Olivia Newton-John Fighting Recurrent Breast Cancer

Olivia Newton-John took to Facebook yesterday to announce that she would have to postpone her June US and Canadian concert dates. The 68-year-old singer will be treated for a recurrence of breast cancer.

The Grease star was originally diagnosed with breast cancer in 1992, after finding a small, painful lump. She underwent a partial mastectomy and breast reconstruction, followed by chemotherapy. She also used complementary treatments, such as herbal supplements, acupuncture, meditation and visualization.

“I researched a lot and felt satisfied with my course of treatment. It was sort of an East meets West approach. I meditated every day, did yoga, and homeopathy, ate well- I boosted my inner strength as much as I could. When bad thoughts came in, I pushed them right out.”

In May, Newton-John postponed some shows, saying that she was suffering with a “long running issue with sciatica”. Turns out, this was not the cause of her back pain. The Facebook statement said:

“The back pain that initially caused her to postpone the first half of her concert tour, has turned out to be breast cancer that has metastasized to the sacrum.”

The sacrum is your “tail bone,” the lowest part of the spine to which the hips are attached. The Facebook post went on to say:

“In addition to natural wellness therapies, Olivia will complete a short course of photon radiation therapy and is confident she will be back later in the year, better than ever, to celebrate her shows.

‘I decided on my direction of therapies after consultation with my doctors and natural therapists and the medical team at my Olivia Newton-John Cancer Wellness and Research Centre in Melbourne, Australia,’ says Olivia Newton-John.”

Three Main Types of Breast Cancer

There are 3 major types of breast cancer that differ in the way they are treated, so it’s important for doctors to diagnose exactly what type a patient has. The three major types of breast cancer and their treatments are:

1. ER/PR-positive (or ER/PR+). About 65% of breast cancers are in this category. ER stands for “estrogen receptor,” PR stands for “progesterone receptor” and these tumors are treated with drugs such as as tamoxifen that block these hormones that act like fertilizers for the cancer cells.
2. HER2-positive (or HER2+). About 20% of breast cancers are in this category. HER2 stands for “human epidermal growth factor receptor number 2.” The HER2 gene is amplified in this form of breast cancer and acts like an accelerator for cancer cells. These gene is blocked by a drug called traztusumab or HERCEPTIN.
3. Triple-negative (TNBC) simply means that this type of cancer lacks the 3 “biomarkers” (ER, PR and HER2) that define the other two types. About 15% of breast cancers are in this category. Triple-negative cancers are treated with harsher chemotherapies because of a lack of “targets” for more modern drugs.

New Hope for Women with Advanced Breast Cancer

According to the American Cancer Society, over a quarter million women will be diagnosed with invasive breast cancer in the U.S. in 2017. About 6% patients will have advanced cancer at the time of diagnosis and another 20% to 30% of patients with early-stage cancer will eventually develop spread to other organs (metastasis), most often bone.

For decades, the primary treatment for women with advanced breast cancer has been hormone (endocrine) therapy with drugs that block the estrogen that allows the cancer to grow. Sadly, and usually within a year, most patients suffer recurrence or progression of their disease.

However, starting in 2015, new “breakthrough” drugs for advanced breast cancer started to become available to patients. These drugs are for “ER-positive, HER2-negative” cancers that are the most common types of breast cancer. (more information about these types of cancer can be found in Chapter 2 of our Women’s Cancers book at http://www.reimaginingcancer.com/ ).

These new drugs, called CDK4/6 inhibitors, include:

• Palbociclib(IBRANCE®), was approved in February 2015 for the treatment of postmenopausal women with metastatic ER-positive, HER2-negative breast cancer in combination with letrozole (FEMARA®). (Letrozole is an anti-estrogen and one of the hormone therapies mentioned previously.)
• Ribociclib(KISQALI®) was approved in March 2017 for the treatment of postmenopausal women with advanced or metastatic ER-positive, HER2-negative breast cancer in combination with an aromatase inhibitor as initial endocrine-based therapy. (Aromatase inhibitor refers to drugs such as Letrozole that block the production by the body of estrogen.)
• KISQALI-FEMARA is a co-packaging of both ribociclib and letrazole.
• Abemaciclib(LY2835219) is an experimental drug for various types of cancer developed by Eli Lilly. It was designated as a breakthrough therapy by the U.S. Food and Drug Administration in October 2015.

Another new drug for advanced breast cancer is everolimus (AFINITOR®) that is used in combination with exemestane (AROMASIN®) after failure of treatment with letrozole or anastrozole (ARIMIDEX®).

If you or someone you know has advanced breast cancer, talk to your doctor about whether these drugs should be added to the treatment you are already receiving.