Articles On Breast Cancer Treatment By Stage
With stage IV, the breast cancer has spread to other parts of your body. Often the bones, brain, lungs, or liver are affected. Because multiple areas may be involved, focused treatments like surgery or radiation alone may not be enough.
Treatment of stage IV doesnât cure the disease. But by shrinking the cancer, it can often slow it down, help you feel better, and let you live longer. Patients with stage IV breast cancer may live for years, but itâs usually life-threatening at some point.
Clinical Manifestations Of Stage 4
The main classification signs of breast cancer stage 4 are its spread to remote organs or lymph nodes. The size of the tumor at this stage is no longer important moreover, it may no longer be detected at the primary site.
It is the metastases that most often develop in the liver, lungs, and bones that give information about the development of the oncological process. They are painful and cause vivid symptoms. Metastases in the liver give jaundice and increase abdominal size. Metastases in the lungs give shortness of breath, and in the bones severe pain and frequent fractures.
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What Is The Treatment For Advanced Breast Cancer
Despite the fact that metastatic breast cancer is not currently curable,there are many treatments available. The aim of treatment is to prolong life and to preserve quality of life by relieving symptoms. The treatment for secondary breast cancer is different for everyone as it is tailored to your individual needs. It is also dependent on where the cancer is in your body and on the characteristics of the cancer cells . The team looking after you will discuss everything with you and select the best treatment for you to manage the disease but will also consider your quality of life.
Treatments may include some that you have had before :
- Hormone therapy:If the cancer is hormone receptor positive, hormonal therapy is used first, even if you have been previously treated with this. Other newer agents such as everolimus can be used in conjunction with hormone treatment for post- menopausal women although some are not currently funded in New Zealand. Pre-menopausal women are usually treated with ovarian suppression to stop the ovaries producing hormones. Hormone therapy is continued for as long as it is effective.
Some people may have a combination of these treatments while others may have only one. Your doctor will explain this in detail before you start any treatment.
You may be able to participate in a clinical trial of a new medication. Ask your oncologist if there are any trials which are appropriate for you and check our clinical trials database.
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Is It Possible To Survive Stage 4 Breast Cancer
While there is no cure for metastatic breast cancer, it is possible to control it with treatment for a number of years. The cancer can also go into remission. There are different types of remission:
- Complete remission : when there are no cancer signs and symptoms that can be detected by tests or scans.
- Partial remission : when the cancer has partly responded to treatment. It is still present but it has gotten smaller.
It is currently not possible to predict how long remission will last. However, the repeated cycle of growing, shrinking and stabilising can mean survival for many years. New treatments also continue to be developed. Treatment can help to control the cancer, help relieve symptoms and help you live longer.
It is not always easy, but many people find that with time, they are able to adjust to their diagnosis. Despite the many challenges that metastatic breast cancer brings, people can continue to live full, meaningful lives.
What Is Stage 4 Breast Cancer
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.
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When Is The Right Time To Use Hospice Care
Many people believe that hospice care is only appropriate in the last days or weeks of life. Yet Medicare states that it can be used as much as 6 months before death is anticipated. And those who have lost loved ones say that they wish they had called in hospice care sooner.
Research has shown that patients and families who use hospice services report a higher quality of life than those who dont. Hospice care offers many helpful services, including medical care, counseling, and respite care. People usually qualify for hospice when their doctor signs a statement saying that patients with their type and stage of disease, on average, arent likely to survive beyond 6 months. More information about hospice can be found below in the Related Resources section of this fact sheet.
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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Stage 4 Breast Cancer Survivor Stories
Following are stories from two survivors of breast cancer, told in their own narrative.
“I am Kathy from Littleton, Colorado. I had been a successful hairstylist till the March of 2013. I was used to the occasional back ache as I did most of my work standing up, but one day the backache was so bad I had to go to the hospital to get some relief. After getting an MRI, I received the news that I had stage four breast cancer that had metastasized in my bones. My stage 4 breast cancer life expectancy was only two months. When looking for treatment, I found the University of Colorado Anchutz Cancer Center. For a year I went through chemotherapy once a week, three biopsies and three rounds of radiation. After two years, I am still battling my cancer while living a healthy life. My doctors call this a miracle as I go to the gym five days a week, work for various cancer awareness organizations and recently started a new business.”
Finding Social And Emotional Support
Its critical to find a strong source of social support, whether its your friends and family, or a support group with other people with breast cancer. While the journey is challenging, you dont have to navigate stage 4 breast cancer alone.
Your healthcare provider can also provide more information about the specifics of your cancer, treatment options, and support programs in your area. If youre not sure where to look for an in-person group, a counselor or social worker can also help.
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.
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.
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Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent bone fractures
- When an area of cancer spread is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand their goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
I May Not Feel Like A Fighter Theres No Final Victory
The language used to describe cancer and its treatment is often the language of war: fighting cancer, battling cancer, being a warrior. But those words may not resonate with women who have metastatic breast cancer.
Sendelbach recalls using fighting words when she was first diagnosed with stage 1 breast cancer. I was 30 years old, and I was in fight mode, she says. I was like, Hell yeah, I can kick cancers ass and so on. When she was diagnosed with stage 4, though, she realized there would be no end in sight, no final victory for her.
Theres not a finish line, she says, so to be in fight mode doesnt really work. There has to be an end in sight to stay in that place.
For her, metastatic breast cancer is something she deals with day to day. She describes her journey as a marathon, not a sprint. If you have to stop sometimes to walk and take water breaks, she says, you should. If you try to run as fast as you can all the time, its inevitable that youre going to fail.
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Stages Of Breast Cancer: Stage Iiic
Stage IIIc breast cancers basically involve tumors of any size with significant metastases to:-
- the lymph nodes behind the sternum
- lymph nodes under the arm
- the lymph nodes above or below the collarbone
The extent and depth of lymph node involvement make these patients unsuitable candidates for surgical treatment as a primary mode of therapy. Chemotherapy is the treatment of choice for women with stage IIIb and IIIc breast cancers.
However, up to 70% of patients with stage III breast cancers who have chemotherapy remain alive and disease-free after 7 years.
Blood Tests For Tumor Markers
In some cases, blood tests for tumor markers may be used to help monitor metastatic breast cancer.
For example, you may have blood tests every few months for cancer antigen 15-3 or cancer antigen 27.29 . These tests are similar. Health care providers usually check one, but not both of these blood tests.
Whether the tumor marker test score rises or falls over time may give some information on tumor response to a drug or tumor spread.
Tumor marker tests are not helpful in every case. Some people with rising tumor marker levels dont have tumor growth, and some people with tumor growth have normal or unchanged tumor marker levels.
Health care providers dont make treatment decisions based on serum tumor marker testing alone. They may combine findings from a tumor marker test with information on symptoms and findings from imaging tests . This combined information can help your health care providers understand if a treatment is working well for your cancer.
Talk with your health care provider about whether tumor marker testing is right for you.
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A Little Bit About The Internal Mammary Lymph Nodes
The internal mammary nodes are located behind the ribs. Ribs are made of bone, but in the front, they turn into cartilage just before they join the sternum.
So, each rib attaches to the sternum with cartilage and each of these cartilage bars is around 5 cm long. Thus, it can be very difficult to remove an internal mammary node. There is an internal mammary artery and vein along with the lymph ducts and other veins.
If you need to remove an internal mammary node, the cartilage in front needs to be cut out. Cartilage, unfortunately, does not grow back or heal and this will leave a gap which makes the rib essentially useless.
So, it is a judgement call by the surgeon as to whether or not one should attempt a surgical approach to remove internal mammary nodes with positive metastasis. This is because surgical removal is just too damaging to the function of the chest and ribs.
However, electron beam radiotherapy is an effective treatment for internal mammary nodes. The electrons penetrate to about the correct depth to reach the internal mammary nodes.
Treatment of Stage IIIa Breast Cancer
The treatment for women with stage IIIa breast cancers tends to be a modified radical mastectomy and locoregional radiotherapy.
Often, chemotherapy is given as adjuvant therapy, but in some cases , pre-operative chemotherapy is also recommended. Breast conservation is generally not a good option with stage IIIa breast cancers.
Cancer In The Tissue Around The Brain And Spinal Cord
Sometimes breast cancer spreads to tissues and fluid that surround the brain and spinal cord. This is known as leptomeningeal metastases.
Symptoms are similar to those of secondary breast cancer in the brain, but may be less obvious and more difficult to diagnose.
Its usually diagnosed using an MRI scan, but you may also have a lumbar puncture to take a sample of fluid to be looked at under a microscope.
Treatment can include steroids, radiotherapy and chemotherapy. Chemotherapy or targeted therapy drugs may be given directly into the fluid surrounding the brain and spinal cord to treat the cancer.
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The Stages Of Breast Cancer
NOTE: Although a lot of this information is still valid, The American Joint Committee on Cancer has recently updated their classifications for staging breast tumors.
We will be updating all our articles on staging in the near future. In the meantime, please click HERE for a brief summary of the major changes in January 2018.
If a breast biopsy confirms that breast cancer is indeed the diagnosis, the staging process begins.
The stages of breast cancer are really the extent of breast cancer. So, in order to choose and begin the best treatment, it is necessary to stage breast cancer. The staging process shows the progression of breast cancer.
Breast cancer progresses in relatively predictable and consistent ways, so it is possible to categorize breast cancer in terms of stages.
There are basically five stages of breast cancer, with some subcategories .
Mammogram And Breast Ultrasound
If you have symptoms and have been referred to a specialist breast unit by a GP, you’ll probably be invited to have a mammogram, which is an X-ray of your breasts. You may also need an ultrasound scan.
If cancer was detected through the NHS Breast Screening Programme, you may need another mammogram or ultrasound scan.
Your doctor may suggest that you only have a breast ultrasound scan if you’re under the age of 35. This is because younger women have denser breasts, which means a mammogram is not as effective as ultrasound in detecting cancer.
Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts, showing any lumps or abnormalities.
Your breast specialist may also suggest a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid.
Find out more about breast screening.
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