Symptoms If Cancer Has Spread To The Lymph Nodes
Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection.
The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. You might have any of the following symptoms if your cancer has spread to the lymph nodes:
- a lump or swelling under your armpit
- swelling in your arm or hand
- a lump or swelling in your breast bone or collar bone area
One of the first places breast cancer can spread to is the lymph nodes under the arm on the same side as the breast cancer. This is not a secondary cancer.
Symptoms Of Metastatic Breast Cancer
When metastatic breast cancer stops responding to treatment, the focus may shift to end-of-life care.
The symptoms of metastatic breast cancer are different to those of early-stage breast cancer. This is because the cancer has spread to other organs and is affecting other body systems, as well as the affected breast.
Most of the time, metastatic breast cancer affects the bones, lungs, brain, or liver.
Having one or more of the following symptoms does not mean that a person has metastatic breast cancer. However, anyone who experiences these symptoms should see a doctor for an evaluation.
Where Can Breast Cancer Go
Breast cancer mostly spreads to the bones, lungs, liver, and brain. When it does, you may start to notice symptoms that affect that area of your body.
Bones: swelling, intense pain, bones that break easily, and pain in your bones, back, neck, or joints
Lungs: long-lasting cough, trouble breathing, chest pain
Liver: Jaundice, or skin with a yellow tint, rashes and itchy skin, not feeling hungry, stomach pain
Brain: headaches that wonât go away, problems with your vision, seizures, vomiting and nausea, memory troubles, feeling dizzy
Other, less common, places where breast cancer spreads include:
Let your doctor know as soon as you can if you have any of these symptoms. They donât always mean your cancer has moved to another organ, but your doctor might want you to take some tests to make sure.
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If Youre Getting Radiation Therapy To The Breast
If you have radiation to the breast, it can affect your heart or lungs as well causing other side effects.
Short-term side effects
Radiation to the breast can cause:
- Skin irritation, dryness, and color changes
- Breast soreness
- Breast swelling from fluid build-up
To avoid irritating the skin around the breast, women should try to go without wearing a bra whenever they can. If this isnt possible, wear a soft cotton bra without underwires.
If your shoulders feel stiff, ask your cancer care team about exercises to keep your shoulder moving freely.
Breast soreness, color changes, and fluid build-up will most likely go away a month or 2 after you finish radiation therapy. If fluid build-up continues to be a problem, ask your cancer care team what steps you can take. See Lymphedema for more information.
Long-term changes to the breast
Radiation therapy may cause long-term changes in the breast. Your skin may be slightly darker, and pores may be larger and more noticeable. The skin may be more or less sensitive and feel thicker and firmer than it was before treatment. Sometimes the size of your breast changes it may become larger because of fluid build-up or smaller because of scar tissue. These side effects may last long after treatment.
After about a year, you shouldnt have any new changes. If you do see changes in breast size, shape, appearance, or texture after this time, tell your cancer care team about them right away.
Less common side effects in nearby areas
What Are The Risk Factors Of Metastatic Brain Tumors
One of the most formidable challenges of cancer research is that doctors still dont know why some people develop cancer and some do not. Even less well understood is why some cancers spread to the brain and other do not. What is known, however, is that brain metastases can occur in any long-term cancer survivor.
In addition, certain cancers as melanoma, or some subsets of other cancerssuch as EGFR-mutant lung cancer and Her2 positive breast canceralso seem to be more likely to spread to the brain.
Patients with these cancer types should undergo brain scans on a regular basis to look for cancer spread to the brain before it causes neurological problems.
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Screening: Pros And Cons
The topic of screening for brain lesions has become controversial in the field of breast cancer, mostly because of a lack of evidence. However, multiple studies in the works will attempt to disentangle the effects of regular brain MRIs on patients with breast cancer.
We dont have definitive data to say that screening is useful, and screening has the potential to be harmful if its done in a way that leads to treatment changes that may or may not be necessary, says Lin, who does not routinely screen patients but has a very low threshold for ordering a brain scan. People could end up getting treatments that they dont necessarily need or getting switched off the treatments that would otherwise have worked. Thats the argument against universal screening for brain metastases.
Hendron and Reece get regular brain MRIs to check for the appearance of new secondary tumors. In 2019, Hendrons doctors uncovered three more brain metastases, which were treated with stereotactic brain radiation therapy. Since then, her scans have been stable.
I often say cancer is a mind game. The body game is what the doctors and medicinedo, but the mind game is the work we have to do, she says. The biggest piece of advice is: You just have to learn to be present. All we have is this moment, and each person has to find what works for them to be in the moment.
Osteonecrosis Of The Jaw
In rare cases, with either bisphosphonates or denosumab, a disorder called osteonecrosis of the jaw may occur . To reduce the risk of this disorder, have a dental exam and take care of any dental work before starting treatment with bisphosphonates or denosumab .
Talk with your oncologist before getting any dental work while youre on bone-strengthening therapy.
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How Are Metastatic Brain Tumors Treated
Treating a brain tumor is usually only one step in treating metastatic cancer. At Yale Medicine, treatment is carefully coordinated among the neurosurgery, radiation oncology and medical oncology teams.
Traditionally, treatment for brain metastases involves radiation and surgery, since chemotherapy has limited ability to penetrate into the brain.
Patients whose brain scans reveal only a few metastases can be considered for a targeted radiation treatment called radiosurgery. At Yale Medicine, this treatment is delivered using a machine known as the Gamma Knife. If this procedure is appropriate, then imaging required for treatment, treatment planning and radiation delivery can all be done in one day. This has the advantage of minimizing interruption of chemotherapy.
For those with larger or more widespread brain tumors, Yale Medicine also offers the more comprehensive treatment options, including:
- Hippocampal sparing whole brain radiation therapy with memantine
- Surgical resection or laser ablation – guided by use of MRI in the operating room
- Microsurgical resection of tumor
Lastly, for select patients, clinical trials are available for the treatment of newly diagnosed brain metastases using chemotherapy alone. At this time, this option is available for patients with lung and melanoma brain metastases.
What Kind Of Treatment Will I Need
There are many ways to treat kidney cancer.
The treatment plan thats best for you will depend on:
- The stage and grade of your cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
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Radioprotective Drugs For Reducing Side Effects
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.
What Is The Outlook For People With Metastatic Breast Cancer And Brain Mets
Many factors influence cancer survival rates. The prognosis for people with metastatic breast cancer and brain mets is improving. Its estimated that 1 in 3 Americans with metastatic breast cancer is alive five years after initial diagnosis. Some people are living for 10 years or more.
From the community:I have positive story re: brain mets. I was diagnosed w mets to pelvis, thoracic vertabrae and skull. there was a 3.5 cm lesion in the right parietal lobe of my brain and a couple of other “spots”. The lesion was removed by craniotomy and the spots were treated with Gamma Knife radiation. I had about 20 more “spots” appear in my brain, all treated with gamma knife. This month I had one more spot appear. It was gamma knifed…
So far, even though the brain mets keep appearing periodically, they have all been treated and gone away. I haven’t had any symptoms other than mild headache. . My brain doctor does brain MRIs regularly to keep an eye on things.
Brain mets are very scary, and I thought for sure I was dying , but that hasn’t been the case for me. There are many here who have had WBRT and done well. There is a special shield during the radiation to preserve cognizant faculties.
There are some pill drugs that supposedly cross the BBB and are good for HER2+ brain mets. For awhile I was on Tykerb . I also think that Kadcyla has helped to keep my brain mets under control. Inspire member
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Comprehensive Care For Tumors And Seizures
Patients battling a brain tumor and seizures require treatment for both. Often, the surgery to remove the tumor is the best opportunity to remove the seizure focus and stop the seizures. In others, seizures persist after surgery or develop later, and patients need ongoing treatment for their epilepsy. To provide this level of comprehensive care, Dr. Templer and her team collaborate with the Lou and Jean Malnati Brain Tumor Institute at Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
Treatment depends on the type of tumor, states Dr. Templer. Some patients may benefit from an electroencephalogram , which records the electrical activity in the brain and identifies abnormalities, allowing physicians to better understand the seizure focus and risk for seizure recurrence. Armed with this knowledge, specialists can come up with a treatment plan.
Medication can help to reduce or stop seizures, although patients who are already receiving brain tumor treatment might be battling lethargy and other negative side effects, and seizure medication need to be well chosen. Epilepsy surgery can be an option in some patients who cannot be controlled by medication.
“You cant take a simplistic approach because of the complexity, Dr. Templer continues. Were always visiting the quality of life at each visit, so they can continue to do what they want.
Putting The Study Results Into Perspective
While this study might lead some to conclude that having excess thyroid hormone promotes the development of breast cancer, experts caution that this study does not prove cause and effect. While there may be an association, it is not clear that an overactive thyroid actually causes breast cancer to develop.
Some critics wonder whether women at risk for hyperthyroidism may also be at risk for breast cancer, or whether the treatment for hyperthyroidism may be to blame for increased cancer risk. Another theory is that women with an overactive thyroid see their doctors more often and therefore are more likely to get screened for other problems like breast cancer.
The effect of thyroid hormone on breast cancer risk clearly requires further study. In the meantime, women with an overactive thyroid should stay in close communication with their doctors and follow routine breast cancer screening recommendations.
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Models Of Metastatic Progression
A model of metastatic progression in cancer. Primary tumor growth and invasion occur through the gain of genetic or epigenetic changes in the primary tumor often in cells that have a change in character through the process of epithelial to mesenchymal transition . Individual cells, or groups of cells, that have gone through this transition, as well as those that have not , gain access to blood vessels through incompletely defined mechanisms. Some of the cells are targeted to specific organs and enter their new microenvironment. Cells that have dedifferentiated are likely able to modify the premetastatic niche to allow for proliferation and invasion with short latency in the metastatic site. Cells shed into the circulation that are more differentiated likely enter a period of prolonged dormancy controlled by a number of factors that may be released over time through changes in the tumor cells or the metastatic microenvironment. In both cases, metastatic progression at the metastatic site likely requires interactions with immune cells, endothelial cells, and the stroma.
How To Spot A Seizure
Each person experiences seizures differently, and seizures may last anywhere from seconds to minutes. During a seizure, you may notice the following:
- Aura, a sudden, brief, unusual sensation
- Uncontrolled jerking
- Brief time gaps or confusion
It is often the first bigger seizure which makes patients to have brain imaging including magnetic resonance imaging or a computed tomography . Many patients already had smaller events or auras which went unrecognized.
Most seizures stop by themselves within two to three minutes, although there can be a prolonged period of confusion afterwards. For seizures longer than five minutes, a call for an ambulance should be placed.
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How Can It Be Treated
Treatment of peripheral neuropathy in cancer patients is difficult, due to the fact that the cause of the issues is necessary as a treatment for the more pressing problem of breast cancer. The symptoms, however, are treatable.
Effective treatments will depend on which symptoms youre experiencing but could include: physical or occupational therapy, acupuncture, manual lymph drainage, steroids, numbing patches or creams, certain antidepressant medicines and anti-seizure medicines, electrical nerve stimulation, and more.
Dont let peripheral neuropathy control your life. Talk to your doctor about your options.
If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
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Range Of Therapy Side Effects
Treatment may involve local therapies directed at the brain metastases, such as surgery and radiation therapy, as well as systemic therapies that treat cancer throughout the body. Surgery could be a viable option for a single, large brain tumor, depending on its location. But for most patients, initial treatment involves either focused radiation or whole brain radiation, depending on the number of metastases and how early diagnosis occurs.
Because she had a single tumor, Hendron had a noninvasive procedure in February 2008 called Gamma Knife stereotactic radiosurgery, which uses 3D imaging to deliver a powerful, precise dose of radiation to a targeted area. It took just a single outpatient session without any incisions or anesthesia to successfully treat her lesion. Side effects of stereotactic radiosurgery can include fatigue, swelling, headache, nausea and vomiting and usually last for a few weeks after treatment.
Gamma Knife was the easiest treatment I ever had and the most effective, Hendron says. I was in the hospital at 7 a.m. and home by 11 a.m. I wore my own clothes and didnt need any pre-meds or post-meds.
Treatment has not been good to me. It has been a struggle really, really tough, Reece says. The side effects from the whole brain radiation were bad. I was nauseous, throwing up, dizzy.
How Will I Know If My Breast Cancer Spreads
Your doctor will use specific kinds of tests to find out if your cancer has gone to other places in your body. First, your doctor will want to know how youâre feeling. They will ask you about any symptoms youâre having and your overall health. They might also look at the size of your tumor and check your lymph nodes.
After that, the doctor may give you:
Blood tests. They look for signs of anything abnormal thatâs happening in your body. For example, results from a liver function test can let your doctor know that breast cancer may have gone to your liver. High levels of some substances in your blood hint that the cancer has spread to your bones.
Imaging scans. These tests make detailed pictures of the inside of your body. They help your doctor pinpoint any cancer spread. These tests include:
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