Metastatic Breast Cancer Treatment: 10 Things to Know When Starting the Treatment

Also known as stage IV or advanced breast cancer, metastatic breast cancer is a term used to refer to the most advanced stage of breast cancer. When you get diagnosed with metastatic breast cancer, it means that your breast cancer has spread beyond the breast tissue and nearby lymph nodes to the other parts of the body, most commonly the lungs, liver, brain, and the bones. If you are handed a diagnosis of metastatic breast cancer, it can be a scary and overwhelming experience. Treatment for cancer is likely to take up most of your time, and your focus tends to shift from work and family to your doctor’s visits, blood tests, and scans. There will be a lot of questions that you will have about metastatic cancer, and here are some important things you need to know when starting treatment for metastatic breast cancer.

Metastatic breast cancer is commonly known as stage IV cancer. When you are diagnosed with metastatic breast cancer, it means that your breast cancer has spread to other parts of the body, most commonly being the brain, liver, bones, or even the lungs. Some people may find that their breast cancer comes back in another part of the body sometimes months or years after the original diagnosis and successful treatment. Approximately 30 percent of all women who are diagnosed with early-stage breast cancer go on to develop this metastatic disease. The symptoms of metastatic breast cancer vary greatly and depend on the location of the cancer. Metastatic breast cancer is not the same for every woman who has it, and the symptoms at this stage 4 of cancer also depend on the degree to which the cancer has already spread throughout the body. Even though metastatic breast cancer has no cure, there are treatments available that can help you live a better quality of life and also increase your life span. Now here are some things you need to know when starting treatment for metastatic breast cancer.

The hardest part of living with metastatic breast cancer is knowing that there is no cure for advanced breast cancer. This is because once the cancer spreads from the breast tissue to other parts of the body, it is no longer curable. However, being incurable does not mean that the cancer is not treatable. Radiation, chemotherapy and even hormonal and targeted therapies are all treatments that can help shrink the tumor and slow down the progression of the disease. These treatments help prolong your life and also enables you to feel better and increase your overall quality of life. ⁽¹⁾

There is no one-size-fits-all treatment for metastatic breast cancer. This is why when you are first diagnosed with stage IV breast cancer, your doctor will start by running some tests that look for certain genes, hormone receptors, and growth factors. These diagnostic tests help your doctor determine the best and most effective treatment plan for your particular cancer type. A particular type of breast cancer is known as hormone receptor-positive, and in this type of cancer, the hormones progesterone and estrogen are responsible for helping the breast cancer cells grow. ⁽²⁾ The hormones, though, only have this particular effect on cancer cells that have a hormone receptor on their surface. This hormone-receptor is similar like a lock, and the hormone functions like a key that fits into this lock. Hormone receptor-positive breast cancers are known to respond well to hormone therapies such as aromatase inhibitors or tamoxifen. These help stop estrogen from helping the cancer cells grow. ⁽³⁾ Certain breast cancer cells are known to have human epidermal growth factor receptors (HERs) on the surface. ⁽⁴⁾ HERs are the proteins that are responsible for signaling the cancer cells to divide. Cancers cells that are known to the HER2-positive tend to grow and divide more aggressively than the other cells. These need to be treated with targeted medications such as pertuzumab (brand name: Perjeta) ⁽⁵⁾ or trastuzumab (brand name: Herceptin) ⁽⁶⁾ that help block these signals for cell growth.

The fact is that if you have been diagnosed with metastatic breast cancer, you will be spending a lot of time at doctors and in medical facilities. Treatments for stage IV breast cancer will require you to visit many doctors and many clinics or hospitals. You will wind up spending a lot of your time with your doctor, so be mentally prepared for it. Chemotherapy treatment for metastatic breast cancer, for instance, is known to be a lengthy process. It is going to take several hours to administer intravenous medication, and in between these treatments, you will also need to return to your doctor for tests for making sure that the current therapy is working. Make sure that you have someone who can drive you to and from the chemotherapy sessions as you could feel tired and it is unsafe to get behind the wheel in such condition. If you are working, then it is important that you talk with your employer and schedule your sessions around the work hours. Some people also find that taking time off for the treatment appointments gives them the time to recover better. ⁽⁷⁾

While the treatments for metastatic breast cancer are highly effective, there are several side effects that are associated with these treatments. For example, hormone therapies may make you experience many of the symptoms that are usually associated with menopause, such as thinning bones (a condition is known as osteoporosis) and hot flashes. Chemotherapy can make you feel nauseated, make your hair fall out, and also cause vomiting and diarrhea. Your doctor will prescribe the best-suited treatment for you and also help you manage the side effects that stem from these treatments. If your doctor finds that you are experiencing too many side effects from a particular treatment, then they will recommend changing over to another treatment. ⁽⁸⁾

Treating cancer is not cheap. It is going to cost you a lot of money regardless of whether you have insurance or Medicare. Most insurance policies do not cover the entirety of your treatment costs, and many of the private insurance plans have caps. These are limits on how much you will need to pay from your own pocket before the insurance plan kicks in. You can end up spending several thousand dollars before you end up reaching your cap. What’s more, during the time period you are undergoing treatment, it might be that you are unable to work and your salary might suffer as a result, making things more challenging financially. This is why it is important that before you begin treatment, you should find out the expected costs from your doctor and medical team. Then call up your health insurance company and find out how much of this cost they will end up covering. If you are worried about not being able to pay the medical bills, you should ask a social worker or even a patient advocate present at the hospital for some advice on how much financial aid you can get and from where. ⁽⁹⁾

When you are getting treated for metastatic breast cancer, it can be exhausting. Furthermore, cancer treatments, such as chemotherapy is only going to aggravate your fatigue. This is why you should be mentally prepared that you will not be able to accomplish everything that you were doing before your treatment began. At this time, support from your family and friends can make a huge difference. This is why it is a good idea to reach out to your loved ones for getting helps with tasks such as cleaning, cooking, and even grocery shopping. The time you save can be put to use for resting and regaining your strength.

Every person who is diagnosed with metastatic breast cancer and is undergoing treatment will be suffering from a different type of cancer and having a different treatment regime. Even if you find someone who has the exact same kind of breast cancer as you, the cancer is not likely going to respond or behave in the same way as yours. This is why it is always better to focus only on your own situation rather than comparing your treatment plan or your condition to others. While it is a good thing to get support from others, do not compare yourself to other women with breast cancer. ⁽¹⁰⁾

Based on your diagnostics tests and your overall condition, your doctor will come up with certain treatment plans for you. However, the decision of choosing a treatment plan will ultimately be up to you. You should choose the treatment that will help extend your life span for as long as possible, but one that will also have the side effects that you find to be the most bearable. You should also take advantage of palliative care. This includes pain relief methods and other tips that will help you feel better as you undergo treatment. There are many hospitals and clinics that offer palliative care as part of their cancer care packages or programs.

According to a study done in 2017, there are more than 15,000 women who are living with metastatic breast cancer in the United States. ⁽¹¹⁾ This staggering statistic shows that you are not alone. You are already part of a community that is full of other women who are also going through the same thing as you. It is a good idea to join a support group either online or even in-person. You can find such support groups through organizations such as the American Cancer Society ⁽¹²⁾, or even through your doctor or hospital. Often, hospitals also have their own in-house cancer support group for patients that provide you with private counseling. You can also seek help from mental health providers if you are feeling overwhelmed and depressed.

If your doctor has gone through all of the existing treatments available for managing metastatic breast cancer and all these treatments either didn’t work or have stopped working, then there is always the option for trying out a clinical trial. These trials are always experimenting with new treatments, and you can ask your doctor about how you can enroll in one of these. It is possible that an experimental therapy during a clinical trial can help slow down or someday, even cure, metastatic breast cancer.

Being diagnosed with metastatic breast cancer can be overwhelming, and you will feel a whole range of emotions from feeling angry to being stressed, scared, outraged, and depressed. Many people tend to question the treatments they are on or get angry at their doctors or themselves for not being able to get ahead of the disease. Others may end up dealing with the diagnosis of metastatic breast cancer matter-of-factly and practically. There is no right or wrong way to come to terms with the fact that you have metastatic breast cancer. There are just some things that you need to be aware of while you are undergoing treatment so that you are able to do and feel what is best for you in the given situation.

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