There are different types of advanced breast cancer. In some types, the hormones estrogen or progesterone can promote the growth and spread of the tumor. Your doctor may refer to this as hormone receptor-positive (HR+) breast cancer.
Hormonal treatment blocks estrogen and stops it from driving cancer progression. This kind of treatment is a primary treatment for HR+ advanced breast cancer. For many, it helps control the cancer and prevents it from getting worse for a period of time.
There are many types of hormonal treatments. Some block estrogen directly whereas others shut down production of estrogen from the ovaries.
If you have HR+ advanced breast cancer, there may be other drugs that can be added to your hormonal therapy. These drugs work to block certain protein cells. Blocking these cells helps stop cancer cells from growing and/or dividing to make new cells, which may slow cancer growth and progression.
Talk to doctor about the different treatment options and which ones may be best for you.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given orally (by mouth) or intravenously (infused into a vein) and is usually given in cycles. Treatment days are followed by periods of rest. Treatment generally does not require a hospital stay; it is often given in an outpatient or clinical setting.
In advanced or metastatic breast cancer, chemotherapy is usually given to HR+ patients who have become resistant to hormonal treatment (hormonal treatment stops working) or to patients who have triple-negative advanced breast cancer. Patients with life-threatening metastases may also receive chemotherapy.
Chemotherapy can shrink tumors relatively quickly. However, chemotherapy destroys both cancer cells and healthy cells. Chemotherapy may also be combined with other therapies to improve tumor response.
The aim of chemotherapy is to slow the growth of tumor cells. If the tumor begins to grow again, which often happens over time, your doctor may prescribe a different chemotherapy regimen.
Read through the information below to get a better understanding of chemotherapy, including treatment, side effects, support, and questions you may want to ask your doctor.
Targeted and Biological Therapies
Targeted therapies are treatments that work to kill (or "target") specific characteristics of cancer cells. Such therapies focus on certain molecules that are known to be involved in tumor growth and spread but are also present in normal, healthy cells. Targeted therapies are also known as "molecular-targeted drugs" or "molecularly targeted therapies."
Targeted therapies may be given along with hormonal treatment, in combination with chemotherapy or alone (monotherapy).
Biological therapies use the body's immune system to fight cancer or to lower the side effects that may be caused by some cancer treatments. Biological response modifiers (BRMs) occur naturally in the body and can be produced in the laboratory. BRMs change the interaction between the body's immune defenses and cancer cells to boost, direct, or restore the body's own ability to fight the disease.
Biological therapies include interferons, interleukins, colony-stimulating factors, monoclonal antibodies, vaccines, gene therapy, and nonspecific immunomodulating agents. A nonspecific immunomodulating agent is a substance that stimulates the immune system in a general way and boosts the body's ability to fight cancer, infection, or other diseases.
Immunotherapy is a new approach that is currently being investigated for the treatment of advanced or metastatic breast cancer. Immunotherapy uses the body's own immune system to fight cancer. It works by either stimulating your immune system to attack cancer cells or giving your immune system what it needs, such as antibodies, to fight cancer. Immunotherapy may be used alone or with other treatments, such as radiation, chemotherapy, or targeted therapy.
Clinical research has shown immunotherapy to be a promising treatment most notably for types of advanced breast cancer that do not respond to targeted therapies or hormone therapy, such as Triple Negative Breast Cancer (TNBC). Talk to your doctor about whether immunotherapy is a treatment you should consider and about possible clinical trials that may be right for you.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. Radiation for advanced or metastatic breast cancer is largely done to reduce pain from bone metastases, which may relieve symptoms and help control specific spots where the cancer has spread.
Surgery is often the first line of attack against early-stage breast cancer. Most people with early-stage breast cancer will have surgery to remove their tumor. The two most common kinds of surgery for breast cancer patients are a mastectomy or lumpectomy. However, surgery for people living with advanced or metastatic breast cancer is not always part of their treatment plan. For advanced breast cancer patients, a tumor might be left in the breast. You should consult your doctor to determine the best treatment approach for your individual situation.
Research is ongoing and new treatments are constantly being developed and studied. If you have been diagnosed with advanced or metastatic breast cancer, you can talk to your doctor about the possibility of joining a clinical trial. Your doctor should be able to tell you which clinical trials you might qualify for and those that are available in your area.
In clinical trials, researchers use a number of assessments to determine whether treatments are effective in helping to control cancer, such as:
- Overall survival, or OS, is the length of time a person lives after being diagnosed with a life-threatening disease, such as cancer, until death from any cause, according to the National Cancer Institute (NCI).
- Progression-free survival, or PFS, is the length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse, according to the NCI.
- Overall response rate to medication is the percentage of people whose cancer shrinks or disappears after treatment.
- Clinical benefit rate is the percentage of patients who achieve a complete response, partial response, or stable disease.
- Improvement in quality of life is an increase in a person's overall enjoyment of life, according to the NCI.
Tune into this video to hear more about clinical trials from advocate Eliza Adams.
Complementary & Alternative Medicine
Complementary and alternative medicine (CAM), as defined by the National Center for Complementary and Alternative Medicine (NCCAM), is a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine can be used together with conventional medicine. Alternative medicine can be used in place of conventional medicine. Conventional medicine is medicine as practiced by holders of MD (medical doctor) or DO (doctor of osteopathy) degrees and by their allied health professionals, including physical therapists, psychologists, and registered nurses. Other terms for conventional medicine include allopathy, Western, mainstream, orthodox, regular medicine, and biomedicine.