Relieving Symptoms Of Advanced Breast Cancer
Treatment to relieve symptoms depends on where the cancer has spread. For example, pain from bone metastases may be treated with radiation therapy, drugs called bisphosphonates such as pamidronate or zoledronic acid , or the drug denosumab . For more, see our information about the treatment of bone metastases.
How Does Cancer Spread Or Metastasize
The spread of cancer usually happens through one or more of the following steps:
- Cancer cells invade nearby healthy cells.;When the healthy cell is taken over, it too can replicate more abnormal cells.
- Cancer cells penetrate into the circulatory or lymph system.;Cancer cells travel through the walls of nearby lymph vessels or blood vessels.
- Migration through circulation.;Cancer cells are carried by the lymph system and the bloodstream to other parts of the body.
- Cancer cells lodge in capillaries.;Cancer cells stop moving as they are lodged in capillaries at a distant location and divide and migrate into the surrounding tissue.
- New small tumors grow.;Cancer cells form small;tumors;at the new location
Value Of Medicines For Metastatic Breast Cancer
With an estimated 1.7 million new cases each year, breast cancer is the most common cancer among women worldwide.1 It is also the leading cause of cancer death among women. In 2015, there were an estimated 560,000 deaths due to breast cancer globally.2 Metastatic breast cancer occurs when the cancer spreads beyond the breast to other parts of the body.3 Patients diagnosed with mBC today face a median survival of approximately three years.4 While mBC currently remains incurable,3 there are reasons to be hopeful. Addressing this high unmet need remains a high priority for drug developers invested in oncology research and development; a number of classes of emerging therapies are currently being studied today for metastatic breast cancer.5
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What Causes Breast Cancer
DNA;is inherited from our parents and it is responsible for providing the instructional codes for how our cells function.; Mutations or changes that can speed up or slow down cell division in our DNA can be responsible for causing normal breast cells to become cancerous.; The inherited tumor suppressor genes, BRCA1 and BRCA2 can also increase the risk of developing breast cancer.; If the BRCA1 or BRCA2 genes demonstrate a mutation, it can be passed down to offspring.; The mutations will then no longer allow for the genes to suppress abnormal cell growth, leading to an increased risk of developing breast cancer.; ; ; ;
;;;;;;;;There are still many risk factors associated with the development of;breast cancer.;;The exact relationship as to why and how these risk factors cause cancerous cells to develop remains unanswered.; Hormones are now recognized as playing a significant part in the complex role in the development of many cases of breast cancer, especially in breast cancer tumors that exhibit;estrogen/progesterone;positive receptors.
;;;;;;;;Although estrogen is usually classified as a hormone found in women, it is also found at significantly lower levels in men.; In approximately;90%;of breast cancer diagnosed in men, the surface cells of the tumors exhibit hormone receptors that are estrogen/progesterone positive that can usually be successfully treated with hormone therapy.; On the other hand, however, estrogen/progesterone negative tumors do not respond to hormone therapy.
Medically Reviewed By Dr Ch Weaver Md 1/2020
As cancer treatment enters a new era of personalized medicine, progress and hope have become a new mantra for those diagnosed with metastatic breast cancer . For many patients living with MBC, their focus is on living each day with quality, coupled with the understanding that novel treatments are now providing long-term survival for many.1
Metastatic breast cancer refers to cancer that originates in the breast but has spread to one or more other locations in the body, such as the lungs, liver, or bones. The majority of patients with MBC have experienced a recurrence following a prior diagnosis of earlier-stage disease; however, patients can also be diagnosed initially with this advanced form of breast cancer.
Although the majority of patients diagnosed with MBC have not historically been considered to have curable disease, more-advanced precision treatment options that are tailored to an individual cancers characteristics continue to be developed and are improving long-term survival rates and quality of life. Importantly, extensive research is currently under way, with the promise of even greater individualized treatment options in the future for patients with MBC.2
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Genetic Testing For Brca Mutations
Genetic testing offers men who are at high risk for developing MBC the opportunity to determine if they have inherited the mutated BRCA gene.;;Prior to genetic testing, the patient should seek advice from a qualified genetic counselor in order to fully understand the complexity of the information associated with the results.;;There can be a lot of uncertainty and ambiguity involved in genetic testing and what the results may mean for other family members. ;Once this test is completed, patients and their associated medical team can begin screening for early signs of MBC.;
;;;;;;;; I have two daughters and no family history of breast cancer, so it was very important for me to determine if I carried the BRCA1 or BRCA2 mutations.;;Fortunately, my results were negative.;;However, it was still recommended that my daughters start a baseline mammogram at the ages of 31-32, because they are at an increased risk of developing breast cancer.
How Mbc Connect Works
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Surveys are brief and easy-to-use, and you can complete them at your own pace
Be the author of your MBC story and share it easily with your family or health care team printed out or on your device
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Based on information you enter, we’ll send you personalized insights and alerts with MBC news, events, and clinical trial opportunities
MBC Connect can help patients feel connected to fellow MBC patients, and their physicians and care teams, like never before.
As a person living with MBC each day,I believe that MBC Connect will help accelerate research for the benefit of a community that demands progress.
We’re working hard to unlock the mysteriesof a marginalized patient population that’sonly received a fraction of breast cancerresearch funding.
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Quick Guide On Hot Flashes And Vaginal Dryness And Discharge For Metastatic Breast Cancer Survivors
This video covers the side effects of hot flashes and dryness that patients living with Metastatic Breast Cancer may experience. It includes what to do when hot flashes become uncomfortable, medications that treat hot flashes, symptoms of dryness or discharge, sexuality and sexual intimacy, and ways to cope. Additionally, there are tips for talking to your health care team about hot flashes and dryness, as well as recommendations they may have.
What Safety Information Do I Need To Know About Halaven
HALAVEN can cause serious side effects, including
- Low white blood cell count . This can lead to serious infections that could lead to death. Your health care provider will check your blood cell counts. Call your health care provider right away if you develop fever , chills, cough, or burning or pain when you urinate, as any of these can be symptoms of infection
- Numbness, tingling, or pain in your hands or feet . Peripheral neuropathy is common with HALAVEN and sometimes can be severe. Tell your health care provider if you have new or worsening symptoms of peripheral neuropathy
- Your health care provider may delay or decrease your dose or stop treatment with HALAVEN if you have side effects
Before you receive HALAVEN, tell your health care provider about all of your medical conditions, including if you
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of HALAVEN?
HALAVEN can cause changes in your heartbeat . This can cause irregular heartbeats. Your health care provider may do heart monitoring or blood tests during your treatment with HALAVEN to check for heart problems.
The most common side effects of HALAVEN in adults with breast cancer include low white blood cell count , low red blood cell count , weakness or tiredness, hair loss , nausea, and constipation.
For more information about HALAVEN, please see full Prescribing Information.
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Myth #: If Youre Diagnosed With Metastatic Breast Cancer You Did Something Wrong Or Didnt Get The Right Treatment The First Time
When some people hear stage IV breast cancer, they assume something must have been missed along the way to let the cancer get that far. There is a misconception that breast cancer always develops in orderly steps from stages I to II, III, and then IV and that theres plenty of time to catch it early. People with MBC can face misguided assumptions that they must have skipped mammograms or self-exams, or they didnt control risk factors such as not exercising enough, watching their weight, or eating healthy. But a person can do everything right and still get MBC. Although regular screenings increase the odds of diagnosing breast cancer at an earlier stage, they cant guarantee it.
Another major misconception: If youre diagnosed with metastatic cancer after being treated for an early-stage breast cancer, you must have chosen the wrong treatment regimen or it wasnt aggressive enough. But between 20% and 30% of people with an earlier-stage breast cancer will eventually go on to develop MBC and theres often no good explanation as to why. And it can happen to anyone. Treatments can reduce the risk of recurrence, but they cant eliminate it.
As Illimae of Houston notes: that a stage IV diagnosis equals negligence on the part of the patient. In my case, it had spread before I ever felt a lump. I felt it Saturday and saw my doc on Monday, I ignored nothing, sometimes it just happens that fast.
Incidence Of Breast Cancer In The United States
Breast cancer is the most common cancer among women in the United States . As of January 1, 2019, there were more than 3.8 million women living in the US who had been diagnosed with breast cancer at some point in their lives. The number of women diagnosed with or living with MBC, however, is not currently measured. This makes it difficult to measure survival rates in MBC.
Clinical Trials Are A Promising Treatment Option
For people with advanced stages of cancer, clinical trials can be considered the gold standard of treatment. I recommend clinical trials highly, says Rosen. You get access to medication and treatment that you normally wouldnt have.
A clinical trial could even have positive results on your cancer. We are living in an exciting time for cancer treatment, says Kimmick. There are myriad new drugs coming out that will improve the lives of all women with breast cancer, both metastatic and early stage.
However, its important to be realistic about the potential outcome of your trial. Rosen was recently enrolled in a clinical trial in which the medication proved toxic for her. But she has no regrets about participating. It feels like Im helping researchers who are working on cures for cancer, she says. When I had a bad reaction to the drug, they were able to put my side effects in their study. I feel like I did help, and that makes me happy.
People interested in joining a clinical trial for treatment should talk to their doctor about options that might be good for them.
How Breast Cancer Metastasizes
When breast cancer metastasizes, the cancer cells enter the lymphatic channels or the bloodstream and spread to lymph nodes or other organs of the body.
Breast cancer cells can travel away from the breast and get into the blood stream fairly easily, but only a select few can survive and grow in other organs. Typically, your body will reject or attack things it doesnt recognize , but in the case of metastasis, cancer cells seem familiar enough that different areas of the body allow them to grow. The most common locations of breast cancer metastases are the liver, bones, lungs and brain.
If you had breast cancer before, this new diagnosis may be referred to as recurrent disease. In this case, some of the primary cancer cells survived the treatments you may have had after your early-stage diagnosis. Systemic therapies like hormonal therapy and chemotherapy aim to eliminate cancer cells in the breast as well as those that may have already started traveling to other parts of the body. But in some cases, those cells escape the treatment and begin to grow later.
Many doctors have researched the process of metastasis, but to date no one can predict how long cancer cells will be inactive before they begin to grow and can be detected.
Your doctors should run tests to make sure that the cancer cells from the metastatic site are the same as your primary diagnosis . They will adjust your treatments if necessary, for the best results possible.
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Update On Hormone Receptor
Hormone receptor-positive metastatic breast cancer is an MBC subtype that tests positive for estrogen receptors, progesterone receptors, or both. HR-positive MBC can be either positive or negative for the HER2 receptor.
While HR-positive MBC is typically sensitive to hormone therapy, it often develops treatment resistance to hormone therapy. See below to read research on newer hormone therapies, targeted therapies like CDK4/6 inhibitors, mTOR inhibitors, PI3K inhibitors, and other therapy combinations for HR-positive MBC.;
How Does Breast Cancer Metastasize Or Spread
Breast cancer metastasis occurs when cancer cells break free from the;original;tumor. These cells enter the bloodstream or lymphatic system. The lymphatic system is made up of;lymph nodes that filter bacteria and viruses. Cancer cells travel through the body;and;make;their way to bones or organs. Once settled, they can;multiply;and form new tumors.;
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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.
Recurrence Of Metastatic Breast Cancer
Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.
But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .
These declines are due in part to improved screening and treatment for the disease.
There are a few general facts that are helpful to know about breast cancer outlook:
- Breast cancer is the most common cancer diagnosis in the United States, according to the
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Quick Guide On Cognitive Changes For Metastatic Breast Cancer Survivors
This video covers the side effect of chemo brain that patients living with Metastatic Breast Cancer may experience during treatment. Chemo brain is characterized by brain fog and difficulty concentrating. The video includes what chemo brain is, tips for coping, and talking to your health care team about chemo brain.
When Do People Get A Metastatic Breast Cancer Diagnosis
Metastatic breast cancer can occur at different points:
- De novo metastatic breast cancer: About 6% of women and 9% of men have metastatic breast cancer when theyre first diagnosed with breast cancer.
- Distant recurrence: Most commonly, metastatic breast cancer is diagnosed after the original breast cancer treatment. A recurrence refers to the cancer coming back and spreading to a different part of the body, which can happen even years after the original diagnosis and treatment.
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Plans Have To Be Flexible
My energy is unpredictable, says Sendelbach. I literally never know how Im going to feel from one day to the next. Its so hard to make plans because if I say yes to something thats two weeks away, the day of, I could wake up and feel absolutely horrible.
When someone with metastatic breast cancer declines an invitation or cancels at the last minute, its most likely not because they dont want to be there. Says Sendelbach, We physically cant do it.
Silberman agrees. Ive been going through for a long time, she says, and Ive had friends drop away. Because of MBC and my treatments, its hard for me to be reliable.
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.