Find the Right Metastatic Breast Cancer Treatment for You The most effective treatment depends on what type of breast cancer you have. An oncologist explains what factors come into play when making a decision. 84

[MUSIC PLAYING]

KEERTHI GOGINENI: I think

of stage 4 breast cancer

and metastatic breast cancer

as being interchangeable.

These mean the same thing

from the standpoint of where

the cancer is,

and we mean that it has left

the breast and the lymph nodes

in the underarm

and found its way

to another part of the body.





The treatment options that are

available that are the most

effective depend on the type

of the breast cancer.

So we have breast cancers that

are sensitive to estrogen

and progesterone,

and using certain medications

to block that can be a really

effective way to treat

those kinds of breast cancers.





There are some women who are

going to have a subtype

of breast cancer

that's called HER2-Positive

breast cancer.

There are a lot of drugs that

target that specific kind

of breast cancer.

And there are women who have

Triple-Negative breast cancer,

and there are new advances

coming for this kind of breast

cancer, as well,

including immunotherapy.

So what might be the best option

for one patient who has

metastatic disease

may not be the best option

for the patient that's coming

in after.





So really trying to combine what

evidence is out there for what's

quote, unquote, best,

but also making sure you're

pairing that with the person's

needs that are in front of you.

Keerthi Gogineni, MD, Winship Breast Oncologist.<br>Pond5. <br>AudioJungle. /delivery/aws/ef/33/ef335f41-287a-372b-a845-1afec3317410/funded-expert-feature-metastatic-breast-cancer-treatment-options_,4500k,2500k,1000k,750k,400k,.mp4 07/30/2019 13:07:00 650 350 photo of xray /webmd/consumer_assets/site_images/article_thumbnails/video/funded_expert_feature_breast_cancer_treatment_options_video/650x350_funded_expert_feature_breast_cancer_treatment_options_video.jpg 091e9c5e81cdd7be

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. Although there is no cure, your doctor has ways to slow the disease's growth and help you keep a good quality of life. And 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.

Difference With Metastatic Breast Cancer Treatment

When you have early-stage cancer, your treatment focuses on a cure and preventing the cancer from coming back.

With stage IV breast cancer, the goal of treatment 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 someday to treat this form of cancer like diabetes and other ongoing, "chronic" conditions, which doctors can manage for several years or even decades.

Treatments

The options your doctor recommends for you will depend on:

  • Where the cancer is in your body
  • The kind of cancer cells you have
  • Your symptoms
  • Breast cancer treatments you’ve had in the past
  • Your health and age
  • Your preferences

How to Pick the Right Treatments

It’s your decision. Doctors will offer choices tailored for your condition. Learn as much as you can about your options, and find out about possible side effects before you decide.

Ask to work with a palliative care team as well. Their focus is to help coordinate your care and help you work through decisions about what types of care you want to receive and how to handle the side effects.

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 targeting the 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 kill cancer cells as well as any other fast-growing cells. A benefit of chemo is that it often can 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 get chemo in cycles. After each treatment period, you get 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 need chemo.

Radiation  and surgery. These therapies are used for specific reasons like treating cancer that has spread to the liver, bone, or brain.

Targeted therapy. Targeted drugs block the growth and spread of cancer cells. They work differently from chemotherapy in that they only attack the cancer and have different side effects. Sometimes they work when chemo drugs don’t. They can also help other types of treatment work better.  

Comfort is important, too. Medication can help with your symptoms or complications of cancer, and also to manage side effects.

You may want to consider joining clinical trials. Ask your doctor if she 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 to Tell 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 if you notice any symptoms.

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 you’ll continue treatment.

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.

If Treatment Stops Working

Cancer sometimes learns to outsmart a drug and finds a way to grow or spread again. If 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 doesn’t, you’ll move on to another one. If the time comes when there aren’t other options or the side effects are too much, let your doctor know how you feel and that you want your treatment to focus on comfort.

How to Feel Better in Body and Mind

Each person is different. But there are things that seem to help most people feel as good as possible, with or without cancer. See how many of these are helpful to you now:

Eat well and stay active. You can keep it gentle. This may help you handle treatment better. Exercise relaxes muscles and keeps you strong. Easy stretches and yoga can make you feel less tired and stressed and help you sleep better.

Lean on loved ones. Your friends and family can support you when you need it the most. Share a meal or watch a movie together to help remind you that life is more than just about cancer.

Get emotional support. Consider joining a support group for people with metastatic breast cancer. Talking to others who are in the same situation, whether it’s online or in person, can help you feel more connected. It also helps to talk to a professional counselor who can help you manage your feelings as you go through treatment.

Stay spiritual if it gives you strength. A religious leader you know and trust, a spiritual counselor, or your small group can help you process what’s happening and stay connected with your community and core beliefs.

Be present. Mindfulness meditation uses deep breathing and relaxation to lessen stress. You can learn it in a class or simply take a few minutes each day to quietly focus on something, such as your breath or a calming word or phrase, letting other thoughts and feelings come and go. It may help you stay in the moment.

Savor life. 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.

WebMD Medical Reference

WebMD Voices

Lisa B.
Coral Springs, FL
Within the past 14 years, I've been on chemo and hormone therapy. The part that gives me hope is new drugs and therapies are more abundant then 20 years ago, with more to come. Every day, breast cancer is my shadow, but is not my life.
Linda L.
Saddle River, NJ
Be your own advocate. If you have a question for your doctor and don't understand the answer, ask again. If it's difficult to speak up, ask a relative or friend to go with you. If you're not comfortable with your doctor or the treatment she recommends, get a second opinion.
Mary G.
Oregon, WI
Swimming helps my whole body relax and relieves my aching bones. Reaching and pulling strokes stretch out and massage my arm. Yoga keeps my breathing calmer, and I use techniques I learn in class to help me go to sleep at night.
Fabianna M.
Dover, NH
Celebrate small successes. It's about progress towards wellness, not an all-or-nothing scenario. After surgery, it was a while before I could drive. The day I got back in the driver's seat, I drove myself to the beach. I remember sitting on a bench for an hour, reveling in the joy of taking my life back.
Mary R.
Livonia, MI
When I was first diagnosed, I was in shock. Getting information helped. My husband and children helped by listening and allowing me to cry when I needed to. I also formed a support group at my hospital. Talking as a group and forming friendships is very helpful. We all know what each of us is going through.
Catriona M.
Canal Winchester, OH
Ask family and friends for help and support. It's so easy to want to try to do it all, but people really do want to help you. You'll need every ounce of strength you have, so let people bring meals and clean your house if they want to. For many, it's how they show they love and care about you.
Suzanne K.
San Francisco, CA
Put your energy elsewhere, in a better place. I got involved with new challenges that inspired me. I joined a new company. I got involved with the Cashmere Foundation, which brings the spa experience to patients undergoing chemotherapy. I feel I'm able to pay back, or perhaps pay it forward, while helping others.
Mary G.
Oregon, WI
Bring a support person to your first appointment to take notes and listen. Learn all you can on reputable websites. Breathe. Gather your inner circle of supportive friends and lean on them. It's OK to be mad as hell. There will be good and bad days. On bad days, think of the good ones just around the corner.
Sheila M.
Swansea, IL
For a very long time, I didn't accept it. When I finally did, I stopped worrying about things that were beyond my control and I started enjoying life. Having MBC has given me a new purpose through my advocacy work with Metavivor's Serenity Project. I want women to stand on my shoulders of hope and love.
Mary R.
Livonia, MI
I always feel better when I'm rested. I sleep 10-12 hours many days. Smiling and having a good sense of humor makes difficult situations better. I don't worry about small things anymore. Meditation, music, and massages help. I also cope by coloring and sewing, when I have the energy.
Sheila M.
Swansea, IL
People often tell me, "Well, you should do this or you should do that." There's no right or wrong answer on how we deal with this disease. I've learned to deal with it on my own terms and in my own way. I continue to let my faith guide me, and I continue to lean on my family and friends for support.
Lisa B.
Coral Springs, FL
In addition to treatment, I do daily meditation, which calms my body as well as my mind. I find it to be very peaceful. I also find walking and yoga to be a form of relaxation -- and it's healthy. I call it ‘doing my homework.' The drugs are doing their job, and it's my responsibility to take care of me.
Lauren H., 39
Oakley, CA
Many with stage IV hate the comment, ‘Well, you don't look sick at all!' This both implies that I should look weak and sad all the time. And since I don't, I'm throwing off their expectations of what someone with cancer should look like.
Jeanette R., 47
Advance, NC
This cancer has been an odd gift, opening my eyes to the beauty in the little everyday things in life. Slow down, pause, savor it. Repeat. … The more I pray for it and practice, the easier it gets.
Lara M., 42
Louisville, KY
The corner … I lived in fear of looking around it for nearly 5 years. Over time, I've learned how to live more fully present instead of worrying about the perceived future.
Ericia L., 42
Massillon, OH
It's about facing one's mortality while trying to keep the courage to continue on for your family. It's like walking through mud with high heels on. You slip and fall and then you get up and try again, over, and over, and over. Sometimes you stay down for a while, sometimes someone throws you a rope to help, but the mud is always there.
Suzi M., 54
White Cloud, MI
I lift up life with cancer with music! With a good soundtrack, I can get through anything. My life consists of various soundtracks that helped me through some of the most difficult times in my life.
Danielle W., 35
Green Bay, WI
Have I done everything that I wanted to do in life? Hell no! My kids are only 8. I’m 34 years old. But I’ll continue to live my life to the fullest with my kids’ happiness first and foremost.
Jeanette R., 47
Advance, NC
I haven’t felt like there has been any new news, but in reflection, that’s not entirely true. Every day that I wake up and get to go to work to help support my family is good news. Every day that I get to spend being a wife and mother is good news.
Lauren H., 39
Oakley, CA
The truth is, I’m not good at having stage IV cancer. I didn’t plan for this, and there aren’t books called 'How to be the Best Version of You With a Stage IV Diagnosis' to provide me with nine steps for dealing with my diagnosis. Instead, I figure it out every day.
Keeli A., 37
Erie, CO
My family’s priorities have changed. We take more vacations, worry about little things less. I’m trying to make my children’s childhood rich with memories and love. When they look back on me, I want them to remember the fun we had, not the illness.

From WebMD

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