Advanced Breast Cancer: What Happens Next?

In In The News by Barbara Jacoby

By: Stephanie Pierce


Get a sense of your treatment and support options going forward.

A diagnosis of stage 4 breast cancer can be overwhelming. Not only must you deal with the many thoughts and emotions competing for space inside your head, but the sheer number of available treatment options can boggle the mind.

Stage 4: What Does It Mean?

Breast cancer develops in “stages,” from 0 (noninvasive) to 4 (advanced). Stage 4 breast cancer has either come back or spread beyond the original site in the breast to other parts of the body. Some common areas where breast cancer might spread include the bones, brain, liver, and lungs. Once it reaches stage 4, the cancer is considered to be incurable, although there are many treatment options available. Many women are now able to live with stage 4 breast cancer as a chronic condition.

Clear Your Head

“Advanced.” “Invasive.” “Metastatic.” Even the words themselves can sound sinister. You’ll need a little while to process your new diagnosis, and the wide array of emotions that go along with it. Take the time to clear your head, because you’ll need your thoughts in order as you prepare yourself for what comes next.

Research Your Options

Treatment options for stage 4 breast cancer have come a long way. This is great news for you, but it can also mean sifting through an overwhelming amount of information as you try to make important decisions regarding your own care. You may choose to let your doctor narrow down your options for you, and then spend some time researching each of those options in depth. When going online, try to stick with reputable websites, like research hospitals, university medical centers, and well-known cancer organizations. Some good starting points include:

Mayo Clinic
MD Anderson Cancer Center
Susan G. Komen
MedlinePlus (part of the National Institutes of Health)

Treatment Basics

Any treatments recommended in your specific situation depend on many factors, including cancer type, where it’s spread, hormone receptor status, and your overall health. As a general overview, there are four basic types of treatment that are usually recommended for metastatic breast cancer:

  • surgery to remove well-defined tumors or whole areas (such as the breast)
  • radiation therapy, which is usually targeted to the tumor itself or the areas where cancer cells are growing. This destroys the cancerous tissue.
  • chemotherapy, which involves a drug or combination of drugs that kill cancer cells. This type of therapy is known as systemic, which means that the drugs travel through your bloodstream to reach the cancer, rather than being localized.
  • hormone therapy, which uses drugs to block specific hormones (like estrogen) that help some types of cancer cells grow and multiply. These drugs usually either slow or stop production of the hormone in your body, or block hormone receptors.

Choose Your Treatment Team

Choose your doctors and the other members of your treatment team wisely. These are the people who are going to help you during the fight of your life. Don’t be afraid to get a second opinion, or to visit with multiple doctors until you find someone who feels like a good fit. You need to feel comfortable with your team, and you need to be able to trust them.

Make a List

Carry a notebook with you everywhere, because you are probably going to think of important questions to ask your doctor. These questions can pop into your mind at inconvenient times. With a notebook handy, you can jot them down while in line at the supermarket, when you wake up in the middle of the night, or while waiting in the parent pick-up line at your child’s school.
Resources for Support

In addition to people close to you, like family and friends, your local chapter of the American Cancer Society may have support groups and meetings to help you navigate your diagnosis and what comes next. Further, thanks to the internet, there are abundant resources available to support you on your journey. Use them. Connecting with others who are going through similar challenges can help you feel less alone, and make you more likely to follow through on your recommended treatment.