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What is metastatic breast cancer? ​​​​​​​ How do doctors make treatment decisions?SurgeryRadiotherapyChemotherapyHormone TherapyTargeted Therapy What matters most to you? Your doctor discussion guideYour questions answered
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What does the future hold?

Is metastatic breast cancer curable?
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Right now, metastatic breast cancer  is not curable but with the right treatment, the growth of the cancer can be reduced so many patients can experience prolonged survival with good quality of life. Therefore, it is important to detect it and start therapy as early as possible.

How long will I have to live?
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Life expectancy depends on many factors and is difficult to predict. Each patient and the way their cancer may progress is different, however, treatments are continuing to evolve and more people are living longer with metastatic breast cancer. Your doctor will be able to talk to you about what you might expect.

Practical considerations

How often will I need to go to the hospital?
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You will need to visit the hospital several times for scanning, therapy, tests, follow-up appointments with members of your assigned care team as well as other specialists like dietitians or physiotherapists. It is important to speak to your doctor about all your treatment options and how frequently you are able to travel to the hospital. Remember – contact your doctor or specialist nurse if you have any concerns between hospital visits. You should also contact them if you notice any new symptoms.

Will I still be able to work, have my hobbies and remain active?
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Maintaining a healthy lifestyle is important for your overall health. However, potential side effects of the treatment, such as tiredness and pain, may alter the way you feel and what you are able to do. Speak to your doctor about what can be done to alleviate symptoms and keep you doing what matters most to you.

Who should I talk to about what I really want from my treatment?
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There are many factors to consider when deciding which treatment is right for you and it’s important that you’re properly informed regarding treatment choices. You can use the resources in this website to consider what you really want from your treatment and then speak to your doctor, nurse or other members of your care team.

Can I still travel?
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You can still enjoy a holiday but it’s important that you check with a member of your care team before going away – especially if you have recently had surgery, chemotherapy or radiotherapy​​ or if you wish to travel outside of Ireland. Remember to take enough of your prescribed medicines with you and check your medical insurance.

Who can I bring with me to meetings with the doctor?
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It can be difficult at times to remember everything the doctor or care team member tells you during a consultation – so bringing someone with you is a good idea. Take someone who can support you, such as a friend or family member. Remember, healthcare professionals are there to help you – and they will be pleased to see that you have some extra care from friends or loved ones.

Metastatic breast cancer

Is there a difference between ‘Secondary’, ‘Metastatic’, ‘Advanced’, and ‘Stage IV’ breast cancer?
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Advanced breast cancer is when cells of the breast tumour​​​​​​​ have spread in/near the breast or to other parts of the body. If the cancer has spread to other parts of the body it can also be called metastatic, secondary, or stage IV cancer.

My doctor has told me the subtype of my cancer, but what does this mean?
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Breast cancer has several subtypes. It is important for your doctor to know your subtype because this has implications for likely outcomes and the way that the cancer can be managed. Knowing your subtype can also help you understand which treatments you might be eligible for.

What are some of the signs to look for if I suspect my breast cancer is spreading?
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Symptoms can vary dependent on where and how much the cancer may have spread and can vary among patients as well. Symptoms can include pain in the bones, headaches, persistent dry coughs, tiredness and/or weight loss.

It is important to remember that if you experience any new symptoms, it may not mean the cancer has progressed. If you experience any new symptoms or changes in your symptoms, inform your doctor.

What causes cancer cells to spread to other parts of the body?
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Metastasis (cancer cells spread to other parts of the body) occurs when cancer cells grow and need more space and nutrients. Although the immune system  ​​​​​​​will attack these cells, some will escape and grow in another area of the body. It is unknown why some people get metastases, and some don’t.

Treatment

Why does my subtype make a difference to which treatment I receive?
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Some of the medicines used to treat breast cancer have effects directed at specific subtypes. For example, there are drugs specially made for cancers that overexpress the HER2​​​​​ ​​gene (HER2-positive).

Have the treatment choices changed since I was first diagnosed with breast cancer?
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They may have. Your doctor will assess the situation and will take into consideration the same factors, i.e. family history and biological factors. Then you can discuss the options together to find a treatment that is most suitable for you.

Why can’t I receive the same type of treatment as someone else?
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Not everyone responds in the same way to therapy. Some treatments may be unsuitable depending on biological factors, such as family history, cancer subtype or other factors, such as suitability for surgery.

If I have had previous treatments, will this affect future treatments?
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Assessing the way you have responded to previous treatments is valuable in helping to determine which medicines to use going forward. For example, if cancer returns despite the use of a particular hormone therapy you received when you had primary breast cancer, your doctor may decide to try a different approach with an alternative hormone therapy or chemotherapy​​​​​​ in the secondary setting.

How does going through the menopause affect my treatment choices?
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As the menopause naturally affects the balance of hormones in your body, your doctor may need to review any medicines used to treat hormone-receptor positive breast cancer because they work in different ways.

Do I need to have chemotherapy?
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Chemotherapy is currently a commonly used option for most patients with metastatic breast cancer . However, speaking to your doctor about all available treatments is advisable.

How long will I have to have treatment for?
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This depends on the treatment regimen ​​​​​​​ you and your doctor have agreed upon and how well your body responds. In your consultations, you can discuss this with your doctor.

Are the available treatments painful?
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Treatments may work differently and cause different side effects in different patients, and not all people are affected by pain in the same way. It is important to discuss and explore all available treatments with your doctor to find a treatment that works best for you.

What are the side-effects of treatment?
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Side-effects vary between treatments and from person to person. You should let your doctor know if you experience any side effects and they can discuss these with you.

Can I be involved in my treatment decision?
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Your doctor will explain the treatment options, how they might work for you, and their potential side-effects during your consultation. It is up to you how involved in your treatment decision you want to be. You may prefer to think about it, talk to your family and friends, and then decide which option is best for you together with your doctor.

YOUR DOCTOR DISCUSSION GUIDE


The What’s Breast for Me? Campaign is funded by Pfizer Healthcare Ireland. Copyright © 2024 Pfizer Healthcare Ireland. All rights reserved. This site is intended for residents of the Republic of Ireland. The information provided on this site is intended for general information and education and is not intended to be a substitute for advice provided by a doctor or other qualified healthcare professional. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patients.

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Date of preparation: January 2024