Is Stage 4 Breast Cancer Treatable

A Disease No One Gets

Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.

âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped foundBreast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â

The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.

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

Treating Stage 1 To Stage 2 Cancer

Doctors perform breast conservation or breast-sparing surgery for these stages of breast cancer. The aim of this surgery is to save as much of the adjacent healthy breast tissue. This procedure includes lumpectomy and partial mastectomy . A patient can opt for breast reconstruction for getting new breasts after the surgical removal of the tumour.

Sometimes, the doctor may advise a procedure known as mastectomy which is the complete removal of one or both breasts. Any affected lymph nodes are also removed. In these stages, a method called Sentinel Node Biopsy is done, to check whether cancer has reached the armpit. In this method, a scan is done and about two or three lymph nodes are taken out and sent for testing. If cancer has spread to the lymph nodes, they are completely removed from the armpit. If cancer has not spread to the armpit, the rest of the lymph nodes are not removed. After the tumour has been surgically removed, some types of systemic treatments are offered to patients. These include:

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Treatment Of Breast Cancer Stages I

The stage of your breast cancer is an important factor in making decisions about your treatment.

Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:

• If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
• If the cancer cells have large amounts of the HER2 protein
• How fast the cancer is growing
• Your overall health
• If you have gone through menopause or not

Talk with your doctor about how these factors can affect your treatment options.

How Long Do People Live With Secondary Breast Cancer

One of the first things many people with secondary breast cancer want to know is how long theyve got to live.

Life expectancy is difficult to predict as each persons case is different and no two cancers progress in the same way. However, as treatments have improved, more and more people are living longer after a diagnosis of secondary breast cancer.

Your specialist will have an understanding of the likely progression of your secondary breast cancer and can talk to you about what you might expect. You may worry if their answers are vague but it isnt possible to accurately predict how each persons cancer will respond to treatment.

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Starting With Neoadjuvant Therapy

Most often, these cancers are treated with neoadjuvant chemotherapy. For HER2-positive tumors, the targeted drug trastuzumab is given as well, often along with pertuzumab . This may shrink the tumor enough for a woman to have breast-conserving surgery . If the tumor doesnt shrink enough, a mastectomy is done. Nearby lymph nodes will also need to be checked. A sentinel lymph node biopsy is often not an option for stage III cancers, so an axillary lymph node dissection is usually done.

Often, radiation therapy is needed after surgery. If breast reconstruction is planned, it is usually delayed until after radiation therapy is done. For some, additional chemo is given after surgery as well.

After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to a year. Many women with HER2-positive cancers will be treated first with trastuzumab followed by surgery and then more trastuzumab for up to a year. If after neoadjuvant therapy, any residual cancer is found at the time of surgery, ado-trastuzumab emtansine may be used instead of trastuzumab. It is given every 3 weeks for 14 doses. For women with hormone receptor-positive cancer that is in the lymph nodes, who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral targeted drug called neratinib for a year.

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.

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What Is Stage 4 Breast Cancer

Stage 4 breast cancer is also called metastatic breast cancer or advanced breast cancer. In this stage, cancer that developed in your breast has spread to other areas of your body.

Cancer cells might have traveled through your lymphatic system to your lungs, bones, liver, brain, or other organs.

Stage 4 is the most serious and life threatening stage of breast cancer. Most often, stage 4 breast cancer develops long after a person has first been diagnosed with cancer. In rare cases, the cancer may have progressed to stage 4 at the time a person is first diagnosed.

Facing stage 4 breast cancer can be challenging. But following your doctors recommended treatment plan and practicing healthy lifestyle habits can help to improve your outcome. It may significantly increase your lifespan and improve your quality of life.

Breast Cancer Healthline is a free app for people who have faced a breast cancer diagnosis. The app is available on the App Store and . Download here.

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.

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Myth #: The Mental And Emotional Experience Of People With Mbc Is The Same As That Of Earlier

People with MBC report hearing comments such as, At least you have a good type of cancer, Arent you glad so much research on breast cancer has been done?, Fortunately you have so many options. These might comfort people with early-stage breast cancer, who can look forward to one day finishing treatment and moving on but people with MBC dont have that luxury. They know they will be in treatment for the rest of their lives. They also know that their life is likely to be shorter than theyd planned.

Mentally and emotionally, people with MBC have a completely different experience. For them, the whole ringing the bell idea does not work, says Dr. Gupta. I have patients who are coming in once a week and have to plan their lives around their treatment. The whole pink brigade idea is very upsetting to them.

Fortunately, more and more people with MBC are speaking up and calling attention to how their experience differs from that of people with earlier-stage breast cancer. People with MBC live with cancer always in the background of their lives, but with new and emerging therapies, many are living longer and maintaining their quality of life.

Clearly, the experience of metastatic breast cancer is quite different from early-stage breast cancer. But there are so many patients who understand just what youre going through. Read more about Living with Metastatic Breast Cancer and join our discussion forum for people with stage IV/metastatic disease.

References

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.

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Treating Stage Iii Breast Cancer

In stage III breast cancer, the tumor is large or growing into nearby tissues , or the cancer has spread to many nearby lymph nodes.

If you have inflammatory breast cancer: Stage III cancers also include some inflammatory breast cancers that have not spread beyond nearby lymph nodes. These cancers are treated slightly different from other stage III breast cancers. You can find more details in Treatment of Inflammatory Breast Cancer.

There are two main approaches to treating stage III breast cancer:

What Should A Person With Stage 4 Breast Cancer Expect From Treatment

Treatment options vary widely depending on where you live, your access to specialists and sub-specialists, and your willingness to try therapies that are still in the experimental phase.

Seek out oncology specialists who specialize in Stage 4 breast cancer. Discuss with your treatment team what clinical trials may be available for your clinical situation.

During this time, be sure to surround yourself with a support system of friends and family.

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Surviving Stage 4 Breast Cancer: Is It Possible

Understanding survival rates of stage 4 breast cancer

According to the National Cancer Institute , an estimated 27 percent of people in the United States live at least 5 years after being diagnosed with stage 4 breast cancer.

Many factors can affect your longevity and quality of life. Different subtypes of breast cancer behave differently. Some are more aggressive than others, and some have far fewer treatment options than others. For this reason, your subtype may affect your outlook.

Higher survival rates are also associated with the extent and location of metastasis. In other words, your long-term outlook may be better if your cancer has only spread to your bones than if its found in your bones and lungs.

Immediately seeking treatment, like chemotherapy, surgery, or hormone therapy, can help improve your outlook. Making healthy lifestyle choices might also improve your chances of survival.

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.

Our information on living with secondary breast cancer addresses the emotional, practical and physical effects of a diagnosis.

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Symptoms Of Stage 4 Breast Cancer

Symptoms will vary depending on where the stage 4 cancer has spread to and can vary from person to person.

If any symptom is experienced for more than three weeks, it would be suggested to contact your health care team or primary physician for further investigation.

Bone pain and tenderness can be a sign that it has spread to the bones. Headaches, seizures, dizziness or vision change could mean it has spread to the brain.

Breathlessness and a persistent cough could mean it is in the lungs and if it has spread to the liver, there could be a loss in appetite, change in urine color, bloated or sore abdomen, jaundice or pain in the right shoulder.

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. It’s 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 cancerit’s still breast cancer, according to the National Cancer Institute .

Stage 4 breast cancer is an uncommon initial diagnosistechnically called de novo metastatic breast cancer, it’s 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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How Common Is It

About 155,000 women in the United States live with metastatic breast cancer. Men can have metastatic breast cancer too, but it’s rare.

Only 6% to 10% of women with breast cancer are diagnosed at stage IV. About 20% to 30% of women are diagnosed with an early-stage breast cancer, and then the cancer spreads.

Types Of Breast Cancer

There are several types of breast cancer, and any of them can metastasize. Most breast cancers start in the ducts or lobules and are called ductal carcinomas or lobular carcinomas:

• Ductal carcinoma. These cancers start in the cells lining the milk ducts and make up the majority of breast cancers.
• Lobular carcinoma. This is cancer that starts in the lobules, which are the small, tube-like structures that contain milk glands.

Less common types of breast cancer include:

• Medullary

• Metaplastic

• Papillary

• Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers.

• Pagets disease is a type of cancer that begins in the ducts of the nipple.

Breast cancer can develop in women and men. However, breast cancer in men is rare. Less than 1% of all breast cancers develop in men.

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Why Does Metastatic Breast Cancer Happen

Most often, metastatic cancer occurs because treatment didnt destroy all the cancer cells. Sometimes, a few cells remain dormant, or are hidden and undetectable. Then, for reasons providers dont fully understand, the cells begin to grow and spread again.

De novo metastatic breast cancer means that at the time of initial diagnosis, the breast cancer has already spread to other parts of the body. In the absence of treatment, the cancer spreads.

There is nothing you can do to keep breast cancer from metastasizing. And metastatic breast cancer doesnt happen because of something you did.

Progression During Hormone Therapy

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 a different aromatase inhibitor, along with a CDK inhibitor. If the cancer has a PIK3CA mutation and has grown while being treated with an aromatase inhibitor, fulvestrant with alpelisib might be considered. If the cancer is no longer responding to any hormone drugs, chemotherapy immunotherapy, or PARP inhibitors might be options depending on specific features of the cancer or any gene changes that might be present.

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