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1. Treatment for secondary (metastatic) breast cancer
2. Decisions about treatment
3. What’s the aim of treatment?
4. Who will treat and care for me?
5. Clinical trials and research studies
6. Availability of new treatments
7. Palliative and supportive care
8. Monitoring your condition
9. Taking a break from treatment or stopping treatment
1. Treatment for secondary (metastatic) 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 in some people.
You can read more information about how these treatments are used in our pages on secondary breast cancer in the:
2. 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
3. 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
4. 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 – can 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 staff – supports you and your family and helps you live with secondary breast cancer
- Marie Curie or Hospice at home nurse – provide hands-on care for people with secondary cancer in their own homes
5. Clinical trials and research studies
Clinical trials and research studies are common as a treatment option for secondary breast cancer. They aim to find new, more effective treatments that have fewer side effects. They may also look at using existing treatments in different ways.
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.
Genomic research and tests
Genomic research is also being used more and more in research trials.
Genomic tests look at groups of genes found in cancer. They may help identify who will benefit from particular treatments and can help doctors understand what is causing the cancer to spread.
The tests are carried out on tissue removed during a biopsy or surgery, usually in a laboratory away from your hospital. Genomic tests are not suitable for everyone and sometimes do not provide a clear answer.
If these tests are suitable for you, your treatment team will discuss this with you.
Finding clinical trials
You can search for current trials for secondary breast cancer on the following websites:
- Be Part of Research
- Cancer Research UK
- Make 2nds Count's Patient Trials Advocate Service
- My tomorrows
6. 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.
To get treatments unavailable on the NHS you can:
- Apply to your local health body – the way this is done will depend on where you live in the UK
- Make an individual funding request to the NHS in the UK nation 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
7. Palliative and supportive care
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, palliative and supportive care also focuses on symptom control and support. Many people benefit from having advice from a palliative care team much sooner, alongside their medical treatment.
It can be helpful at any stage to prevent and relieve symptoms and help you deal with any other physical, emotional, social and spiritual effects of secondary breast cancer.
Palliative and supportive care usually involves a team of healthcare professionals such as specialist nurses, doctors, social workers, physiotherapists and occupational therapists.
Many people access palliative and supportive care for specific symptom control, such as relieving pain or improving fatigue. Others may access complementary therapies or psychological support for themselves or their families.
You can be referred by your treatment 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.
8. Monitoring your condition
Regular appointments
You should have regular hospital appointments with your treatment team to check how you are feeling both physically and emotionally.
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 treatment 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. These are proteins found in the blood that may be produced by the body in response to the presence of cancer.
However, it’s not clear how reliable the measurement of blood tumour markers is. This is because they can be raised for different reasons, such as other benign (not cancer) health conditions or the treatment for these.
For some people, tumour markers may be normal even when breast cancer has come back.
If tumour markers are raised at the time of diagnosis, some oncologists may continue to check them regularly. When used, tumour markers are a very small part of monitoring your condition and are not often used on their own to make decisions about starting or changing treatment.
Scans
Scans may not always be done routinely, 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.
9. Taking a break from treatment 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 treatment 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.