Shannen Doherty, known for her role in the nineties TV show Beverly Hills 90210, has announced that her stage four breast cancer has metastasized to her brain.
After a recurrence of cancer in late 2020, the disease has spread to other parts of her body, including her brain, as indicated by January scans. In a candid revelation, Ms. Doherty shared personal moments of herself undergoing radiation treatments, a procedure that employs high-powered X-rays to target and eliminate cancer cells.
Speaking openly, Shannen Doherty expressed, “This is a glimpse of what cancer can entail,” as she shed light on the challenges she faces. She further shared that her intense claustrophobia poses difficulties in undergoing the necessary treatment.
Breast cancer is a prevalent concern, with approximately 264,000 cases diagnosed in women and 2,400 cases in men each year in the United States. Recent years have witnessed a gradual increase of 0.5 percent per year in the incidence rates, which experts attribute to factors like rising body weight, declining fertility rates, and older ages at first childbirth among women.
Brain metastases, while relatively uncommon among breast cancer patients, affect around 10 to 15 percent of cases. Although the prognosis for individuals like Ms. Doherty, who have breast cancer that has spread to the brain, has improved over the past two decades, the overall survival rate for breast cancer patients with brain metastasis remains slightly over two years.
Ms. Doherty, aged 52, has endured a challenging journey with cancer. She was initially diagnosed with stage two or three breast cancer in 2015, which had already spread to her lymph nodes. Following a mastectomy, she underwent additional treatments, including chemotherapy and radiation, until announcing her remission in 2017.
On Tuesday, she disclosed that a CT scan conducted in early January revealed the presence of brain metastases. While she did not disclose the specific subtype of aggressive cancer she is facing, it is worth noting that the risk of brain metastases is highest in individuals with certain subtypes, such as HER2-positive or triple-negative breast cancer.
In the case of HER2-positive breast cancer, the overexpression or amplification of the HER2 protein leads to the abnormal growth and proliferation of cancer cells, causing harm to healthy tissues throughout the body.
On the other hand, triple-negative breast cancer, accounting for a smaller proportion of cases compared to HER2-positive cancer (10 to 15 percent versus 20 percent), lacks estrogen and progesterone receptors, as well as the HER2 protein.
For stage four cancers, targeted therapies like specific drugs and monoclonal antibodies, along with chemotherapy, are often utilized. In some cases, surgery is considered to improve survival rates.
Radiation therapy, which Shannen Doherty has undergone, is a common approach in cancer treatment.
Cancer arises when cells undergo genetic mutations, leading to uncontrolled growth and division. Normally, genes regulate cell division for the purpose of repairing or replacing damaged or aging cells.
However, cancer cells carry faulty genes that disrupt this regulation, causing cells to divide uncontrollably. These cells accumulate and form a mass called a tumor, which continues to grow by receiving oxygen and nutrients from nearby blood vessels.
As the tumor expands, cancer cells can infiltrate surrounding tissues by exerting pressure on healthy tissue adjacent to the tumor.
Cancer cells that metastasize to the brain accumulate numerous genetic mutations that enable them to breach the blood-brain barrier, which typically hampers the effectiveness of various cancer treatments, including chemotherapy.
Radiation therapy can overcome this barrier by disrupting the network of blood vessels and tissue that forms the protective layer lining the brain. This disruption allows radiation to reach recurring cancer or cancer that has spread to other parts of the body, unlike many other cancer treatments.
Radiation therapy, which can involve X-rays or other types like proton radiation, is a common approach for treating cancer. In the case of breast cancer that has spread to the brain, oncologists often use a form of radiation therapy known as whole brain RT (WBRT). This treatment typically involves 10 to 15 sessions over a few weeks.
While WBRT is considered the standard treatment for multiple brain metastases, its effectiveness in prolonging life is limited, usually extending survival by approximately six months.
During the radiation therapy sessions, oncologists use a thermoplastic mask that is custom-fitted to the patient’s face. This mask helps keep the head still throughout the treatment. Initially, the mask is applied as a warm and wet mesh on the skin, which then hardens and cools after about 15 minutes, securing the head in place.
Shannen Doherty shared an emotional video documenting this process, where she became tearful as doctors placed the mask over her face. To ensure a proper fit, they had her bite down to ensure the mask adhered to her mouth and chin.
Reflecting on her experience, she expressed her fear and acknowledged the challenges she was facing in her life at that time. She highlighted the importance of having skilled doctors like Dr. Amin Mirahdi and the dedicated technicians at Cedars-Sinai Medical Center. She also emphasized that this is what cancer can look like, acknowledging the emotional and physical turmoil it can cause.
