Fact-Checked: Wark’s Statement That “Stage 1 Breast Cancer is a Myth” Has No Basis in Facts and Truth

Abstract:

Chris Wark’s statement in the video that “stage 1 breast cancer is technically stage 4” is a pernicious falsehood that has absolutely no basis in science.   Science has Good News though!  Read on.

The Claim:

Starting at 12:06 in the “How April Healed Stage 4 Breast Cancer with Nutrition and Cannabis” video, published to Youtube in June 2018:

Basically by the time you are Stage 1 you already have cancer cells that have left that site and are in other parts of your body even if you don’t have active tumors yet.  So Stage 1 is really technically already Stage 4. There are already cancer cells in other parts of your body even if they haven’t set up tumors yet. That’s a long way of me explaining to anyone listening that, uh Stage 1 is just sorta like a myth.

Fact-Checked:

1. Chris Wark gives absolutely no research references whatsoever to validate his statement.  That should raise a red flag immediately.

2. Chris has made a declarative statement that ALL Stage 1 breast cancers are metastatic.  He may be basing his statement on a commonly cited breast cancer statistic that circulates in blogs, breast cancer forums, news articles and even a few research articles that “30% of all early-stage breast cancers will progress, despite treatment, to deadly metastatic disease”.  Many metastatic breast cancer support groups use this statistic, often repeatedly stated in their videos, to lobby for increasing research funding into metastatic breast cancer.  Example below.

 

The problem? There is no science-based evidence of this statistic being true.

Blogger Ann Silberman, who has Stage 4 metastatic breast cancer, spent 7 months researching the origin of the “30% metastatic recurrence rate” meme. Her conclusion was that there was no citation nor study which substantiated the statistic.  You can read her detailed research on her popular blog But Doctor I Hate Pink.   Nick Mulcahy, in an August 2015 article titled “The Mystery of a Common Breast Cancer Statistic” for Medscape.com, concurred with Ann Silberman stating, “A commonly cited breast cancer statistic — that 30% of all early-stage breast cancers will progress, despite treatment, to deadly metastatic disease — appears to have no strong contemporary evidence to back it up.”

I don’t think it helps our cause as advocates for women with metastatic cancer to repeat misinformation. I also think that certain groups (K*ough*omen) deliberately misuse statistics for their own purposes, stats that were never meant to be used the way they are and which are now misunderstood by everybody.  Ann Silberman

3. If this statement were true, “..at Stage 1 you already have cancer cells that have left that site and are in other parts of your body…”, conventional medical doctors would be prescribing chemotherapy and radiation for EVERY case of cancer regardless of staging.

Clearly Chris either is unaware of or does not understand Sentinel Lymph Node Biopsy (SLNB) and the mechanism by which metastatic cells spread.

In the 1940s, studies by Gilchrist [1] and Zeidman and Buss [2] demonstrated that metastatic cells spread through regional lymphatics in an orderly and reproducible manner, thus paving way for the evolution of SLNB. The sentinel lymph node (SLN) is the initial nodes that drains the lymph from a particular organ before draining into subsequent nodes (non-SLNs) with  the science being that metastatic cancer cells migrate through the lymphatic system first.

A sentinel lymph node biopsy is a procedure that was developed to identify metastasis of  cancer to the lymph nodes. The first lymph node to encounter cancer cells is the sentinel lymph node. In a sentinel node biopsy, surgeons remove only this initial lymph node, the sentinel lymph node.  Radiographers identify the sentinel lymph node with a dye.   A negative Sentinel Node biopsy usually means all other lymph nodes are cancer free and that means no chemotherapy is recommended .  Prior to SLNB, a common treatment for breast cancer and melanoma was to remove dozens of lymph nodes as a precaution with no idea as to which ones actually had cancer cells.  In some people I know as many as 40 lymph nodes were removed which can create a side effect of lymphadema whereas SLNB removes from 1-3 nodes.   SLNB are considered extremely accurate, saves the patient additional surgery to remove unnecessary lymph nodes and limits the use of chemotherapy to patients shown to have metastases in lymph nodes.

4.  Do some Stage 1 breast cancers progress to Stage 4?  Yes, they can and the determination of whether this happens depends on the cancer’s oncotype.  The larger the tumor, its hormone receptor status, whether it is HER2 negative or positive, the cancer’s genotype and the grade all factor into a greater risk that a Stage 1 cancer progresses to Stage 4.   But there’s GOOD NEWS!   Chris fearmongers with his “opinion” that all Stage 1 breast cancers are metastatic.  The science tells us something very different.

A Dutch Study published in 2017, following over 7969 patients, found that the percentage of distant metastases in patients having an early stage of breast cancer was 7.8% at the point of diagnosis.  “Early stage” was defined as T1N0, meaning the tumor (T) was stage 1 and there were no nodes(N) found to have metastatic cancer.   However, as the years go by, that risk of a Stage T1N0 breast cancer progressing to Stage 4 declines dramatically to 0.6% at 10 years after diagnosis.  [3]

The Good News gets better! The authors acknowledged that the study used data from the pre-trastuzumab (Herceptin) era, “which may have led to higher recurrence rates for these patients” compared with those diagnosed and treated more recently, after trastuzumab was approved by the European Medicines Agency in 2000 for certain patients with breast cancer.

In the 2014 study of 205,827 women, the authors report that for stage 1, “the conditional 5-year relative survival remained approximately 95% up to 15 years after diagnosis.”  The search authors’ conclusion:  “Patients with stage I or II breast cancer had a (very) good long-term prognosis.” [4]  

An excellent synopsis of the 2014 and 2017 studies can be read HERE.

Conclusion:  92-95% of all Stage 1 breast cancer patients will never progress to stage 4 cancer at diagnosis.  As the years go by disease free, their risk of developing stage 4 cancer declines remarkably to less than 1%.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1390783/
[2] https://www.ncbi.nlm.nih.gov/pubmed/13160971
[3] https://www.ejcancer.com/article/S0959-8049(18)31093-1/fulltext
[4] https://www.ncbi.nlm.nih.gov/pubmed/24201973

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.