Medpagetoday, a site targeting medical professionals, reports:

John Edwards, the former senator, announced today that his wife, Elizabeth Edwards, 57, has had a recurrence of breast cancer, a bony metastasis, but he is continuing his campaign to be the Democratic candidate for the presidency. Elizabeth Edwards had a lumpectomy in 2004 and adjuvant chemoradiation. He and his wife called the malignancy treatable. "The campaign goes on," he said.

There are a few comments on the website, but it is a relatively new development that even metastatic breast cancer, especially in postmenopausal women, is moving to become a manageable chronic disease. I do not suggest it is trivial or can be managed without excellent care and drugs. In the context here, this personal tragedy may be able both to draw attention to research, participation in clinical trials, and the need for access to the appropriate level of care for all patients.

Several consecutive clinical trials managed the "hole in one" status of being stopped by the safety monitoring board, and the experimental treatment made available to all participants. This is done when the experimental treatment demonstrates statistically significant improvement over the best standard treatment, and it is considered unethical to withhold it.

The first such stop was with tamoxifen. Several years later, trials with aromatase inhibitors, with tamoxifen as the control arm, also were stopped.

At present, one of the research frontiers is to find out which aromatase inhibitor is best, or, as is suspected, different variants work better in different women. There's a possibility that drug selection should be based on body fat percentage.

Other research is exploring whether there are good reasons to use tamoxifen and aromatase inhibitors together.