Myth #: People With Metastatic Breast Cancer Look Sick And Lose Their Hair
You dont look sick. You look so well. Why do you still have your hair? Are you sure you have cancer? These are comments that people with MBC report hearing. But there are many treatment options besides chemotherapy, and people often appear well while taking them.
As NancyHB comments: Id much rather be a poster child for how sometimes we can live with, rather than die from, MBC at least for a while. Instead, I find myself defending against people who are increasingly becoming impatient with my lack of cancer-patient appearance. Im grateful for this time of feeling good, and theyre harshing my buzz.
Some people with MBC report that they actually look better than they feel while in treatment. So they sometimes have to let family and friends know that even though they appear fine, they dont feel well.
Shetland Pony notes: If she looks good, she is good. Nope. Many of us suffer from the invisible disability of fatigue. I would venture to say every available treatment causes us some level of fatigue. We struggle to keep up. It may look like we are doing the bare minimum when we are really giving it our all.
JoE777 of Texas adds: The new normals advertised about therapies on TV are deceiving about the side effects. They talk about side effects while women are skipping through life. not looking to show the harsh side effects but think there is something wrong with me that my life is not like that.
Treatments For Bone Metastases
To understand how treatments for bone metastasis work, it can help to first understand how breast cancer cells behave in the bones.
A bone can function like a storage tank that traps and holds breast cancer cells. For some time, those cells may not cause any problems. Eventually, though, the cancer cells can hijack the normal, healthy process through which bone tissue regenerates itself.
Your bones are constantly breaking down and clearing away old cells and stimulating new cells to grow. Breast cancer cells in the bone can speed up the breakdown of normal bone tissue and weaken the bones. This is called osteolytic metastasis. Breast cancer cells also can overstimulate the production of new bone, leading to large, rigid growths. This is called osteoblastic metastasis.
Its possible to have osteolytic metastasis, osteoblastic metastasis, or a combination of both. Treatment helps slow or stop these bone metastasis cycles to reduce the risk of whats called a skeletal-related event .
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hypercalcemia of malignancy, or an excessive amount of calcium in the blood
Its important to address any potential symptoms of bone metastases quickly. In addition to controlling the growth of the cancer, the goals of treatment for bone metastasis are to relieve pain, preserve function, and prevent SREs. Doctors can often stabilize bone metastases and help people manage it for long periods of time.
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the cancer is growing quickly
Learn more about Hormonal Therapy.
Symptoms Of Metastasis May Vary Depending On Where The Cancer Has Spread To
Here are some symptoms that vary by locations commonly associated with breast cancer metastasis.
Metastasis in the bone may cause:
- Severe, progressive pain
- Bones that are more easily fractured or broken
Metastasis to the brain may cause:
- Persistent, progressively worsening headache or pressure to the head
- Vision disturbances
- Behavioral changes or personality changes
Metastasis to the liver may cause:
- Jaundice
- Abnormally high enzymes in the liver
- Abdominal pain, appetite loss, nausea, and vomiting
Metastasis to the lungs may cause:
- Chronic cough or inability to get a full breath
- Abnormal chest X-ray
- Chest pain
- Other nonspecific systemic symptoms of metastatic breast cancer can include fatigue, weight loss, and poor appetite, but its important to remember these can also be caused by medication or depression.
If you notice these symptoms, be sure you talk with your physician. They could be important for getting the treatment you need.
Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.
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How Is Brain Metastasis Diagnosed
If your symptoms suggest the presence of brain metastasis, your doctor can use a variety of tests to make a diagnosis.
Initially, blood tests will be ordered to get an idea of your overall health and the function of various organs. These can include:
- a metabolic panel, which can assess liver and kidney function as well as levels of electrolytes in the blood
- a complete blood count, which measures the levels of different blood cells
- tests for breast cancer tumor markers, which are proteins that can be produced by breast cancer cells
Your doctor can use a head MRI to confirm the diagnosis of brain metastasis. This will typically be done with a contrast solution thats given via an intravenous line. Using a contrast solution can help to make the images from the MRI clearer.
The treatment thats recommended for brain metastasis can depend on a few factors, including:
- how many metastases are present in the brain
- where in the brain the metastases are located
- the HER2-positive and ER-positive status of your cancer
- whether your cancer has also metastasized to other areas of the body
- if certain genetic changes are present in your cancer
- your age and overall health
- your personal preferences
There are several potential treatment options for brain metastasis. Doctors generally divide these treatments into two categories: local and systemic.
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.
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How Can My Symptoms Be Relieved
It is very unlikely that you will have all of these symptoms or even most of them. If you have any symptoms that are troubling you, let your doctor or nurse know. Sometimes radiotherapy and chemotherapy can be used to help symptoms. But there other things that can help. Read more about coping with side effects and symptoms.
What Is Male Breast Cancer
Breast cancer in men is very rare, with less than 1 percent of all breast cancers found in men. The risk increases for older men and those with high estrogen levels, low male-hormone levels or a family history of breast cancer. Increased risk is also associated with those who have been exposed to radiation, heavy drinkers, and those with liver disease or who are obese. Treatment options include surgery, radiation therapy, chemotherapy, hormone therapy and drugs that target genetic changes in cells that cause cancer.
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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 Are The Common Signs And Symptoms Of Breast Cancer
The following early signs and symptoms of breast cancer can happen with other conditions that are not cancer related.
- New lump in the breast or underarm
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area of the breast
- Pulling in of the nipple or pain in the nipple area
- Nipple discharge other than breast milk, including blood
- Any change in the size or the shape of the breast
- Pain in any area of the breast
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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.
Dimples On The Breast
Yet another one of the common and warning signs of breast cancer is the presence of dimpled skin around the breast region. It is very common for you to experience dimpling around the skin when you wear tight clothes and such.
But, the problem does arise when the condition is persistent and doesnt go away. If you find that the dimple in the skin around the breast is persistent and doesnt go away, it is best to consult a doctor to get the same checked out.
This is predominantly caused when the tumor inside the breast causes a pull in the skin, thus leaving behind an indent in that area. If you are confused as to how you will detect the same, it can easily be done when you do lift your hands above your head and check whether the whole skin of the breast rides up and down with the motion of your arms.
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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 five 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.
As KatyK of Idaho comments: that you are cured if you are cancer-free five 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.
Discuss Your Symptoms With A Specialist At Moffitt
If you are concerned about metastatic breast cancer symptoms, you can consult with the outstanding team of experts in the Don & Erika Wallace Comprehensive Breast Program at Moffitt Cancer Center, where all of our diagnostic, treatment and supportive care services are available in a single location. To request an appointment, please call or complete our new patient registration form online.
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Where Can Breast Cancer Spread
The most common places for breast cancer to spread to are the lymph nodes, bone, liver, lungs and brain. The symptoms you may experience will depend on where in the body the cancer has spread to. You might not have all of the symptoms mentioned here.
Remember other conditions can cause these symptoms. They dont necessarily mean that you have cancer that has spread. But if you have symptoms that you are worried about, discuss them with your GP, cancer specialist, or breast care nurse so that you can be checked.
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Myth #: Metastatic Breast Cancer Requires More Aggressive Treatment Than Earlier
Related to myth #3 is the notion that because MBC is advanced cancer, doctors have to pull out all the stops to fight it. But thats actually not the case, says Breastcancer.org professional advisory board member Sameer Gupta, MD, a medical oncologist at Bryn Mawr Hospital in Bryn Mawr, Pa., and a clinical assistant professor of medicine at Jefferson Medical College in Philadelphia. The goal is control rather than cure. Think of it as a marathon vs. a 50-yard dash.
Doctors treat earlier-stage breast cancer more aggressively because the goal is to cure it: destroy all of the cancer cells and leave none behind, reducing the risk of recurrence as much as possible. With MBC, the goal is control so that patients can live well for as long as possible. And chemotherapy isnt necessarily the mainstay of treatment.
DivineMrsM of Ohio shares her experience: eople in general think we should be hooked up to a chemo IV and looking sickly. When I told one woman I took a daily anti-estrogen pill to combat MBC, she looked at me with pity and sadness like I had no clue what I was talking about. Or that I was making up that I had advanced breast cancer, perhaps as a sympathy ploy or for attention. She even asked, Arent you on chemo? And I worked with this woman for a number of years, she was not a stranger!
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Treatment For Physical Symptoms
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.
Consider A Clinical Trial
Doctors and scientists continue to research new approaches for treating cancer, including brain metastases. These new approaches are tested in clinical trials.
If youre interested in trying an experimental treatment option, talk with your oncology care teamabout clinical trials that you may be eligible for. You can also find a searchable database of NCI-supported clinical trials
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Symptoms If Cancer Has Spread To The Lymph Nodes
Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection.
The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. You might have any of the following symptoms if your cancer has spread to the lymph nodes:
- a lump or swelling under your armpit
- swelling in your arm or hand
- a lump or swelling in your breast bone or collar bone area
One of the first places breast cancer can spread to is the lymph nodes under the arm on the same side as the breast cancer. This is not a secondary cancer.
Breast Cancer Symptoms You Shouldn’t Ignore
Most breast cancer symptoms are discovered by women during regular dailyactivities like bathing. Knowing how your breasts look and feel, andbeing alert for the signs and symptoms of breast cancer, like a lump,can help you detect the disease early, when it’s easiest to treat.
Most breast changes are due to hormonal cycles or conditions that are less worrying than breast cancer. However, if you experience any of the following breast cancer symptoms, even if they seem mild, see your doctor.
- A lump in the breast or armpit is the most common symptom of breast cancer. Patients often describe this as a ball or a nodule. Lumps may feel soft and rubbery or hard. Unless you have small breasts or the lump is very large, you probably wont be able to see it.
- Skin redness
- Nipple changes, including the nipple turning inward, pulling to one side or changing direction
- Ulcer on the breast or nipple
- Thickening of the skin, resulting in an orange-peel texture
Though rare, men can also get breast cancer. The most common symptoms of male breast cancer are a lump, discharge or dimpling.
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