Treatments For Stage 4 Breast Cancer
Treatments at stage four of breast cancer do not cure the disease but slow down its effects, make you feel better, and perhaps make stage 4 breast cancer life expectancy longer.
This is the main type of treatment provided to patients with stage four breast cancer. It is usually used in combination with hormone therapy and helps to reduce the spread of cancer. There are different ways of getting chemo. You can either take pills or liquids or it can be injected directly into your veins.
2. Hormone Therapy
This treatment can be really helpful for women who have hormone receptor-positive cancers. This basically means that the cancer needs hormones to grow. For such women, medications under this treatment can prevent the cancer from getting the hormones. There are a variety of drugs that are administered for women who are postmenopausal. For women who haven’t undergone menopause yet, removing their ovaries is an option to reduce the production of hormones.
3. Targeted Therapy
This is a relatively newer treatment. Among the women who are diagnosed with breast cancer, about 20% have been found to have too much of the protein known as HER2. This protein makes the cancer spread quickly. For such women, trastuzumab, also known as Herceptin, is prescribed to stop the protein from helping the cancer grow. This drug also boosts the immune system, allowing the body to fight the cancer on its own. This treatment is usually used in conjunction with chemotherapy.
What Is Metastatic Breast Cancer
Metastatic breast cancer is the most advanced stage of breast cancer. Breast cancer develops when abnormal cells in the breast start to divide uncontrollably. A tumor is a mass or collection of these abnormal cells.
Metastasis refers to cancer cells that have spread to a new area of the body. In metastatic breast cancer, cells may spread to the:
Healthcare providers name cancer based on its primary origin. That means breast cancer that spreads to other body parts is still considered breast cancer. The cancer cells are still breast cancer cells. Your care team will use breast cancer therapies, even if the cancer cells are in other areas.
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.
Survival Rates For Metastatic Breast Cancer
According to the American Cancer Society , the 5-year survival rate after diagnosis for people with stage 4 breast cancer is 28 percent. This percentage is considerably lower than earlier stages. For all stages, the overall 5-year survival rate is 90 percent.
Because survival rates are higher in the early stages of breast cancer, early diagnosis and treatment is crucial. But remember: The right treatment for stage 4 breast cancer can improve quality of life and longevity.
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.
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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.
What Is Stage 0
Stage 0 is the least invasive stage of breast cancer and usually detected early in patients, according to the American Cancer Society. In this stage, cancer cells or non-cancerous abnormal cells are only in the part of the breast in which they formed and haven’t spread.
“At this stage of breast cancer, we tell patients not to be too worried. Stage 0 is extremely treatable and we ask people not to shed a tear over the diagnosis just yet,” said Cruz.
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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.
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
Research Into Advanced And Metastatic Breast Cancer
As metastatic breast cancer remains the leading cause of death from breast cancer, NBCF is committed to funding a broad spectrum of research that helps to further understand breast cancer metastasis, develop improved treatment options and enhance patient quality of life for those with metastatic breast cancer.
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What Affects Survival
Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread.
The type of cancer and grade of the cancer cells can also affect your survival. Grade means how abnormal the cells look under the microscope.
Your general health and fitness also affect survival, the fitter you are, the better you may be able to cope with your cancer and treatment.
Another factor that can affect survival is whether the cancer cells have receptors for particular cancer drugs.
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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Treatment Starts With Hope
Sofia Merajver, M.D., Ph.D., medical oncologist and scientific director of the Rogel Cancer Centers breast oncology program, approaches each patients cancer individually and does not think predictions make sense until treatment begins.
Joses treatment plan included four rounds of chemotherapy, which reduced her 5-centimeter tumor to undetectable.
I wanted to immediately convey to Heather that wed have a long road together, including the medical center helping her family get through this challenge. Thats why I wanted to know about her husband and family members, says Merajver. In addition to giving her confidence that weve seen her disease before, a first step is to begin to recruit the social support the patient needs.
Because Joses cancer had spread, she knew not to expect to be cured. She had a double mastectomy, received radiation therapy and joined a clinical trial to receive two stem cell transplants. There have been several recurrences over the years, but each has been managed as treatment progresses for metastatic breast cancer.
The goal for me is to hear that my scans are stable. Stable means good, Jose says.
Living With Metastatic Breast Cancer: How I Reinvented Myself
Shonte Drakeford is a 36-year-old Washington, D.C. native, nurse practitioner, United States Army wife, and German Shepherd mama. She was diagnosed with stage IV metastatic triple-positive breast cancer in 2015 that metastasized to her lungs, hip, rib, spine, and lymph nodes. She also has a genetic trait for colon cancer her cancer detection started early at the age of 25. She has been surviving and living a life without fear as positively as possible. You can follow her on .
You must now reinvent yourself.
Those were the words my husband said to me when I was diagnosed with stage 4 metastatic breast cancer at the age of 31 on June 17, 2015. Not once did I think that out of all I have been through, cancer would become part of my life story.
I am a part of a few statistics. I am one of the 6% of women who gets metastatic breast cancer as their first diagnosis, which is also called de novo metastatic breast cancer. I am a part of the 27% 5-year survival rate. Hopefully, I wont be a part of the statistic of Black women who have a 40% higher rate of mortality than my white counterparts.
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Treatment For Advanced Breast Cancer
Treatment of metastatic breast cancer aims to control the growth and spread of the cancer, to relieve symptoms, reduce pain, and improve or maintain quality of life.
The treatment recommended by doctors will depend on which treatments are likely to control the breast cancer and what side effects the person can cope with. Treatment options may involve:
Metastatic Breast Cancer Treatment And Planning
After a diagnosis of metastatic breast cancer, its helpful to take all the time you need to gather information and make decisions about your treatment. Learn about the medical specialists that may be involved in your care, treatment options, genetic testing, taking a break from treatment, and more.
SurgeryDoctors sometimes recommend surgery for metastatic breast cancer in order, for example, to prevent broken bones or cancer cell blockages in the liver. Learn more.
ChemotherapyChemotherapy is used in the treatment of metastatic breast cancer to damage or destroy the cancer cells as much as possible. Learn more.
Radiation TherapyYour doctor may suggest radiation therapy if youre having symptoms for reasons such as easing pain and controlling the cancer in a specific area. Learn more.
Hormonal TherapyHormonal therapy medicines are used to help shrink or slow the growth of hormone-receptor-positive metastatic breast cancer. Learn more.
Targeted TherapyTargeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Learn more.
Local Treatments for Distant Areas of MetastasisLocal treatments are directed specifically to the new locations of the breast cancer such as the bones or liver. These treatments may be recommended if, for example, the metastatic breast cancer is causing pain. Learn more.
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Symptoms Of Metastatic Breast Cancer
The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.
- If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
- If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
- Breast cancer that has spread to your lungs or liver usually causes no symptoms.
The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.
These treatments may include:
- hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
- chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
- immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
- a combination of these therapies
The following are the common treatment options for different types of stage 4 breast cancer.
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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Our Advice To Other Women With Metastatic Breast Cancer: Be Nice To Yourself
Give yourself a break! is the advice that Sendelbach offers. Stop negative self-talk about what you should have done but didnt do, she says. If you have MBC, you need to be kind and loving to yourself.
The body has only so much energy to offer per day, and managing metastatic breast cancer requires a lot of it. So it doesnt make sense to try to compare what youre able to do with what your cancer-free friends are accomplishing.
Just getting through the day can be hard, Sendelbach says. Getting rid of those not good enough feelings can lift a huge weight off you.
Survival For All Stages Of Breast Cancer
Generally for women with breast cancer in England:
- Around 95 out of every 100 women survive their cancer for 1 year or more after diagnosis
- Around 85 out of every 100 women will survive their cancer for 5 years or more after diagnosis
- Around 75 out of every 100 women will survive their cancer for 10 years or more after diagnosis
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.
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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, and a woman’s age, general health, and desire to continue getting treatment.
Is Stage 4 Cancer Always Terminal
More severe cancers are more likely to be terminal. However, that is never a certainty. For example, the American Cancer Society say the 5-year survival rate for breast cancer that spreads to distant body parts is 27%, or 86% when it only spreads locally.
Determining the severity of cancer and its stage is a complex process. Doctors are still learning about all the factors that affect how cancer develops and affects the body.
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