Stephanie Walker was diagnosed with metastatic breast cancer (MBC) nearly a decade ago — an experience she says transformed every part of her life.
“Metastatic breast cancer is like a thread that has been woven through every aspect of my life: from my professional life to my personal life, to my emotional and financial life,” Walker said.
MBC, also known as stage IV breast cancer, occurs when cancer cells spread beyond the breast to other parts of the body, such as the bones, lungs, liver, or brain. While it is not considered curable, it is treatable — and advances in cancer research continue to help extend survival and strive to improve quality of life for people living with MBC.
Living in a rural area of North Carolina, Walker spent eight years traveling 100 miles each month for treatment. This kind of travel burden is not uncommon for Walker and the estimated 168,000 women living with incurable MBC, and can significantly disrupt daily routines, professional commitments and personal relationships.[i]
For Walker, those long trips and extended appointments meant time away from her husband and missed moments with her grandchildren.
“I absolutely can say that I had no control of my life at one point,” she said. “I was always going to the doctor’s office.”
Beyond the physical toll, many patients with MBC face emotional strain from the relentless cycle of appointments, scans, and treatments. Life can begin to feel divided into short intervals, waiting for the next scan or result.
For some, new treatments that seek to emphasize comfort, convenience, and flexibility offer hope — not only in improving physical outcomes but also in helping patients reclaim more of their everyday lives.
Dr. Lillian Smyth, senior vice president, global development head, breast cancer, is a medical oncologist and leads the development of breast cancer medicines at Eli Lilly and Company (Lilly). Her work plays a critical role in making today’s investigational treatments into tomorrow’s standard of care.
Dr. Lillian Smyth
Senior Vice President, Global Development Head, Breast Cancer, Eli Lilly and Company (Lilly)
“Every day I have the ability to make a broader impact on patient outcomes,” she recalled. “I, like many other oncologists, just want additional treatment options for patients, and I want them urgently.”
For Dr. Smyth, advancing care for people with MBC is more than a profession — it’s a personal mission. She is dedicated to discovering and developing medicines that have the potential to meaningfully improve patients’ lives.
“More recently, the pace of drug development is greatly accelerating,” she shared. “Ultimately, that’s a good thing for patients — bringing more options to those who need them.”
Recent advancements in MBC treatments have focused on the development of targeted therapies to improve patient outcomes. For example, oral selective estrogen receptor degraders (SERDs), help treat estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-)—the most common subtype of MBC.
An estimated 50% of ER+, HER2- MBC patients may develop a mutation in the estrogen receptor 1 (ESR1) gene after exposure to aromatase inhibitors, leading to estrogen-independent tumor growth, accounting for acquired endocrine resistance.
Oral SERDs help address key challenges associated with treatment resistance, and may also provide a promising alternative to existing hormone therapy — which are often administered as an intramuscular injection — potentially allowing patients to take an oral medication at home.[ii]
Additionally, recent treatment advances for MBC provide the potential for increased patient comfort and convenience, and may also eliminate the time and travel burden associated with some doctor’s office visits.
Many of these advances mark a meaningful step forward in the treatment of MBC, especially for patients whose disease may no longer respond to traditional hormone therapies.
While the physical symptoms of an MBC diagnosis may be visible, the emotional and psychological toll often remains unseen — and overlooked. According to Lilly’s MBC survey, oncologists and nurses have reported a growing need for patient mental health support, with increases of 15% and 23%, respectively, between 2018 and 2024.
The results found a majority of people living with MBC and their loved ones reported developing or experiencing worsened mental health after their diagnosis. Across all three years of the study, more than half of patients’ friends and family reported feeling anxiety, and nearly 50% experienced depression in 2024 alone.
From the long medical appointments to challenges in both professional and personal life — and the mental health impact that can follow — MBC remains a life-altering diagnosis that profoundly affects patients physically, emotionally, and socially, and fuels a shared passion for better care among patients, advocates, and healthcare professionals alike.
“Patients like me just want their life to go back to as normal as possible, including work,” Walker said. “Hopefully, we will get closer to that with the treatments being developed.”
Walker’s resilience and Dr. Smyth’s unwavering dedication embody the strength of the MBC community. Whether it’s raising their voices in advocacy or advancing care in the lab, they represent a powerful force of unity and determination — leading the way toward a better future in the face of this disease.
[i] Quick Facts on Metastatic Breast Cancer | NIH MedlinePlus Magazine. MedlinePlus, U.S. National Library of Medicine, 14 Oct. 2020, magazine.medlineplus.gov/article/quick-facts-on-metastatic-breast-cancer.
[ii] Lloyd, Maxwell R, et al. “Next-Generation Selective Estrogen Receptor Degraders and Other Novel Endocrine Therapies for Management of Metastatic Hormone Receptor-Positive Breast Cancer: Current and Emerging Role.” U.S. National Library of Medicine, PubMed Central, 30 July 2022, pmc.ncbi.nlm.nih.gov/articles/PMC9340905/.
