How Do I Know If I Should Keep Getting Treatment
How much is treatment helping?
For some people, getting cancer treatment helps them feel better and stronger. It also helps control the cancer so they can live longer. But for others, being in treatment works the opposite way they may reach a point where it only makes them feel worse. Side effects might keep you from enjoying the life you have left. Only you can decide how you want to live your life. Of course, youll want to know how your family feels about it, too. Their feelings are important since they are living through the cancer with you. But keep in mind, the final decision is yours.
Do the benefits outweigh the side effects?
When a person has had many different treatments that didnt help stop the cancer, it may mean that its become resistant to all treatment. At this time you might want to weigh the possible limited benefit of a new treatment against the possible downsides, including the stress of getting treatment and the side effects that go with it. Everyone has a different way of looking at this. Talk to your cancer care team about what you can expect from treatment. They can help you make the best decision for yourself and your family.
How Often It Happens
Though we have clearly documented cases of spontaneous regression, it’s hard to know how common this phenomenon actually is. We know it is not rare, with over a thousand case studies in the literature. In addition to those studies which document;a cancer;which goes away without any treatment, it’s not clear how often a cancer make go away;despite;treatment;or at least decrease in size despite treatment.
Some have estimated the incidence to be roughly one out of 100,000 people, but it’s difficult to know if that number is even in the ballpark. It does appear to be more common with some tumors rather than others, with spontaneous regression of blood-related cancers such as lymphoma, and skin cancers such as melanoma being reported more commonly.
Living With Stage : The Breast Cancer No One Understands
Editor’s note: We’re bringing back this piece from October 2014 for Metastatic Breast Cancer Awareness Day and to honor Jody Schoger, featured in the story. Schoger died of metastatic breast cancer in May. Want to learn more about MBC? Look for our tweets at the Northwest Metastatic Breast Cancer Conference this Saturday at Fred Hutch.
A no-nonsense Texan of 60 years, Jody Schoger* has a very no-nonsense way of educating people about her metastatic breast cancer.
âSomeone will say, âWhen are you done with treatment?â and Iâll tell them, âWhen Iâm dead,ââ said Schoger, a writer and cancer advocate who lives near Houston. âSo many people interpret survivorship as going across the board. That everybody survives cancer now. But everybody does not survive cancer.â
An estimated 155,000-plus women in the U.S. currently live with âmets,â or metastatic breast cancer. This type of cancer, also called stage 4 breast cancer, means the cancer has metastasized, or traveled, through the bloodstream to create tumors in the liver, lungs, brain, bones and/or other parts of the body. Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent; median survival is three years. Annually, the disease takes 40,000 lives.
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Many Women Live For Decades With Metastatic Breast Cancer
A stage 4 diagnosis is not an instant death sentence, says Renee Sendelbach, 40, from Austin, Texas, who was diagnosed seven years ago, when she learned that her breast cancer had moved into her lungs, bones, and lymph nodes.
Ive had metastatic breast cancer for five years and Im still kicking, says Susan Rosen, 53, from Franklin, Massachusetts.
According to a 2017 article in the journal;Cancer Epidemiology, Biomarkers & Prevention, 34 percent of women diagnosed with metastatic breast cancer have been living with the disease for five years or longer.
The goal of treatment is to keep patients on their feet as long as possible so that they can continue to do what they want to do, says;Gretchen Kimmick, MD, associate professor of medicine at the Duke Cancer Institute in Durham, North Carolina.
In recent years, treatment for breast cancer has vastly improved, largely because doctors are able to more accurately target therapy to the type of breast cancer a woman has. The discovery of the HER2 protein and medicines that block it has revolutionized treatment for women with cancers that overexpress this protein, Dr. Kimmick says. This cancer was pretty deadly two decades ago, and now we are starting to debate if weve cured it in some women.
If You Decide Not To Have Treatment
If you decide not to have treatment, the doctor who knows your situation best is in the best position to discuss your prognosis.
Survival statistics most often come from studies that compare treatments with each other, rather than treatment with no treatment. So, it may not be easy for your doctor to give you an accurate prognosis.
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How Can I Take Care Of Myself While Living With Metastatic Breast Cancer
Living with metastatic breast cancer can be challenging. Your care team can help provide physical and emotional support. Talk to them about how you can:
- Eat the most nutritious diet for your needs.
- Exercise regularly.
- Get emotional support, including finding support groups.
- Reach out for help from friends, family and loved ones.
- Find mental health services.
- Find complementary therapies.
Intrahepatic Chemotherapy And Chemoembolisation
Intrahepatic chemotherapy and chemoembolisation involve giving chemotherapy directly into the liver. This is done through a thin tube, called a catheter, into the main blood supply to the liver.
Giving chemotherapy directly into the liver means a higher concentration of the drug can be delivered to the area of cancer.
In chemoembolisation, the chemotherapy is delivered along with an oily liquid or foam which blocks the blood supply to the cancer. The cancer is deprived of oxygen and nutrients, and the chemotherapy stays in the area for longer. The liver continues to be supplied with blood in the normal way.
These treatments may not be routinely available on the NHS but may be offered as part of a clinical trial.
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What Does It Mean To Be In Remission For Cancer Dana
- Metastatic prostate cancer usually responds to hormonal therapy and goes into remission, but cancer cells can sometimes resist treatments. Prostate cancer cells can learn how to grow, even without male hormones. Doctors call this condition hormone-resistant prostate cancer
- The goal is to enhance the patient’s immune system with many more T-cells that recognize and attack metastasized tumor cells. This study reports on a single patient whose metastatic breast cancer is still in remission after more than 22 months following ACT. Relevance
- Currently available combination chemotherapy treatment for stage IV cancer results in complete remission in up to 20% of patients, with average survival of 8-12 months. As newer drugs, such as the taxanes, Camptosar ® , and Gemzar ® , are incorporated into regimens, this may continue to improve
- Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent; median survival is three years. Annually, the disease takes 40,000 lives
Newly Diagnosed Or Worried About A Symptom
In the days or weeks after a diagnosis of secondary breast cancer, you may feel in turmoil and find it hard to think clearly.
You can read our;information for people;newly diagnosed;with secondary breast cancer, including where to find support.
If you havent been diagnosed but are worried about a symptom, find out more about the;signs and symptoms of secondary breast cancer.
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Support For Living With Secondary Breast Cancer
Everyones experience of being diagnosed with secondary breast cancer is different, and people cope in their own way.
For many people,;uncertainty;can be the hardest part of living with secondary breast cancer.
You may find it helpful to talk to someone else whos had a diagnosis of secondary breast cancer.
- Chat to other people living with secondary breast cancer on;our;online Forum.
- Meet other women with a secondary diagnosis and get information and support at a;Living with Secondary Breast Cancer;meet-up.
- Live Chat;is a weekly private chat room where you can talk about whatever is on your mind.
You can also call Breast Cancer Nows;Helpline;free on;0808 800 6000.
Can The Cancer Stage Change
Once diagnosed, a cancers stage never changes. Even if the patient improves or gets worse, their cancer is the same as when diagnosed.;
Once diagnosed with stage 4 cancer, you will always have stage 4 cancer. That doesnt mean that you cannot sustain a long period of disease-free survival.
Part of the reason for this is statisticalstages help scientists track and reevaluate survival statistics and treatment protocols.; But they also let doctors track the efficacy of treatments for your stage.
Doctors use cancer stages to compare patients with similar diagnoses, to more easily study the effectiveness of treatments, to track a persons cancer progression, and as a way to estimate survival rates for specific cancers.;
Part of the confusion regarding staging status arises from the fact the disease is sometimes re-staged. Re-staging determines if there has been a progression or remission of the disease.
If cancer is re-staged or recurs , doctors keep the initial staging diagnosis and add a new stage to the patients diagnosis. New staging diagnoses get differentiated with letterslike c for clinical, p for pathological , or y for after treatment.
For instance, stage 2 breast cancer that suddenly spreads to the lungs is stage 2 breast cancer with lung metastases rather than stage 4 breast cancer. Similarly, if stage 4 breast cancer meets the definition of remission after treatment, they describe it as stage 4 breast cancer with no evidence of disease.
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Infection And The Immune System
Looking at people who have had a;spontaneous remission of their cancers, it’s quickly noted that;most;of these regressions are associated with an acute infection. Infections often result in a fever and stimulation of the immune system.
We know that our immune systems have the ability to fight off cancer. That is, in fact, the logic behind immunotherapy.;Immunotherapy medications, while still in their infancy, have resulted in dramatic remissions of cancer for some people, even in the advanced stages of cancer. These drugs work in different ways, but a common theme is that they essentially enhance the ability of our own immune systems to fight cancer.
Infections which have been associated with spontaneous remission include diphtheria, measles, hepatitis, gonorrhea, malaria, smallpox, syphilis, and tuberculosis.
The Cycle Of Recurrence And Remission
Most chronic cancers cannot be cured, but some can be controlled for months or even years. In fact, theres always a chance that cancer will go into remission. There are different kinds of remission.
- When a treatment completely gets rid of all tumors that could be measured or seen on a test, its called a complete response or complete remission.
- A partial response or partial remission means the cancer partly responded to treatment, but still did not go away. A partial response is most often defined as at least a 50% reduction in measurable tumor. Here, when we refer to a remission it will generally mean a partial remission.
To qualify as either type of remission, the absence of tumor or reduction in the size of the tumor must last for at least one month. Theres no way to tell how long a remission will last, so remission does not mean the cancer definitely has been cured.
Some cancers , have a natural tendency of recurrence and remission. Often, this repeating cycle of growing, shrinking, and stabilizing can mean survival for many years during which the cancer can be managed as a chronic illness. Treatment can be used to control the cancer, help relieve symptoms, and help you live longer.
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What Does Cancer Remission Mean
Cancer remission is when the signs and symptoms of cancer have lessened or are undetectable.
In blood-related cancers like leukemia, this means youll have a decrease in the number of cancer cells. For solid tumors, that means that the tumor size has decreased. The decrease must last for at least one month to be considered remission.
types of cancer remission
There different types of remission:
- Partial. A reduction of at least 50 percent in measurable tumor size or cancer cells
- Complete. All detectable evidence of cancer is gone.
- Spontaneous. When cancer goes into remission without therapy considered adequate to otherwise lead to remission. This usually happens after a fever or infection, and is rare.
Remission is not a cure, and it doesnt mean that youre totally cancer-free. Even in complete remission, there can still be some cancer cells in your body, and these can start growing again.
What I Wish People Knew About Metastatic Breast Cancer
Women with metastatic breast cancer think about fighting cancer very differently than women who don’t have a stage 4 diagnosis. If you have advanced cancer, these women understand what youre going through.
The term metastatic breast cancer describes breast cancer that has spread beyond the breast to the bones, liver, brain, or another organ. Even if the cancer is found in another organ, its still referred to as breast cancer and is treated as such.
While metastatic breast cancer is terminal and cannot be cured, because of improved treatments more women are living longer than ever with it. Even so, a lack of information and many misconceptions about this diagnosis persist.
Here are several things you should know about metastatic breast cancer and the women who are living with it.
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Factors Associated With Long
Patients who were younger at diagnosis of inoperable locoregional recurrent or metastatic disease and had a good performance status exhibited a trend towards longer TTP in the univariate analysis . In addition, best response to trastuzumab treatment had an influence on TTP . Interruption of trastuzumab treatment was associated with shorter TTP . We could not observe an influence of tumor size, grading, hormone receptor status, nodal status or disease-free survival in univariate analysis. The absence of distant metastases at the onset of trastuzumab treatment or the initial combination of trastuzumab with endocrine therapy or chemotherapy had also no impact on TTP .
Table 4 Association of clinicopathological and treatment characteristics with time to tumor progression
In the multivariate analyses, interruption of trastuzumab treatment turned out to be associated with shorter TTP .
Why Does My Provider Need To Test The Metastatic Tumor
Your care team will test the metastases to figure out the biology of the tumor, which can help guide your treatment plan. Providers may test tumors for:
- Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy may be your first treatment.
- HER2 status: Human epidermal growth factor receptor 2 is a protein that is overexpressed on some breast cancer cells. HER2-positive cancer responds to specific HER2-targeted therapies.
- PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider may test for this gene mutation. Specific targeted therapies can be used to treat tumors with this mutation.
- PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1 status. If the PD-L1 test is positive, you may be recommended to receive a combination of immunotherapy and chemotherapy.
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Complete Remission Vs Partial Remission
There are different kinds of remission:
Complete remission is when there are no more signs of cancer. If tests show your tumor is gone, or too small to see or measure, it means youre in complete remission.
Another term for complete remission is complete response.
Partial remission is when your treatment reduced the cancer but didnt make it go away completely. Doctors usually consider at least a 50% reduction in the size of a tumor to be partial remission.
Another term for partial remission is partial response.
Just Imagine How Many People
Just imagine how many people we never hear from. Id imagine there are alot of people who got the stage 4 diagnosis and never posted or used the internet. Id imagine some of the people that went NED no longer post. I know when my mom was diagnosed I kept asking my dad how long did the doctor give her. My dad said they didnt even give an expected life span. The doctor said we can treat this like a chronic condition thats the stage medicine is at with regards to colon cancer. I hope the doctor is right and my mom is around alot longer.
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Are There Ways To Stop Cancer From Reoccurring
As previously noted, it may be recommended for some patients to continue treatment even after they have achieved a complete response. Because there is potential for cancer to return after remission, its important for patients to continue to see their cancer care team for follow-up care. These ongoing visits offer an opportunity to check on a patients overall health, monitor them for late- or long-term side effects of treatment, and assess any signs of disease recurrence. They also allow patients to have ongoing conversations with their care team and alert them of any concerning symptoms or developments.