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 estrogen-receptor positive.
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 months.
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 Disease.
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."