Being told you have metastatic (stage IV) breast cancer is a lot to take in. It means your cancer has spread to other parts of your body. There is no cure, but your doctor has ways to slow the disease's growth. You might live for many more years.
Thanks to better treatments, people are living longer than ever.
To manage your treatment and life on your own terms, learn about the disease and what to expect.
What’s Different About Metastatic Breast Cancer Treatment?
When you have early-stage cancer, your treatment is short-term and focused on a cure.
With stage IV breast cancer, some form of treatment will be a part of your life from now on. The goal is to slow the disease’s growth for as long as possible, with the least amount of side effects or pain.
As medical therapies improve, experts hope that this form of cancer someday will be treated like diabetes or other ongoing, "chronic" conditions, where the disease is managed for several years or even decades.
How Is It Treated?
The options your doctor recommends for you will depend on:
- Where in your body you now have cancer
- The kind of cancer cells you have
- Your symptoms
- Breast cancer treatments you’ve had in the past
- Your general health and age
- Your preferences
What Treatment Is Right for Me?
That decision is up to you. Doctors will offer you choices based on your unique situation. Find out as much as you can about your options, and make sure you know the side effects before you make decisions.
These common treatments are often used alone or in combination:
Hormone therapy. If your cancer is fueled by estrogen or progesterone, hormone therapy medications can help shrink the tumors. They starve cancer cells by cutting off the supply of hormones they need to grow.
Anti-HER2 targeted treatment. Some breast cancer cells have too much of a protein called HER2. This makes them more likely to grow and spread. Drugs that target this protein can help slow the growth of HER2-positive breast cancers.
Chemotherapy. These medications work by killing cancer cells. A benefit of chemo is that it can often shrink tumors fast. But the treatment usually has more side effects than hormonal or targeted therapy. Common ones include hair loss, vomiting or nausea, and tiredness.
You receive chemo in cycles. Each treatment period is followed by a rest to give your body time to recover.
Breast cancers that aren't fueled by hormones or the HER2 protein are called triple negative. They generally respond to chemo.
Comfort care is important, too. Medication can help with your symptoms or complications of cancer, and it helps manage side effects, too.
You may want to consider clinical trials. Ask your doctor if he knows of one that may be a good match for you. All of today’s standard treatments were first tested in research studies. It’s possible you may get a cutting-edge therapy before it’s available to everyone.
How Will Doctors Know if the Treatment Is Working?
Every few months, you’ll get X-rays and other scans to see if the cancer has grown, shrunk, or stayed the same. You’ll get a physical exam, too. Tell your doctor about any symptoms you've noticed.
Your doctor may order a test to check for "tumor markers." Some cancer tumors release these signs, which can show up in your blood. If the test shows that these markers are rising, it could mean that the cancer is growing or spreading.
Doctors will look at all your test results and your symptoms to decide whether your treatment is working.
Sometimes cancer can no longer be seen on scans. Your doctor may say you have “no evidence of disease.” This is something to celebrate, but the cancer isn't gone. Cells are still circulating in your body, so your treatment will continue.
Can I Take a Break From Treatment?
Yes, it’s possible. You might need one, especially if side effects bother you.
Talk to your doctor about it if an important occasion is coming up, like a wedding or a milestone birthday. A break may be just what you need to enjoy this special time.
What Happens if the Treatment Stops Working?
Cancer often learns to “outsmart” a drug and finds a way to grow or spread again. When this happens, your doctor will talk to you about other options.
You’ll stick to a treatment for as long as it works. When it stops, you’ll move on to another one.
Eventually, there may be no new options. They may not work, or the side effects may be too much for you.
If you stop, the focus of your treatment will shift to keeping you as comfortable as possible so you can enjoy life.
What Can I Do to Feel Better in Body and Mind?
Eat well and stay active. A well-nourished body can handle treatment better. Exercise relaxes muscles and keeps you strong. Yoga can be helpful because it can lessen fatigue and stress, and improve your sleep.
Lean on loved ones. Your friends and family can support you when you need it the most. Sharing a meal or seeing a movie together can remind you that your life isn’t just about cancer.
Get emotional support. There will be times when you may feel alone, out of control, or anxious. Consider joining a support group specifically for people with metastatic breast cancer. The web site of the Metastatic Breast Cancer Network offers links to several. Talking to others in your same situation, whether it’s online or in person, can help you feel more connected.
Stay spiritual if it gives you strength. Now’s the time when beliefs can be tested the most. A religious leader or spiritual counselor can help you make sense of what’s happening and reconnect you with your core beliefs.
Be present. Mindfulness meditation uses deep breathing and relaxation to lessen stress. It's taught in a class. Practicing it every day for at least 20 minutes can help ease pain and help you learn how to live in the moment.
Smell the roses. Take the time to do the things that bring you joy. Paint a picture. Dance to your favorite tunes. Drink in that beautiful sunrise. If it puts a smile on your face, it’s worth doing.