Olivia Newton-John died 30 years after she was first diagnosed with breast cancer — a disease that would come back twice and spread after her initial treatment.
In 2017, the singer and actress announced the cancer had returned and metastasized. The following year, she revealed that she had also been treated for the disease in 2013 after discovering a lump in her shoulder.
When Newton-John learned the cancer had returned, she was caught off guard “because in my mind, it was over. I’d finished with it,” she told TODAY in 2017.
"Olivia has been a symbol of triumphs and hope for over 30 years sharing her journey with breast cancer," her husband, John Easterling, wrote in a statement announcing her death Monday.
The goal of breast cancer screening and treatment is to catch it early, eradicate all traces of it and prevent it from ever coming back, but that doesn’t always happen.
What is metastatic breast cancer?
Also called stage 4 or advanced breast cancer, it’s breast cancer that has spread to other parts of the body, most often the bones, lungs, liver or brain, according to the National Cancer Institute.
It happens when cancer cells travel from the primary tumor in the breast to those distant places via the lymph system or blood.
Some breast cancer patients already have the advanced form of the disease when it’s first detected, but that’s rare, accounting for 6% percent of diagnoses in U.S. women and 9% in U.S. men, the Susan G. Komen Foundation noted.
Most commonly, metastatic breast cancer is found after the original diagnosis and treatment — sometimes years later.
Why does breast cancer spread?
Fewer than 1 in 3 women who are diagnosed with early-stage breast cancer later develop metastatic breast cancer, according to the Cleveland Clinic.
It usually happens because treatment didn’t destroy all of the cancer or some of the cells remain dormant or hidden and — for unknown reasons — begin to grow again and spread, the clinic noted.
The risk depends on the biology of the tumor, the stage of the initial diagnosis and the treatments for the original cancer.
What are the symptoms?
The warning signs depend on where the breast cancer has spread. If it has reached the bones, for example, a patient may experience bone pain. A persistent cough or chest pain may indicate it has spread to the lungs. Headaches, vision problems or seizures may be caused by brain metastases.
How is metastatic breast cancer treated?
Systemic drug therapies, including chemotherapy, immunotherapy and targeted drugs, are the main treatments, according to the American Cancer Society. Radiation and surgery can also sometimes be used.
Treatment can shrink tumors and help patients live longer, but there is no cure for stage 4 breast cancer, the organization said.
What is the outlook for metastatic breast cancer patients?
The five-year survival rate for patients whose breast cancer has spread to distant parts of the body is 29%, according to the American Cancer Society.
Better treatments may one day turn this advanced cancer into a chronic disease like diabetes, where patients can stay stable on medications for decades, the Metastatic Breast Cancer Network noted.
But for now, it continues to claim lives. It’s estimated more than 43,000 women will die from breast cancer this year, according to the American Cancer Society.
October 13 marks Metastatic Breast Cancer Awareness Day.