Living with Metastatic Breast Cancer
by Diana Donovan
It is no secret that the battle against breast cancer is ongoing. What is less well known, however, is that thousands of women with metastatic breast cancer are not only surviving for many years following diagnosis, but many are living longer and better lives during treatment. Thanks to more treatment options available today than ever before, doctors and nurses now approach metastatic breast cancer as a chronic condition that can be managed with ongoing therapy, rather than suggesting it may be “time to get your affairs in order.”
All chemotherapy medicines treat cancer by stopping or slowing the growth of cancer cells, but treatments for metastatic breast cancer are different from the treatments given for early-stage breast cancer, which aim to promote survival by removing the cancer completely and prevent it from ever returning. With metastatic breast cancer, the aim is to prolong the person’s life and the quality of that life by controlling tumor growth with as few side effects as possible. Indeed, as therapies improve, metastatic cancer treatments have become easier to withstand. This means many women are able to continue to work during treatment, retain much independence, and generally go on living their lives while undergoing one treatment after another to keep disease progression in check, relieve symptoms, and provide the best quality of life possible.
In years past, women whose metastatic breast cancer did not respond to surgery, radiation, or the handful of anticancer therapies that were available had no hope of long-term survival. Now, however, a better scientific understanding of why current treatments don’t always work has led to the development of new options for women living with breast cancer that returns or spreads. Some of these new treatments are designed to overcome the ways tumors resist traditional cancer therapy, while others target specific proteins that are more plentiful in tumor cells than in normal cells.
Many of these new agents are FDA approved, but an increasing number of women are also willing to enter clinical trials evaluating new investigational agents. In addition to receiving cutting-edge breast cancer therapy, these women are aiding in the fight against breast cancer for future generations. Each new treatment that emerges provides one more reason to be optimistic about the future of metastatic breast cancer treatment.
A better scientific understanding of why current treatments don’t always work has led to the development of new options for women living with breast cancer that returns or spreads.
Naturally, however, women diagnosed with metastatic breast cancer will still feel afraid, angry, and/or shocked. They may feel like they are fighting the disease alone, or they may feel like a statistic, rather than individuals in their own right with unique medical issues that need to be addressed. When these feelings arise, you must resist the urge to withdraw or fight alone.
Many breast cancer support groups are targeted to women with early-stage breast cancer and may not be appropriate for someone whose cancer is in the metastatic stage. As an alternative, many women with metastatic breast cancer tell me they’ve found personal counseling to be quite helpful. Your healthcare team is a good resource for counselors or therapists who are well versed in breast cancer issues and are experienced in dealing with women with metastatic breast cancer and their loved ones.
You can maintain some sense of control by being involved in decisions about your care, and for that to happen, you must educate yourself on the choices of treatment available. There is no single “right” therapeutic choice that fits everyone, so you should carefully discuss all available treatment options (including clinical trials) with your healthcare team to determine the best choice for you. Treatment decisions depend on not only the specific features of your breast cancer, the expected response of the cancer to the various types of therapy, and the side effects, but also upon your personal preference and lifestyle.
Today, women are active participants and even leaders in their treatment, armed with hope, an arsenal of powerful new cancer therapies, and the confidence that comes from being a part of a healthcare team whose members communicate openly and as equals. As a confident, well-equipped woman, you have the tools with which to adjust to your changing circumstances, which means that metastatic breast cancer won’t prevent you from living a full life.
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Diana Donovan is a nurse practitioner at the Weill Cornell Breast Center at Cornell University, New York-Presbyterian Hospital in New York, NY, where she works with women who are living with breast cancer on a daily basis.
This article was originally published in Coping® with Cancer magazine, September/October 2009.