1. Treatment for secondary breast cancer
2. What’s the aim of treatment?
3. Who will treat and care for me?
4. Clinical trials
5. Availability of new treatments
6. Palliative and supportive care
7. Monitoring your condition
8. Taking a break from or stopping treatment
1. Treatment for secondary breast cancer
If your breast cancer has spread to another part of your body, you may be offered one or more different treatments.
Treatments commonly used in secondary breast cancer include:
- hormone (endocrine) therapy – if your cancer is hormone receptor positive
- chemotherapy
- targeted (biological) therapy
- bone-strengthening therapy – if the cancer is in your bones
Radiotherapy may be used to control the cancer or relieve symptoms if the cancer has spread to the bones or brain.
Surgery is not commonly used to treat secondary breast cancer, but may occasionally be considered.
You can read more information about how these treatments are used in our pages on secondary breast cancer in the:
Decisions about treatment
When making decisions about how best to treat you, your specialist team will consider factors such as:
- where the secondary breast cancer is in the body
- how extensive it is (how many sites and how large)
- any symptoms you have
- what treatment you’ve had in the past
- the features of the secondary cancer
- your general health and any other medical conditions you have
Listen to a discussion with Claire Ryan (Macmillan Nurse Clinician – Metastatic Breast Cancer) about how secondary breast cancer is treated.
2. What’s the aim of treatment?
While secondary breast cancer can be treated, it cannot be cured.
The aim of treatment for secondary breast cancer is to:
- control and slow down the spread of the cancer
- relieve symptoms
- maintain health and wellbeing
- give you the best quality of life for as long as possible
3. Who will treat and care for me?
You’ll be looked after by a team led by a cancer specialist (oncologist).
Everyone diagnosed with breast cancer should have access to a specialist breast care nurse who’s there to provide them with information and support. Some people will have a secondary breast cancer nurse specialist.
Other people who may be involved in your care include:
- GP – has overall responsibility for your health when you’re at home
- district or community nurse – coordinates and delivers nursing care when you’re at home
- palliative and supportive care team – helps with managing symptoms
- occupational therapist – can assess what aids and adaptations you may need
- social worker – assess what welfare benefits you may be entitled to
- social services – can provide practical information and support, such as home carers
- benefits and finance adviser – gives specialist information on benefits, tax credits, grants and loans
- hospice – supports you and your family and helps you live with secondary breast cancer
- Marie Curie or Hospice at home nurse – provides hands-on care for people with secondary cancer in their own homes
4. Clinical trials and research studies
Clinical trials and research studies are common in secondary breast cancer. They aim to find new or better treatments. They may also look at using existing treatments in different ways.
Clinical trials for people with secondary breast cancer may look at:
- new drug treatments
- new doses or regimes of drugs
- new ways of measuring response to treatment
- new types of palliative and supportive care to control symptoms
- patient attitudes towards treatments
- how treatment affects quality of life
Taking part in a trial
As part of your treatment you may be interested in, or may be asked if you’d like to take part in, a clinical trial. Your specialist will talk with you about this, or you can ask if there are any trials that are appropriate for you.
Taking part in a clinical trial may give you access to a new treatment or a new way of receiving treatment that may otherwise not be available to you.
All clinical trials are regulated to make sure everyone receives at least the standard of treatment that would have been recommended if they hadn’t been taking part in the trial.
Finding clinical trials
You can search for current trials for secondary breast cancer on the following websites:
5. Availability of new treatments
Sometimes a treatment for secondary breast cancer may not be routinely available on the NHS, but you may still be able to access it.
It can be expensive to receive treatment outside the NHS, so it’s important to speak to your specialist to make sure it’s the best treatment option for you.
To get treatments unavailable on the NHS you can:
- apply to your local health body – this will depend on where you live
- apply to The Cancer Drugs Fund (in England) or other funding bodies
- pay for your own drugs or treatment
- consider using co-payment options
- contact your local member of parliament
You can find out more on the Macmillan Cancer Care website about what to do if a treatment is not available.
6. Palliative and supportive care
Palliative and supportive care can be helpful at any stage of your illness to:
- prevent and relieve symptoms, such as pain or fatigue
- help you deal with any other physical, emotional, social and spiritual effects of secondary breast cancer
People often think of palliative care as being associated with end-of-life treatment, so are worried when it’s mentioned as part of their care.
However, many people benefit from having advice from a palliative care team much sooner, alongside their medical treatment.
Palliative care usually involves a team of healthcare professionals such as:
- specialist nurses
- doctors
- social workers
- physiotherapists
- occupational therapists
You can be referred by your specialist team, GP or specialist nurse depending on your situation.
Your needs and those of your family will be assessed by the palliative care doctor or nurse, who may see you at the hospital, hospice or in your own home.
If palliative care input is no longer needed, you can be discharged but be seen again when required. It can continue up to and including end-of-life care.
7. Monitoring your condition
Regular appointments
You should have regular hospital appointments with your specialist team to check how physically and emotionally well you are.
They should ask you:
- how you’re feeling
- if you have any new symptoms
- how you’re managing your day-to-day activities
This is a very important way for your specialist team to assess your condition and any changes that may have happened.
You should also have the name and contact number of someone to get in touch with if you have routine or urgent concerns (both during working hours and at night or the weekend) or if you need to change an appointment.
Blood tests
You may have blood tests while you’re at the hospital to check if anything has changed.
Some people have a blood test for tumour markers, which may help monitor how the cancer is responding to treatment. Tumour markers are substances found in the blood. However, these tests are not widely used because doctors don’t agree on how reliable they are. They’re rarely used on their own to make decisions about starting or changing treatment.
Scans
Scans may not always be routinely done, but may be planned by your oncologist to see how the secondary breast cancer is responding to a new treatment or if you have new or worsening symptoms.
If you’re taking part in a clinical trial you may have scans more frequently, depending on the requirements of the trial.
8. Taking a break from or stopping treatment
Unlike treatment for primary breast cancer which comes to an end, most people diagnosed with secondary breast cancer will be on treatment continually.
It can be difficult to continue with daily routines while trying to manage ongoing side effects of treatment.
Because of this your specialist team may suggest a break from treatment. Alternatively you may wish to take a short break for a special occasion or a longer break to recover from the effects of treatment.
Your specialist team can talk this through with you and explain the possible effect on your condition.
Thinking about stopping treatment
Many people reach a point when they decide not to have any more cancer treatment. This is often because the side effects from treatment are significantly reducing their quality of life, and they prefer to have supportive care and symptom control only.
This is never an easy decision to make. Sometimes people feel under pressure to have any treatment offered. Family and friends may also find it hard to accept their loved one has stopped having cancer treatment.
It’s a very personal decision, so if you don’t want to carry on with treatment, try not to feel guilty about something that you feel is the right step for you.
Whatever you decide it shouldn’t make any difference to the care and support available to you.
If you’d like to talk to someone about any aspect of your treatment and care, you can call our free Helpline on 0808 800 6000.