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For Elizabeth Edwards, a public battle with breast cancer

For Elizabeth Edwards, a public battle with breast cancer

Doctor offers a guarded assessment

CHAPEL HILL, N.C. -- When Elizabeth Edwards was diagnosed with breast cancer more than two years ago, she hoped for a complete cure. Yesterday, with her husband at her side, she told the world that those hopes are gone.

Elizabeth Edwards' cancer has advanced to the disease's most serious phase -- stage four -- and it is no longer curable, the couple said. Now, as Ms. Edwards, 57, again prepares to wage a public battle against cancer, the strategy has shifted to controlling her disease and keeping her as healthy as possible.

Both Edwardses said they remain upbeat in the face of the unwelcome news. "It is completely treatable," John Edwards said.

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Elizabeth Edwards' oncologist, Dr. Lisa Carey of the Lineberger Comprehensive Cancer Center at the University of North Carolina in Chapel Hill, said the ductal carcinoma that was originally diagnosed in the fall of 2004 has spread to the right rib, surrounding bones and, possibly, to her lungs. Still, Dr. Carey characterized the amount of cancer in Ms. Edwards' system as "small."

The recurrence was discovered in an X-ray taken after she sought treatment this week for a left rib, which she apparently fractured moving a heavy piece of furniture in the family's new home in Chapel Hill. Had it not been for that injury, Ms. Edwards said, it might have been months before the recurrence was discovered. She said she has no symptoms and is otherwise in excellent health -- factors that she is confident will keep her feeling well, even as she undergoes another round of treatment.

Dr. Carey offered a guarded assessment of Ms. Edwards' prognosis.

"We can suppress it, we can even shrink it, but we can't eradicate it from her body," said the doctor, who indicated that Ms. Edwards would likely begin treatment within a week or two. "The fact that she is a healthy person, that she doesn't have a lot of cancer, and that she doesn't have symptoms all work in her favor."

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Dr. Carey said she has patients who have had a similar diagnosis live "many years." But survival rates for people with stage four breast cancer, which means the disease has spread to other organs and tissue, are poor. Only about 16 percent of patients are alive after five years, according to the American Cancer Society.

Oncologists often warn patients to ignore such statistics, because so much depends on the characteristics of their cancers and their response to treatment.

"There are situations where it may be rapidly progressive, and there are situations where you see [slow-moving] disease, and patients may live for several years," said Dr. Elizabeth Campbell, a medical oncologist with Cancer Centers of North Carolina in Raleigh, one of the state's largest private cancer practices.

"It is sobering for anybody to have a recurrence at any point," said Dr. Campbell, who is not involved with Ms. Edwards' care. "But there still are potentially lots and lots of alternatives for treatment."

Further tests will determine what therapy Ms. Edwards will face. Ms. Edwards said she believes that it will be less toxic than the original round of chemotherapy she underwent before having a lumpectomy and radiation.

First Published: March 23, 2007, 4:00 a.m.

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