing hope through increased survival rates and transformative potential. Side Effects and Risks While immunotherapy offers promising benefits, it is not without risks. Common side effects include fatigue, skin reactions, and flu-like symptoms. More severe reactions can occur, such as inflammation in organs like the lungs, liver, and intestines. Open communication with healthcare providers is crucial for effectively managing these side effects. Discussing potential side effects with a healthcare provider before starting immunotherapy is essential to ensure patients are well-informed. Accessibility and Financial Challenges Despite its promise, access to immunotherapy can be limited by financial and geographical barriers. High treatment costs and insurance coverage issues can make it difficult for many patients to benefit from these advancements. Efforts are underway to improve access, including initiatives to expand insurance coverage and reduce treatment costs.

Leading Voices: Expert Perspectives and Patient Advocacy

Oncologists Weigh In Leading cancer specialists emphasize the significant role of immunotherapy in the current and future landscape of cancer treatment. Experts like Dr. Leisha Emens, a pioneer in immunotherapy research, provide insights into ongoing research and its potential to revolutionize cancer care. These specialists highlight the importance of continued research and patient education. Patient Perspectives Quotes from patients who have undergone immunotherapy offer a firsthand perspective on its impact. For example, Aleksey, a patient who faced a grim diagnosis, shared, "The immunotherapy treatment I received in Israel saved my life. This has been confirmed by multiple examinations, showing that the illness has taken steps back. I have no active medical issues and no active cancer process. Comparing traditional, conventional medicine to immunotherapy - there's no comparison. The people involved in immunotherapy are leading the future of cancer treatment worldwide." Transcript edited for clarity. You can find Aleksey’s testimonial along with additional cancer immunotherapy reviews & success stories in this link. Shannen Doherty's Legacy
Shannen Doherty’s advocacy significantly influenced the conversation around metastatic breast cancer. By openly sharing her journey, she highlighted both the physical and emotional challenges faced by patients. Sadly, she recently passed away, but her efforts underscored the need for better treatment options, increased research funding, and the importance of emotional support. Doherty inspired many by fostering a sense of community and support among those affected by metastatic breast cancer. Her honest portrayal of her battle helped to destigmatize the disease and encourage open discussions about cancer. This advocacy not only raised awareness but also emphasized the critical importance of early detection and screening. Through social media and public appearances, Doherty encouraged others to share their stories, creating a strong support network. Her influence continues to inspire new generations of patients and advocates, demonstrating the power of personal narratives in driving awareness and change.

The Future of Immunotherapy: A Beacon of Hope

Ongoing Research Recent research has shown promising results in the use of new drug combinations and personalized therapies. For instance, clinical trials exploring the combination of checkpoint inhibitors with other treatments have shown improved outcomes for some patients with metastatic breast cancer. Additionally, advancements in CAR-T cell therapy and cancer vaccines are being investigated for their potential to significantly enhance the immune system's ability to fight cancer (National Cancer Institute, 2023; American Cancer Society, 2023). Combination Therapies Immunotherapy can be used alone or with treatments like chemotherapy, radiation, or targeted therapy to improve outcomes. Research shows that these combinations can enhance the immune system's ability to target cancer cells. Personalized Medicine Selecting immunotherapy treatments based on the specific characteristics of a patient's cancer, such as genomic and molecular profiling, allows for tailored treatments that improve effectiveness. Novel Targets Scientists are continually discovering new antigens and proteins on cancer cells, leading to the development of new drugs and therapeutic approaches that improve immune response. Patient Empowerment Informed decision-making is crucial for patients navigating cancer treatment. Empowering patients with knowledge about their options, including immunotherapy, is essential. Support networks and resources, such as support groups, financial assistance programs, and advocacy organizations, play a vital role in providing emotional and practical support. Support and Resources: Support Groups: National organizations like Living Beyond Breast Cancer (LBBC), Susan G. Komen, or local support groups. Financial Assistance Programs: Information on organizations that offer financial aid for cancer treatment, such as the HealthWell Foundation and the Cancer Financial Assistance Coalition. Advocacy Organizations: Groups like the Metastatic Breast Cancer Network (MBCN) and METAvivor provide information and support. Education and Advocacy: Educational campaigns targeting patients and healthcare workers are necessary to integrate immunotherapy into clinical practice. Advocates like Shannen Doherty educate the public about the effectiveness of immunotherapy, encouraging informed discussions with healthcare providers. A Message of Hope Advancements in immunotherapy and the dedication of advocates provide hope for the future of cancer care. The progress made underscores the potential for greater breakthroughs, offering optimism and encouragement to those affected by cancer. Increased Survival Rates: Immunotherapy treatments have improved survival rates for cancers like metastatic breast cancer based on clinical trials and case studies. These successes suggest more patients will benefit from these treatments in the future. Quality of Life Improvements: Patients receiving immunotherapy often experience fewer side effects than those undergoing chemotherapy, leading to an improved quality of life. This aspect is crucial for patients with metastatic cancer, where quality of life is a significant focus. Future Breakthroughs: Ongoing research and development in immunotherapy promise more advanced and individualized treatments in the coming years. The efforts of researchers, practitioners, and advocates continue to drive improvements, turning a better future for cancer patients into a realistic goal.

Conclusion

Shannen Doherty's courageous journey and advocacy brought significant attention to metastatic breast cancer and the potential of immunotherapy. Sadly, she recently passed away, but her story, along with the promising advancements in immunotherapy, offers hope for improved outcomes and quality of life for patients. The progress made thus far underscores the potential for even greater breakthroughs in cancer treatment.

References

Adams, S., Gatti-Mays, M. E., Kalinsky, K., Korde, L. A., Sharon, E., Amiri-Kordestani, L., Bear, H., McArthur, H. L., Frank, E., Perlmutter, J., Page, D. B., Vincent, B., Hayes, J. F., Gulley, J. L., Litton, J. K., Hortobagyi, G. N., Chia, S., Krop, I., White, J., & Sparano, J. (2019). Current Landscape of Immunotherapy in Breast Cancer. JAMA Oncology, 5(8), 1205. https://doi.org/10.1001/jamaoncol.2018.7147 Doherty. (2020). Instagram. Www.instagram.com. https://www.instagram.com/theshando/?hl=en Glasgow, G. (2014). Shannen Doherty’s Breast Cancer Journey Shines Focus on Health Insurance. News.cuanschutz.edu. https://news.cuanschutz.edu/cancer-center/shannon-doherty-breast-cancer National Breast Cancer institute. (2024). Metastatic Breast Cancer: What Is It, Symptoms, and More. National Breast Cancer Foundation. https://www.nationalbreastcancer.org/metastatic-breast-cancer/ National Cancer Institute. (2019, September 24). Immunotherapy to Treat Cancer. National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/treatment/types/immunotherapy National Cancer Institute. (2022, April 1). T-cell transfer therapy - immunotherapy. National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/t-cell-transfer-therapy NBBC. (2024). Breast Cancer Advocacy & Support. National Breast Cancer Coalition. https://www.stopbreastcancer.org/ News, A. B. C. (2023). Shannen Doherty gives sobering update on cancer fight, shares “fear” and “turmoil.” ABC News. https://abcnews.go.com/GMA/Culture/shannen-doherty-sobering-update-cancer-fight-shares-fear/story?id=99898892 NIH. (2024). Breast Cancer Treatment (Adult) (PDQ®): Patient Version. PubMed; National Cancer Institute (US). https://www.ncbi.nlm.nih.gov/books/NBK65969/ Shockney, L. (2023, June). Breast Cancer Facts & Statistics for 2022. National Breast Cancer Foundation. https://www.nationalbreastcancer.org/breast-cancer-facts/ By Chris Bates
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