If you're facing advanced breast cancer, called metastatic or stage IV cancer, you probably have a lot of questions.
"The goals of therapy are to prolong life, while at the same time maintaining a good quality of life," says Julie Gralow, MD, of the Seattle Cancer Care Alliance and the University of Washington School of Medicine.
Though there is no cure, "there is no question that patients are living longer with metastatic disease, and our patients have many more treatment options than even just a few years ago," Gralow says.
So what are those options?
Until recently, not many women had surgery for advanced breast cancer. Now research shows it may help.
Your doctor may want to remove a tumor and start you on chemotherapy at about the same time, says Virginia Borges, MD, of the University of Colorado-Denver School of Medicine. Most patients with breast cancer will need surgery.
Rarely, your doctor may remove a tumor that's spread to another organ.
Doctors call this "oligometastatic" breast cancer, meaning that it is very limited in spread. "When that happens, we can sometimes go in and remove that -- for example, if there's just one small spot on the liver," says Gralow.
Surgery may also help if you have stubborn pain, a weak bone that needs to be stabilized, or another problem.
You can't have radiation to a breast that's already been treated with radiation. But radiation can be a very important tool to shrink tumors in other areas of the body. It can:
Stop the cancer from growing and keep symptoms under control. You might get radiation on a tumor that presses on your backbone, for example, to make you more comfortable.
Control bleeding or pain from cancer that's spread to the bone or liver.
For some people, doctors may use "stereotactic" treatment -- highly focused radiation -- to target spots in the liver or the lungs.