The question of what type of cancer a figure named Susannah had is a common query, frequently stemming from a popular work of fiction. This article clarifies the identity of the individual most often associated with this question and provides a detailed medical explanation of the specific cancer diagnosis. Understanding the nature of the disease requires moving from the character’s narrative to the underlying biological and clinical realities of the condition.
Pinpointing the Specific Susannah
The inquiry almost certainly refers to Susannah Fisher, a central character in the book series and television adaptation The Summer I Turned Pretty. Susannah’s illness is a primary narrative device, shaping the lives and relationships of the other main characters. She is the mother of Conrad and Jeremiah Fisher and the lifelong best friend of Laurel Park. Her battle with cancer is a defining element of her character, driving much of the emotional conflict in the series. She is depicted as having undergone a period of remission before the disease returned, leading many to search for the specific medical details of her condition.
The Confirmed Cancer Diagnosis
Susannah Fisher’s diagnosis was explicitly breast cancer, which had been successfully treated once before, only to recur later in the narrative. In the books, the recurrence of her breast cancer was described as having metastasized to her liver, a significant clinical detail. Metastasis occurs when cancer cells break away from the original tumor site and travel through the body to form new tumors in distant organs.
When breast cancer returns and spreads to a different organ, it is classified as metastatic, or Stage IV, breast cancer. This progression signifies that the disease is no longer localized to the breast or surrounding lymph nodes. Diagnosis typically involves imaging tests like mammography and ultrasound, followed by a biopsy to confirm malignant cells. For a recurrence, diagnostic tests like CT scans or PET scans are used to check for new tumor sites, such as in the liver.
Biological Characteristics of Breast Cancer
Breast cancer is a heterogeneous disease, encompassing several distinct types that arise from different cell lines within the breast. The most common type, invasive ductal carcinoma, originates in the cells lining the milk ducts and represents about 80% of all cases. Less commonly, cancer may begin in the lobules, the glands that produce milk, in a form known as invasive lobular carcinoma. The behavior of the cancer is determined by its molecular subtype, which is identified through testing tumor tissue.
Molecular Subtypes
Molecular subtypes are defined by the presence or absence of specific receptors that drive cell growth. These receptors include estrogen receptors (ER), progesterone receptors (PR), and the human epidermal growth factor receptor 2 (HER2). Hormone receptor-positive cancers rely on estrogen or progesterone to grow. Triple-negative breast cancer (TNBC) lacks all three receptors and is often more aggressive, presenting unique treatment challenges.
The recurrence of Susannah’s breast cancer, particularly its spread to the liver, indicates the tumor cells retained the ability to invade surrounding tissues. The liver is a common site for breast cancer metastasis due to its extensive blood supply, which allows circulating tumor cells easy access. The presence of tumor cells in the liver changes the disease classification to Stage IV. Risk factors include genetic predisposition, such as mutations in the BRCA1 and BRCA2 genes, and lifestyle factors.
Standard Treatment Pathways and Prognosis
The treatment for metastatic breast cancer shifts from curative intent to management of the disease and quality of life. The approach is systemic, meaning it targets cancer cells throughout the body, since the disease is no longer localized. Standard treatment modalities depend heavily on the tumor’s molecular subtype, as identified by biopsy of the primary or metastatic site.
Systemic Therapies
For hormone receptor-positive disease, treatment often begins with endocrine therapy, such as aromatase inhibitors, which block the effects of estrogen. These hormonal therapies are frequently combined with targeted drugs, like CDK4/6 inhibitors, to enhance effectiveness and delay the need for chemotherapy. If the tumor is HER2-positive, targeted therapies such as trastuzumab are used to specifically block the HER2 receptor, often alongside chemotherapy. Chemotherapy remains a standard option for triple-negative breast cancer or for cancers resistant to targeted therapies.
Radiation therapy and surgery may be used to manage localized symptoms, such as pain from bone metastases, but they are not the primary treatment for widespread metastatic disease. The prognosis for Stage IV breast cancer is highly variable. The five-year survival rate for distant metastatic disease is roughly 30%. Advances in systemic therapies have significantly improved management, allowing many patients to live for years with a good quality of life.