Breast Discomfort And Pain
Women may feel discomfort and pain as the cancer grows and spreads in the breast. Cancer cells do not cause pain but as they grow they cause pressure or damage to surrounding tissue. A large tumor can grow into or invade the skin and cause painful sores or ulcers. It can also spread into the chest muscles and ribs causing obvious pain.
A Number Of Physical Changes Are Common When The Patient Is Near Death
Certain physical changes may occur in the patient at the end of life:
- The patient may feel tired or weak.
- The patient may pass less urine and it may be dark in color.
- The patients hands and feet may become blotchy, cold, or blue. Caregivers can use blankets to keep the patient warm. Electric blankets or heating pads should not be used.
- The heart rate may go up or down and become irregular.
- Blood pressure usually goes down.
- Breathing may become irregular, with very shallow breathing, short periods of not breathing, or deep, rapid breathing.
However, these signs and changes don’t always occur in everyone. For this reason, it may be hard to know when a patient is near death.
What Is Stage Ii Breast Cancer
Stage II describes cancer that is in a limited region of the breast but has grown larger. It reflects how many lymph nodes may contain cancer cells. This stage is divided into two subcategories.
Stage IIA is based on one of the following:
- Either there is no tumor in the breast or there is a breast tumor up to 20 millimeters , plus cancer has spread to the lymph nodes under the arm.
- A tumor of 20 to 50 millimeters is present in the breast, but cancer has not spread to the lymph nodes.
Stage IIB is based on one of these criteria:
- A tumor of 20 to 50 millimeters is present in the breast, along with cancer that has spread to between one and three nearby lymph nodes.
- A tumor in the breast is larger than 50 millimeters, but cancer has not spread to any lymph nodes.
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Financial Help In The Final Stages Of Cancer
In addition to physical challenges, the final stages of cancer may also bring about additional financial challenges at the end of a long and costly treatment process. If your family needs supplementary funds to pay for care and ensure your loved ones quality of life, please contact Fifth Season Financial to learn more about the Funds for Living Program a way to get funding from your loved ones life insurance policy that can be used for their care today, without selling the policy.
What To Do If You Have Breast Cancer
When you learn about such an unpleasant diagnosis, the first thing to do is to avoid panic in any way. Try to pull yourself together. After that, be sure to look for an experienced doctor who will tell you what to do and how to proceed. Only an experienced doctor will be able to give you the right diagnosis, assess your overall condition, and be able to provide assistance that will lead to a positive result.
The main thing, in this case, is to see a professional doctor. Unfortunately, many countries have adopted a radical fight against this disease. Therefore, the question, whether it is possible to cure without surgery, the answer is a resounding no. But in the USA, such treatment can be carried out much more gently. Clinics here offer to conduct surgery for breast cancer, but try to keep as much healthy tissue as possible. In addition, after surgery in such centers, you will certainly be offered plastic surgery to restore the breast.
So, if you or your loved one was diagnosed with breast cancer, even if it is stage 4, do not panic. Find a great oncologist, select the best treatment option, and start it immediately. With this approach, the probability of a positive outcome increases many times. Remember even the worst and most difficult diagnosis can be a thing of the past if you start the right treatment on time and believe in the best outcome.
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Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open or painful wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent or treat bone fractures
- When a cancer is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms anywhere in the body
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand the goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
Palliative Sedation To Treat Eol Symptoms
In rare situations, EOL symptoms may be refractory to all of the treatments described above. In such cases, palliative sedation may be indicated, using benzodiazepines, barbiturates, or neuroleptics. Refractory dyspnea is the second most common indication for palliative sedation, after agitated delirium. For more information, see the Palliative Sedation section.
References
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The Tnm Staging System
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M.
The T category describes the original tumor:
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HER2 status: are the cancer cells making too much of the HER2 protein?
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Oncotype DX score, if the cancer is estrogen-receptor-positive, HER2-negative, and there is no cancer in the lymph nodes
Adding information about tumor grade, hormone-receptor status, HER2 status, and possibly Oncotype DX test results has made determining the stage of a breast cancer more complex, but also more accurate.
In general, according to experts, the new staging system classifies triple-negative breast cancer at a higher stage and classifies most hormone receptor-positive breast cancer at a lower stage.
You also may see or hear certain words used to describe the stage of the breast cancer:
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Distant: The cancer is found in other parts of the body as well.
The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized.
Phase : Living With Progressive Disease
Uncertainty pervaded every element of womens lives during this phase of illness. The continual oscillations between illness, treatment and recovery that women experienced undermined their ability to adjust. Those with more aggressive disease appeared to have little respite from the cycle of disease progression and treatment. They struggled to keep pace with changing events which eroded their sense of self and ability to adjust and adapt to the rapidity of events, at the same time as coping with the present and a foreshortened future.
For example, Jills illness trajectory highlighted a life with metastatic breast cancer which was dominated by sequential treatments. Over a 3-year period, she endured nine different episodes of treatment . Jill went through cycles of feeling and looking well and living her life to the full, followed by disease progression and illness.
A few of the women had involvement with palliative care services, but only one maintained this relationship over time.
All the women had times when their disease was stable. During this time, anticipating progressive disease meant the women lived with relentless vigilance over their bodies.
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Living With Metastatic Breast Cancer
An advanced breast cancer diagnosis often elicits a flood of emotions: fear, confusion, sadness, anger and worry. You may wonder, Why me? You may think its unfair that this has happened to you. All of these emotions and feelings are normal, so take the time to process your thoughts, speak with your care team to understand your diagnosis, and connect with loved ones and close friends for support.
Over time, as the shock wears off, many patients find that they get on with their lives, adjusting to what some call their new normal. You may continue to work, enjoy life and spend time with family and friends, even if sometimes you have less energy than before.
Try to eat a nutritious diet to feel stronger and better tolerate treatments. Maintaining good nutrition may also help lower your risk of infection and provide you with more energy for enjoying life.
Light exercise may give your mind and body’s boost, helping you feel energized, especially if you spend time in the fresh air. Always seek medical advice before making any changes to your diet or exercise routines.
Last Days Of Life Health Professional Version
On This Page
Despite progress in developing treatments that have improved life expectancies for patients with advanced-stage cancer, the American Cancer Society estimates that 609,360 Americans will die of cancer in 2022. People with cancer die under various circumstances. A report of the Dartmouth Atlas Project analyzed Medicare data from 2007 to 2010 for cancer patients older than 65 years who died within 1 year of diagnosis. Across the United States, 25% of patients died in a hospital, with 62% hospitalized at least once in the last month of life. In addition, 29% of patients were admitted to an intensive care unit in the last month of life. Approximately 6% of patients nationwide received chemotherapy in the last month of life. Conversely, about 61% of patients who died used hospice service. However, the average length of stay in hospice was only 9.1 days, and 11% of patients were enrolled in the last 3 days of life. Significant regional variations in the descriptors of end-of-life care remain unexplained.
This summary provides clinicians with information about anticipating the EOL the common symptoms patients experience as life ends, including in the final hours to days and treatment or care considerations. The decisions commonly made by patients, families, and clinicians are also highlighted, with suggested approaches. The goal of this summary is to provide essential information for high-quality EOL care.
References
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What Does It Mean To Have Stage 4 Breast Cancer
Stage 4 breast cancer means that the cancer has spread to other areas of the body, such as the brain, bones, lung and liver.
Although Stage 4 breast cancer is not curable, it is usually treatable and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal. With excellent care and support, as well as personal motivation, Stage 4 breast cancer may respond to a number of treatment options that can extend your life for several years.
Other Ways To Help Cancer Pain
With certain types of pain, doctors can do special procedures such as nerve blocks, targeted radiation treatments, or even surgical procedures to control pain. Sometimes physical therapy may help. If your pain isnt well controlled, your doctor might also refer you to an expert in pain management. The pain specialist might have some different options to help you.
Medicines and medical procedures are not the only ways to help lessen your pain. There are other things you can do. Some people find distractions like music, movies, conversation, or games help. Using heat, cold, or massage on a painful area can help. Relaxation exercises and meditation can help lessen the pain and lower anxiety for some people. Keep in mind that for most people with cancer pain these measures alone are not enough to control pain. But, they may help improve comfort when used along with pain medicines.
You can learn more in Cancer Pain.
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What Is Breast Cancer
Breast cancer originates in your breast tissue. It occurs when breast cells mutate and grow out of control, creating a mass of tissue . Like other cancers, breast cancer can invade and grow into the tissue surrounding your breast. It can also travel to other parts of your body and form new tumors. When this happens, its called metastasis.
What Caregivers Can Do
- Help the patient turn and change positions every 1 to 2 hours. It’s best to time any position changes to be about 30 minutes after pain medicine is given.
- Speak in a calm, quiet voice and avoid sudden noises or movements to reduce the chances of startling the patient.
- If the patient has trouble swallowing pain pills, ask about getting liquid pain medicines or a pain patch.
- If the patient is having trouble swallowing, do not give them solid foods. Try ice chips or sips of liquid.
- Do not force fluids. Near the end of life, some dehydration is normal.
- Apply cool, moist washcloths to head, face, and body for comfort.
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Advanced Cancer That Progresses During Treatment
Treatment for advanced breast cancer can often shrink the cancer or slow its growth , but after a time, it tends to stop working. Further treatment options at this point depend on several factors, including previous treatments, where the cancer is located, a woman’s menopause status, general health, desire to continue getting treatment, and whether the hormone receptor status and HER2 status have changed on the cancer cells.
Clinical Manifestations Of Stage 4
The main classification signs of breast cancer stage 4 are its spread to remote organs or lymph nodes. The size of the tumor at this stage is no longer important moreover, it may no longer be detected at the primary site.
It is the metastases that most often develop in the liver, lungs, and bones that give information about the development of the oncological process. They are painful and cause vivid symptoms. Metastases in the liver give jaundice and increase abdominal size. Metastases in the lungs give shortness of breath, and in the bones severe pain and frequent fractures.
- severe intoxication
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What Are The Early Signs Of Breast Cancer
Breast cancer symptoms can vary for each person. Possible signs of breast cancer include:
- A change in the size, shape or contour of your breast.
- A mass or lump, which may feel as small as a pea.
- A lump or thickening in or near your breast or in your underarm that persists through your menstrual cycle.
- A change in the look or feel of your skin on your breast or nipple .
- Redness of your skin on your breast or nipple.
- An area thats distinctly different from any other area on either breast.
- A marble-like hardened area under your skin.
- A blood-stained or clear fluid discharge from your nipple.
Some people dont notice any signs of breast cancer at all. Thats why routine mammograms and are so important.
Stage 2 Breast Cancer Symptoms
Patients with stage 2 breast cancer may not experience any symptoms, and the cancer may be discovered during a routine mammogram. Possible breast cancer symptoms in stage 2 include:
- Dimpled skin on the breast
- Swelling or redness
- An inverted or flattened nipple
- Changes to the skin of the breast
- Changes to the size or shape of the breast
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Talking To Your Healthcare Provider
It is crucial that you talk to your oncologist and healthcare team about any and all symptoms you are experiencing. Some of these symptoms, such as pain, are under-treated in people with metastatic cancer. This is not because healthcare providers fail to treat the symptoms, but because they are simply unaware that a person is coping with them.
Breast Cancer Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
With all of the talk about people with cancer being brave or strong, you might hesitate to share symptoms that could make you appear frightened or weak. Yet facing metastatic cancer is frightening, and being able to share your concerns is a sign of strength, not weakness. There is a lot that can be done to ease most of the symptoms of metastatic breast cancer, but the only way that your oncologist can know what you are feeling is if you are brave enough to speak up.
In addition, sharing your symptoms, even if they may seem of little consequence to you, may help your oncologist better recognize the extent of your disease, anticipate potential complications, and suggest the best possible treatments for your disease.