The five-year mark for a breast cancer patient is a special date. It usually marks the end of hormone therapy and the completion of active treatment. Many of us bid farewell to our oncologist and go forth into a cancer-free future. I'm sure that's what Robin Roberts, co-anchor of "Good Morning America" was hoping for at her 5-year checkup, but it didn't happen. Instead, she was told that the chemo drugs which saved her life from breast cancer had caused another life-threatening problem: myelodysplastic syndrome (MDS). Myelodysplasia is a rare blood condition -- and while it isn't actually cancer, it can develop into leukemia if left untreated.
Chemotherapy drugs work by attacking fast-growing cells in the body -- and blood cells fit neatly into that description. In Roberts' case, the chemo apparently permanently damaged cells in her blood stream. Cells have a natural life cycle: they grow, divide, and die off. Healthy new blood cells replace the healthy old blood cells that have finished their job, so a constant blood supply is maintained. Myelodysplasia is a condition in which damaged blood cells don't live out their normal life span and don't replace themselves with an equal number of new cells. This leaves the body with fewer red cells than normal - anemia, or fewer white cells than is healthy - neutropenia. Myelodysplasia makes a person easily fatigued, at greater risk of infections, and since fewer platelets are produced - in danger of bleeding that is difficult to stop, since the clotting capability of the blood stream is reduced. Just about 5% of all breast cancer patients who took chemo may develop myelodysplasia, but if MDS runs in your family, tell your oncologist before starting treatment.
Robin Roberts announced her diagnosis on GMA today, with tears and thanks: her sister has undergone genetic testing and will be Robin's bone marrow donor. Myelodysplasia is treated by bone marrow transplant, given after special chemo preparations are given to kill off all of the patient's defective blood cells. It is a rigorous treatment regime - my sister had a bone marrow transplant for MDS just last year - and the body can go to war with itself when the transplanted cells are infused into a patient's bone marrow. There is the risk of graft versus host disease (GVHD) - if your body' immune system attacks the donor cells, it becomes a war within your bone marrow. The good news is this: Roberts is 51 - young enough and healthy enough to withstand treatment and with better odds of conquering myelodysplasia. Patients who are children or relatively young adults have between a 30 - 50% cure rate from a bone marrow transplant. Having a close relative as a donor improves the odds, so having her sister Sally-Ann Roberts as a genetic match is a great blessing.
Roberts will soon have a PICC line placed in her arm, to make blood draws, transfusions, and chemotherapy treatments easier on her and her healthcare team. Intravenous catheters can protect your veins from chemical damage and cut down on repeated needle sticks due to rolling veins. It's likely that she will begin regular chemotherapy treatments aimed at killing off the damaged blood cells before her bone marrow transplant, so if you don't see her on GMA in her regular spot, don't worry. She will be starting a new routine, with a treatment schedule and side effects that will be different than those she has already endured.
Robin Roberts is an icon of strength, a brave and beautiful model of a public figure that refuses to hide her health ordeal or pretend that things are just fine. She and her sister are soon to share a very close bond - those special shared marrow cells - and bring greater awareness to bone marrow donation. She spoke about her situation, saying, "Bottom line: I've been living with this diagnosis for awhile and will continue to anchor GMA. I love what I do and the people with whom I do it. Along with my faith, family and friends, all of you at ABC News give me the motivation and energy to face this challenge." Many people followed her very public fight with breast cancer which she recalled, "When I faced breast cancer, your prayers and good wishes sustained me, gave me such hope and played a major role in my recovery. In facing this new challenge, I ask humbly for more of your prayers and love - as I will keep you in my mine and update you regularly on my condition." Best wishes to Robin Roberts - one tough and wonderful lady.