For Family And Friends
Caring for a loved one with stage 4 breast cancer has special challenges as well. Fortunately, organizations such as CancerCare now offer support groups design for loved ones who are caring for someone with cancer. In addition to caring for yourself , it’s helpful to learn about metastatic breast cancer.
Common things that people learn about cancer usually refer to an early-stage disease, and myths about metastatic breast cancer can be painful for those living with advanced disease. For example, one of the things not to say to someone with metastatic breast cancer is, “When will you be done with treatment?”
For the most part, people with metastatic breast cancer will require some type of treatment for the rest of their lives.
Life Expectancy Of Stage 4 Breast Cancer
According to the American Cancer Society, 22% of the patients live five years after being diagnosed of stage 4 breast cancer. Compared to earlier stages of the cancer, this rate is considerably lower. At stage two, the five year survival rate is at 90% and at stage three, it is 72%. This shows that an early diagnosis is important for better chances of survival.
Predicting survival rates for patients are never really accurate. Your age, general health, hormone receptors on cells with cancer, the type of tissue the cancer has affected and your general outlook on life all affect your stage 4 breast cancer life expectancy.
About 50% percent of women who are diagnosed with stage four breast cancer are still alive 18 months after their diagnosis. Over the years, life expectancy for stage four cancer has been steadily and slowly improving. This has been mainly due to combination treatment of surgery, radiation, multiple medications, and a much more positive support network.
Treatment Options For Stage 4 Cancer
Stage 4 cancer is challenging to treat, but treatment options may help control the cancer and improve pain, other symptoms and quality of life. Systemic drug treatments, such as targeted therapy or chemotherapy, are common for stage 4 cancers.
Often, a clinical trial may be an option, offering new treatments to help you fight stage 4 cancer.
Below are the prevailing treatment options for the five most common cancers.
Treatment of stage 4 breast cancer: For cancer that has spread beyond the breast and nearby lymph nodes, systemic drug treatments are typically used. These include:
- Hormone therapy
They may be used alone or in combination, and they may also be determined by the hormone receptor and the HER2 status of the cancer.
Surgery and radiation may be treatment options in specific cases to help improve symptoms caused by a growing tumor, not to get rid of the cancer. The tumor may be removed with surgery or shrunk by radiation therapy if, for example, its:
- Blocking a blood vessel
- Causing a wound
- Affecting the spinal cord
Treatment of stage 4 lung cancer: In general, stage 4 lung cancer is also treated with systemic drug therapies.
Stage 4 lung cancer that has spread to one distant area tends to be treated differently than lung cancer that has spread more widely. For stage 4A cancers, treatment tends to focus on the one site where the cancer has spread.
There may also be clinical trials assessing new treatments for stage 4 melanoma.
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The Advocate Steps Up
She didn’t start out as an advocate for Black patients with cancer. Jamil Rivers was a breast cancer patient herself, and doing well. Other patients would drop by the chemo infusion room and ask her for advice.
“They were saying, ‘Hey, you seem to be doing OK. You know, can you share what you know?’ And then it just kind of grew from there” into a nonprofit Rivers founded, called the Chrysalis Initiative.
“I would always hear that the reason why Black women were dying at such a higher rate from breast cancer was social and biological differences and poverty and all these different rationales,” Rivers says. “But then, as I started finding out more, I found that the biggest contributor was actually the racism.”
Its Never Too Late To Exercise
Exercise is important for your overall mental and physical health. Since fatigue is often a symptom associated with stage 4 breast cancer, it can help to plan your exercise during your most energetic time of day.
Consistency is key. Its better to exercise in small amounts every day than to follow an extreme pattern of occasional intense activity between long periods of inactivity.
While there are potential benefits to exercise when you have stage 4 cancer, its important to talk to your healthcare provider before starting an exercise program.
If your blood counts are low or your electrolyte levels are imbalanced, most healthcare providers wont recommend exercising because you could put yourself at risk for further harm.
Also, your healthcare provider may recommend avoiding public places, like gyms, because of your risk for germ exposure.
Safety is always a concern when you have stage 4 breast cancer. Bleeding and risks of injury are important considerations.
Some women experience balance and foot numbness problems due to their treatments and fatigue. If this is the case, its best to do exercises that put you at less risk for falls. An example could be riding a stationary bicycle instead of running on a treadmill.
There might not be a direct link between exercise and stage 4 breast cancer survival rates, but you can reap other benefits from regular exercise.
For example, it may help you:
- lose excess body fat
- improve your quality of life
- reduce side effects from treatment
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After Her Breast Cancer Recurred And Metastasized Janet Klein Participated In A Clinical Trial For Palbociclib Which Has Kept Her Disease In Check For More Than Five Years
Janet Klein believed that she would be diagnosed with breast cancer at some point.
My mothers had breast cancer twice. My sisters had it, she said, so I just assumed that eventually it would be my turn. I stayed vigilant with my mammograms and hoped for the best.
And when her turn came, Janets caution paid off. Her breast cancer was at caught in stage 1 before it had spread.
I was very, very fortunate, she said. There was no lymph node involvement. I had a wonderful surgery followed up by tamoxifen and thought I was finished and very, very lucky.
But about four years after her surgery, and well into her five-year course of tamoxifen, Janet got a call from her gynecologists office following a screening mammogram. Theyd found something suspicious. Janet underwent another mammogram and followed up with one of her surgeons, who recommended she undergo a needle biopsy right away.
So that is what I did, and sure enough, I had a recurrence of the breast cancer in the small amount of breast tissue left after the mastectomy, Janet said.
A PET scan and bone biopsy revealed that the cancer had metastasized to her left iliac bone. Janet underwent a lumpectomy and surgery to remove both ovaries a bilateral oophorectomy and then met with her oncologist to discuss and plan her treatment options.
Read or the full AACR Cancer Progress Report 2015.
Understanding Her2+ Status And Survival
Doctors use three markers to help define breast cancers and guide treatment. One of those is the HER2 protein. The other two are hormone receptors . When a cancer has none of these, doctors call it triple negative. Until recently, there wasnât much information about how these markers changed survival rates for breast cancer.
A recent study looked at the National Cancer Institute data to see if there were differences in survival for women based on these markers. The study shows there are. Overall, women who have HR+ and HER2- breast cancer do best. But in the later stages, those who have the HER2+ type have better survival rates than those with HER2-. Breast cancers that are triple negative have the lowest survival rates. The 4-year survival rates are as follows:
- HR+/HER2-: 92.5%
- HR-/HER2-: 77.0%
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Dear World You’re Not Going To Have The Year You Thought You’d Have
Her gloom began to lift when she began doing her own research. Loniewska is a Ph.D. toxicologist.She put that expertise to work, and made a welcome discovery.
“I realized that a lot of MBC patients were doing well and the treatments work for a while. And then you switched treatments. You know, there’s always these hopeful stories of people, living five years, 10 years, 15 years.”
Or even more. We all hope to be one of those. But since the 5-year survival rate is just 28% for women and 22% for men, we know many of us won’t be.
There’s a saying in the MBC community: It’s the worst diagnosis, but you meet the best people. I’ve met some good ones. And since a 2020 National Cancer Institute study estimates that 168,000 women in the U.S. are living with metastatic breast cancer, I don’t think I’ll be running out of new friends any time soon.
Correction Dec. 12, 2021
In a previous version of this story, the name of Margaret Loniewska’s daughter was misspelled as Mariana. Her name is Marianna.
Her2+ Status Cancer Stage And Survival
The importance of HER2 status for survival will depend on how far the cancer has spread. If itâs only in the breast, then it wonât make much difference. Most women in the early stage of the disease do well because a surgeon can remove the tumor.
Itâs when a breast tumor grows and spreads to lymph nodes or farther away in the body that HER2 status becomes more important for treatment and survival. Thatâs because there are now drugs that target HER2, but these work only for cancers that are HER2+. A common drug for HER2+ breast cancer is trastuzumab , but there are others. Because there are more treatments, women with more advanced HER2+ breast cancers today will on average have better survival rates than those with more advanced HER2- breast cancers.
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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.
Whats The Outlook For Metastatic Breast Cancer
The right treatment plan can improve survival for people with metastatic breast cancer. However, survival rates vary and are dependent on a number of factors including type/biology of the breast cancer, parts of the body involved and individual characteristics. About 1 in 3 women live at least five years after diagnosis. Some live 10 years or longer. Your care team will discuss your prognosis with you in more detail.
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Can You Actually Survive Stage 4 Breast Cancer Nowadays
Thanks in advance for any advice or answers.
Am sorry to trouble you but am confused about what i have read and what i have been told.
I have been told by a medical team that advanced breast cancer can be loooked at just like a chronic illness in some circumstances
And I have also read recently that advanced breast cancer has an excellent survival rate,.
But what is excellent in these circumstances? I want to be positive but also realistic.
I read tales where people are happy that either themselves, their friends or relatives made it to 5 years, which indeed is lovely.
And I know this may sound odd or maybe ungrateful but Is this considered excellent?
I always thought with chronic illnesses you just lived a normal life span but carried on with treatment.
Has anyone ever made it to 10, 20, 30,or even 40 years?
Survival Rates Of Stage 4 Breast Cancer
Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.
Factors affecting survival rate of metastatic breast cancer
Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:
- Response to treatment
- The extent and location of metastases
- The presence of other health issues not related to cancer
- The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.
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There Are Good Days And Bad Days
There are days when I say to myself, Ive had enough. I cant take it anymore, says Rosen. But I want to keep on living. I love my life. Overall, I have a great life except for the cancer.
Rosen has a few mantras she uses when things get tough. A lot of the tough times are treatment related, she says. I refer to those as bumps in the road, and , This too shall pass.
What Are The Signs That Death Is Approaching And What Can The Caregiver Do To Make The Person Comfortable During This Time
Certain signs and symptoms can help a caregiver anticipate when death is near. They are described below, along with suggestions for managing them. However, each persons experience at the end of life is different. What may happen to one person may not happen for another. Also, the presence of one or more of these symptoms doesnt necessarily mean that the patient is close to death. A member of the health care team can give family members and caregivers more information about what to expect.
Withdrawal from friends and family:
- People often focus inward during the last weeks of life. This doesnt necessarily mean that patients are angry or depressed or that they dont love their caregivers. It could be caused by decreased oxygen to the brain, decreased blood flow, or mental preparation for dying.
- They may lose interest in things they used to enjoy, such as favorite TV shows, friends, or pets.
- Caregivers can let the patient know they are there for support. The person may be aware and able to hear, even if they are unable to respond. Experts advise that giving them permission to let go may be helpful. If they do feel like talking, they may want to reminisce about joys and sorrows, or tie up loose ends.
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What Can I Expect While Living With Metastatic Breast Cancer
Your care team will monitor you every few months to check if the cancer is responding to treatment, and also to see if you are having any side effects. The process of restaging the cancer includes:
- History/physical exam.
- Blood tests.
- Imaging tests, including CTs and bone scan or PET scan.
Before your scans or tests, its normal to feel anxiety. It may help to bring a friend or family member to the appointment with you.
What Exactly Is Stage 4 Breast Cancer
In the simplest terms, a stage 4 breast cancer diagnosiswhich is often referred to as metastatic breast cancer or terminal breast canceris the disease in its most serious and life-threatening form, according to the American Cancer Society .
Stage 4 breast cancer refers to the spread of breast cancer beyond the area of the breast and surrounding lymph nodes,Debu Tripathy, MD, professor and chairman of the Department of Breast Medical Oncology, at the University of Texas MD Anderson Cancer Center, tells Health. The more common sites of spread include the bone, lung, liver and brain. Itâs important to note, however, that when breast cancer spreads to another area of the body, like the bones or lungs, it does not become bone or lung canceritâs still breast cancer, according to the National Cancer Institute .
Stage 4 breast cancer is an uncommon initial diagnosistechnically called de novo metastatic breast cancer, itâs only found in 6 percent of all breast cancer diagnoses. Instead, metastatic breast cancer often emerges months or years after someone has already completed treatment for an initial breast cancer diagnosis in an earlier stage.
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