Not long ago, the main goal of treating metastatic breast cancer -- meaning the disease has spread well beyond the breast -- was to keep a woman comfortable. But a lot has changed in the past decade. Now treatment can help many women live longer, better, and disease-free for periods of time.
Pamela Drullinsky, MD, a cancer doctor at Memorial Sloan Kettering Cancer Center in New York, says many doctors now see metastatic breast cancer as a chronic illness, because it can be managed for years. “This is similar to [people with diabetes] taking insulin,” she says. “It is still incurable but can be controlled.”
Here's how to take charge of your diagnosis and live better with metastatic breast cancer.
The uncertainties of having metastatic breast cancer can make you feel like you've lost control of your life. A treatment plan will help you feel more in control. To create one:
Learn as much as you can about where your cancer has spread and what type of tumor you have. Your treatment will depend largely on these things.
Think about the main goal of treatment. Do you want to get rid of the new cancer, or relieve symptoms? Talk to your doctor about realistic goals.
Decide whether you want to use the same medical team or add other doctors.
Even if you're happy with your doctors, it's a good idea to get a second opinion to confirm that you're getting the best treatment possible. "It is also important to be evaluated at an academic or research institute that may have cutting-edge trials,” says Tiffany Troso-Sandoval, MD, a cancer doctor at Memorial Sloan Kettering Cancer Center.
Metastatic Breast Cancer Treatments
The most common treatments for metastatic breast cancer are ones that travel through the blood, treating your entire body. Most likely you'll start with one or more of these:
Anti-estrogen therapies, also known as hormone therapy. If your breast cancer is hormone receptor-positive, your body's estrogen makes the cancer cells grow faster. In that case, there's a good chance the cancer will respond to an anti-estrogen drug like anastrozole (Arimidex), exemestane (Aromasin), fulvestrant (Faslodex), letrozole (Femara), tamoxifen (Soltamox, Nolvadex), or toremefine (Fareston). These drugs prevent cancer cells from getting the estrogen they need to grow. Clinical trials are also using newer medicines in combination with these.