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How Do You Die From Metastatic Breast Cancer

Interactive Statistics With Seer*explorer

Cancer Facts : How Does a Person Die From Cancer?

With SEER*Explorer, you can…

  • Create custom graphs and tables

SEER*Explorer is an interactive website that provides easy access to a wide range of SEER cancer statistics. It provides detailed statistics for a cancer site by gender, race, calendar year, age, and for a selected number of cancer sites, by stage and histology.

Systemic Treatments For Stage Iv Breast Cancer

Treatment often continues until the cancer starts growing again or until side effects become unacceptable. If this happens, other drugs might be tried. The types of drugs used for stage IV breast cancer depend on the hormone receptor status and the HER2 status of the cancer:

Hormone receptor-positive cancers

Women with hormone receptor-positive cancers are often treated first with hormone therapy . This may be combined with a targeted drug such as a CDK4/6 inhibitor, everolimus or a PI3K inhibitor.

Women who havent yet gone through menopause are often treated with tamoxifen or with medicines that keep the ovaries from making hormones along with other drugs. Because hormone therapy can take months to work, chemo is often the first treatment for patients with serious problems from their cancer spread, such as breathing problems.

Hormone receptor-negative cancers

Chemo is the main treatment for women with hormone receptor-negative cancers, because hormone therapy isnt helpful for these cancers.

HER2-positive cancers

Trastuzumab may help women with HER2-positive cancers live longer if its given along with chemo or with other medications such as hormonal therapy or other anti-HER2 drugs. Pertuzumab , another targeted drug, might be added as well. Other options might include targeted drugs such as lapatinib or ado-trastuzumab emtansine .

HER2-negative cancers in women with a BRCA gene mutation

HER2-negative breast cancers in women with a PIK3CA mutation

You Will Be Surprised At How Quickly You Adapt

Nothing can prepare you for the shock of being told this news. From the moment you wake up to the moment you go to bed, for the first few months its all you can think about.

However you might feel now, you will not die tomorrow. You will have time to get used to this new normal Now is the time to be gentle on yourself. Trust me, you will smile and laugh again. You will find the joy in life that those without this diagnosis do not know.

If you find solace and a sense of control by changing your eating habits and exercising, then do it. But do not feel guilty if you cant. For the first year I drank a lot and ate terribly but Ive been stable for four and a half years. Dont beat yourself up about this.

Do not give up hope. I felt so broken and was so envious of those around me. The thought of being in treatment forever is overwhelming. You will be surprised at how quickly you adapt and build your life around it.

Take one day at a time and don’t lose hope. This is a path that you cant imagine being able to walk down. But you will. You are stronger than you think. Dita

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Emotional And Spiritual Care

End-of-life care also includes emotional, mental, and spiritual therapy. A personâs healthcare team may include social workers, counselors, mental health professionals, and religious or spiritual advisors.

According to the Anxiety and Depression Association of America, up to 40 percent of people with cancer experience serious mental distress. This may include anxiety, depression, panic attacks, and post-traumatic stress disorder .

Medications, therapy, religious or spiritual rituals, and support groups can help a person cope with mental health issues and stress during this difficult time.

Caregivers may also need help with stress, anxiety, and depression. The palliative care team can usually also provide support and advice to caregivers for their emotional needs.

The Breast Cancer Healthline app provides people with access to an online breast cancer community, where users can connect with others and gain advice and support through group discussions.

What Should I Ask My Healthcare Provider About Metastatic Breast Cancer

Metastatic Breast Cancer

If youve been diagnosed with metastatic breast cancer, ask your provider:

  • What are my treatment options?
  • What is my prognosis?
  • What side effects can I expect?
  • Will complementary therapy help me feel better?
  • What if I want to stop treatment?
  • How can I feel my best during treatment?

A note from Cleveland Clinic

Metastatic breast cancer is advanced breast cancer. Providers classify it as stage 4 breast cancer. It happens when cancer cells, often left behind after previous breast cancer treatment, start to spread to other parts of the body. While there is no cure for metastatic breast cancer, treatment can prolong your life and help you feel better. There are many medications available, so if one treatment isnt working, your care team can try a different approach. If you notice any symptoms or dont feel your best, especially if youve undergone breast cancer treatment in the past, talk to your healthcare provider.

Last reviewed by a Cleveland Clinic medical professional on 04/14/2021.

References

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Myth #: If An Earlier

Ninety percent of MBC diagnoses occur in people who have already been treated for an earlier-stage breast cancer. Many people are under the impression that remaining cancer-free for 5 years means that a metastatic recurrence cant happen. However, distant recurrences can occur several years or even decades after initial diagnosis. Factors such as original tumor size and the number of lymph nodes involved can help predict the risk of recurrence.

For example, a 2017 survey of 88 studies involving nearly 63,000 women diagnosed with early-stage, hormone-receptor-positive breast cancer found that the risk of distant recurrence within 20 years ranged from 13% to 41%, depending on tumor size and lymph node involvement.1

As KatyK of Idaho comments: that you are cured if you are cancer-free 5 years after initial diagnosis. I fell for that one myself. When I was diagnosed with MBC 12 years after initial diagnosis I was shocked. I thought I was cured, which to me means all better. Nope! Not even sure medically what cured means.

Recurrence Of Metastatic Breast Cancer

Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.

But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .

These declines are due in part to improved screening and treatment for the disease.

There are a few general facts that are helpful to know about breast cancer outlook:

  • Breast cancer is the most common cancer diagnosis in the United States, according to the

Also Check: How Long Can You Live Without Treatment For Breast Cancer

When Should You Ask For Hospice Care

Very often we hear people say they wish they had opted for hospice care earlier on, so how can you know when it is time?

In order to receive hospice care, you usually need a physicians note saying that you are expected to live six months or less. If you live longer, that’s not a problem and there’s no penalty. Your care can either be renewed for another six months or discontinued. You can also change your mind at any time if you decide you would rather pursue treatments designed to treat your cancer.

Metastatic Breast Cancer: What You Should Know

Metastatic Breast Cancer – living the last weeks in the ‘dying time’

What does it mean to have metastatic, or stage 4, breast cancer? A Rogel Cancer Center oncologist explains the diagnosis and how its treated.

After hearing a diagnosis of metastatic breast cancer, a rush of questions emerges. But often, its not until long after leaving the doctors office.

Metastatic means the cancer has spread beyond the breast and immediate lymph nodes to other organs or tissues in the body, most often the bones, brain, lungs or liver. Its considered stage 4 breast cancer, which means the cancer has progressed to its most advanced stage.

But even though its moved to other organs, it still behaves like breast cancer and is treated with breast cancer therapies.

More than 154,000 U.S. women are estimated to have metastatic breast cancer, according to the Susan G. Komen organization. Men can have metastatic breast cancer too, but its rare.

To help patients fill in information gaps, N. Lynn Henry, M.D., Ph.D., the breast oncology disease lead for the University of Michigan Rogel Cancer Center, explains the nuances of stage 4 metastatic breast cancer.

What are the differences between metastatic breast cancer, stage 4 breast cancer and advanced cancer?

If any doctor uses the term advanced, ask for clarification, Henry adds.

When does metastatic breast cancer appear?

What are the symptoms?

Symptoms of bone metastases:

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Defining The Illness Trajectory Of Metastatic Breast Cancer

The concept of illness trajectory has been described extensively in relation to chronic illness and to the process of dying., It refers to the events over the course of illness which are shaped by the individual’s response to illness, interactions with those around them and interventions. Glaser and Strauss refer to the events that unfold for an individual who is dying as having two elementstime and shape, and chart the relationship between expectations of when death may occur by professionals, family members and the individual. The concept of trajectory introduced by Strauss et al encompasses not only the physiological unfolding of a patient’s disease but the total organisation of work done over the course of illness and the impact on those involved with that work and its organization and despite the passage of time is still considered relevant today. There has been considerable interest in charting the course of different dying trajectories as a means of tailoring palliative care services prior to death, most recently exploring the experience of patients living through the trajectories of specific cancers, such as glioma. Strauss et al described a Chronic Illness Trajectory Framework where the pattern of illness is characterised by a cycle of decline-reprieve-decline-reprieve-decline to death, which renders expectations uncertain and arrangements and plans unpredictable.

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Can Metastatic Breast Cancer Go Into Remission

Metastatic breast cancer may never go away completely. But treatment can control its spread. Cancer may even go into remission at some points. This means you have fewer signs and symptoms of cancer.

A treatment break may be considered in certain situations, including if remission occurs or if someone is experiencing intolerable side effects. A pause in treatment can help you feel your best and improve your quality of life.

How Is Secondary Breast Cancer In The Bone Treated

Metastatic breast cancer treatment: what really matters ...

Treatment for secondary breast cancer in the bone aims to relieve symptoms such as pain, maintain and improve mobility and strengthen the bones, as well as slow down the growth of the cancer.

Treatments can be given alone or in combination.

When making decisions about how the best treatment for you, your specialist team will consider factors such as:

  • how extensive the cancer is in the bones
  • whether the cancer has spread to other organs
  • any symptoms you have
  • what treatment youve had in the past
  • the features of the cancer
  • whether you have been through the menopause
  • your general health

Your specialist should discuss any recommendations for treatment with you and take your wishes into account. They will talk with you about your options, explain what the aims of treatment will be and help you weigh up the potential benefits against the possible side effects.

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Happiness Will Creep Back In If You Let It

We went home and I mourned myself for 2 weeks and thought hard about a way out of this, but there wasn’t/isn’t. So, I’ve chosen to obsess with diet, exercise, and research. I’ve always eaten well and exercised, or so I thought, but I’m now healthier than ever and have to admit I am happy. I know that sounds strange, but I believe if you are willing, happiness will creep back in if you let it, I promise.

In short, I found obsession with nutrition my thing to occupy myself and it definitely won’t hurt to stay as fit as possible for this SOB called cancer. Thicket

Treatment For Physical Symptoms

Several medications can help relieve pain. The American Cancer Society urge that a person should not have to endure pain in the final months and days of life.

Many people find relief with opioid medications, but these can cause side effects such as fatigue and constipation. A person may use opioids in combination with other pain relief medications, such as acetaminophen or ibuprofen.

Other drugs, such as antidepressants and antiseizure medications, can also treat certain types of pain.

Doctors can also prescribe medications for nausea and vomiting. Some drugs for treating nausea can make a person drowsy. However, these drugs may help people eat and drink more or simply make it easier for them to function and interact with other people.

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Myth #: Metastatic Breast Cancer Is Curable

Whether metastatic breast cancer is someones first diagnosis or a recurrence after treatment for earlier-stage breast cancer, it cant be cured. However, treatments can keep it under control, often for months at a time. People with MBC report fielding questions from family and friends such as, When will you finish your treatments? or Wont you be glad when youre done with all of this? The reality is they will be in treatment for the rest of their lives.

A typical pattern is to take a treatment regimen as long as it keeps the cancer under control and the side effects are tolerable. If it stops working, a patient can switch to another option. There may be periods of time when the cancer is well-controlled and a person can take a break. But people with MBC need to be in treatment for the rest of their lives.

As Breastcancer.org Community member Vlnprh of Wisconsin comments: The vast majority of people have no idea what MBC treatment involves. They somehow think that you will undergo something similar to early-stage patients surgery, radiation, chemo, whatever and then be done. They want to see you as a pink-tutu-wearing cheerleader jumping up and down declaring that you have beaten this disease

Amarantha of France writes: The one I get over and over is, How long will you be on this chemo? I mean doesn’t it end sometime? Yes, it ends when it stops working and then we go on to another treatment lather, rinse, repeat I guess until we run out of options.

Progression While Being Treated With Hormone Therapy

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For hormone receptor-positive cancers that were being treated with hormone therapy, switching to another type of hormone therapy sometimes helps. For example, if either letrozole or anastrozole were given, using exemestane, possibly with everolimus , may be an option. Another option might be using fulvestrant or an aromatase inhibitor , along with a CDK inhibitor. If the cancer has a PIK3CA mutation and has grown while on an aromatase inhibitor, fulvestrant with alpelisib might be considered. If the cancer is no longer responding to any hormone drugs, chemotherapy is usually the next step.

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Scenario : The Cure Model

We consider a cohort of 45,647 women with a survival of 72.4% at 20 years. Assume that a new treatment prevents 30% of all deaths . In this simulation, we randomly removed 30% of deaths from the cohort and assumed that these women were alive at 20 years. We assume further that the time to death of women who are not cured is the same as in the absence of treatments. The three curves representing the survival experience of the untreated and treated women are presented in Fig. ac.

a Impact of 30% reduction in deaths on annual mortality rates, ER-positive patients in SEER. b Impact of 30% reduction in deaths on actuarial survival, ER-positive patients in SEER. c Impact of 30% reduction in deaths on time to death, ER-positive patients in SEER

My Social Worker Suggested That I Reframe My Thoughts

Change your thoughts around to make the situation easier to mentally deal with. When we assume we are “dying of cancer, all treatments and side effects will seem worse. This was my experience.

My social worker suggested that I reframe my thoughts around “living with cancer” instead. It does take a long time, but most days, I do not feel gloomy about it.

The second piece of advice if you want a natural mood booster is walking. I walk approximately an hour a day, always outside, even if cold and snowy. I believe the fresh air and exercise aid my sleep and any side effects I may get from ongoing treatment, and boosts my overall mood.

Recommended Reading: What Is Mbc Breast Cancer

From Cured To Stage 4

Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.

Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.

âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â

In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.

âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â

Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.

âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â

And along with mets, she also had to deal with many misconceptions regarding her disease.

The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.

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