“It’s a very long time from her primary [diagnosis] and that usually means that it’s very treatable, and you can put it into long term remission,” explains Carolyn Runowicz, an oncologist and associate dean at the Herbert Wertheirm College of Medicine at Florida International University, who is not treating Newton-John. “It’s never good news to have a recurrent tumor — that’s devastating to the patient. But the further out you are from your initial diagnosis, the better the prognosis.”
Doctors have diagnosed the star, 68, with breast cancer that has metastasized to the sacrum (a bone in the lower back), according to a statement the singer posted on Facebook. She has also put her U.S. and Canadian concert tour on hold after initially postponing two weeks ago because of severe back pain from what she thought was sciatica.
“We’re lucky that there’s new drugs being developed and new treatments over time that make a difference, but this is something that 10 years of her life will be about trying to control this,” says Laura Esserman, director of the UCSF Carol Franc Buck Breast Care Center. “Part of anybody’s treatment should be about how you can handle every day in spite of the situation you find yourself in.”
Metastasis is the development of secondary malignant growths from a primary site of cancer, and the sacrum, where Newton-John is affected, is situated between the two hipbones of the pelvis.
“Bone metastatic disease is the most common type of metastatic disease from breast cancer,” explains Raquel Prati, a breast surgeon at the Ronald Reagan UCLA Medical Center. “When it goes to the bone only, she may not need very aggressive treatment.”
According to Prati, metastatic to the bone tends to behave better than in other areas that breast cancer can affect, such as the liver or the brain.
Along with natural wellness therapies, the entertainer will be treated with a “short course of photon radiation therapy,” according to the statement.
Sheri Marquez, a radiation oncologist and medical director at the Cecilia Gonzalez De La Hoya Center in California, notes that Newton-John’s diagnosis “is not considered curable, but considered treatable” and breaks down what her type of radiation treatment typically entails.
“We use higher energy x-rays to kill cancer cells, basically,” Marquez says. “When you get radiation therapy, the x-ray is stronger, and it’s focused treatment so we can shape where the radiation goes.”
As Marquez explains, radiation therapy is planned for the area that needs to be treated, so the side effects of treatment will relate only to what’s treated.
“When we’re treating the pelvis, and the rest of the body is being protected, she won’t lose the hair on her head,” Marquez says. “She may get nausea, vomiting or diarrhea from irritation in those treatment areas.”
Since bone marrow would be the target in this case, there’s a chance that white blood cell, red blood cell, and platelet count could be affected. With that, there’s a higher risk of infection, bleeding, and fatigue.
With a short course of treatment, Marquez says that over 90 percent of patients will report some benefits and eventually over 50 percent will have complete resolution of their pain.
“We try very hard with the treatment to spare what we don’t need to treat so patients can get back to their lives,” Marquez says.
In 2013, Newton-John lost her beloved sister Rona to brain cancer shortly after her diagnosis. Whether her family history will come into play now, Prati says, “Brain cancer tends not to be related to breast cancer, but it depends on how much more family history she might have.”
“All cancers are genetic, but all cancers are not inherited,” adds Runowicz. “So you have to take a very careful history.”