Metastatic Breast Cancer as a Chronic Condition
For women whose breast cancer has spread, treatments can improve their condition and add years to their life.
Treatments for Breast Cancer that Has Spread continued...
That usually involves one or more of three primary options:
Hormonal therapies, like Tamoxifen or Arimidex. These
treatments tend to have fewer side effects than chemotherapy. They control
metastatic disease just as well as or better than more aggressive treatment,
doctors say. They are only effective in women whose disease is
Herceptin. A monoclonal antibody, Herceptin works by
specifically targeting cells that overexpress the Her2 protein -- something
that happens in about one of every four breast cancers. Trials show that
Herceptin can lengthen survival for these women by an average of about 13
Chemotherapy. Chemotherapy for metastatic disease is a
very different animal from the aggressive regimens for early-stage breast
cancer. This often involves relatively high doses of multiple drugs.
- "For metastatic cancer, we usually prefer to use sequential
single-agent chemotherapy rather than a combination," says Hudis. "Our
goal is enough of a response rate to control the tumor while having a minimal
impact on the quality of a woman's life."
- Although the precise chemotherapy drugs used may vary, one of the best
currently available for metastatic disease is Xeloda, which is long lasting and
effective and can be taken at home in pill form.
Newer treatment approaches have also done wonders to reduce the often
painful symptoms of the disease. "Supportive care has gotten a lot better,
so that the symptoms that people have from treatments and progression of the
disease are much more controlled," says Musa Mayer, survivor of stage II
breast cancer, patient advocate with the National Cancer Institute, and author
of Advanced Breast Cancer: A Guide to Living with Metastatic
For example, a class of drugs known as bisphosphonates -- both pill
medications like Fosamax and Actonel, and stronger versions given by
intravenous injection called Aredia and Zometa -- has changed things
dramatically for women with cancer that has spread to their bones.
"These drugs have been very beneficial, because they slow the breakdown
of bone. One of the big problems with bone metastases used to be
fractures," says Mayer. "With these drugs, you don't have the kind of
damaging, progressive bone disease that we used to see."