Main Approaches for Managing Advanced Metastatic Cancer
This article explains the main treatment options for metastatic breast cancer, including hormonal therapy, chemotherapy, and targeted therapy. It details how each approach works, their uses based on cancer types, and potential side effects. The focus is on managing the disease to improve quality of life and prolong survival, with treatment choices tailored to individual patient needs and disease characteristics.
Metastatic breast cancer, also known as Stage IV or advanced breast cancer, represents the most severe form of the disease, where cancer cells have spread beyond the breast to other organs such as the brain, liver, bones, or lungs. Despite the spread, treatment remains focused on controlling the disease. In the US, approximately 154,000 individuals are diagnosed with metastatic breast cancer, often recurrence occurs years after initial early-stage treatment.
Individuals with a history of breast cancer are at higher risk of developing metastasis. While no cure exists for metastatic breast cancer, treatments aim to extend life quality and duration. The primary goal is to slow disease progression with minimal discomfort and side effects.
Treatment options depend on the cancer's characteristics, spread extent, patient health, age, symptoms, and prior therapies.
Hormonal Therapy
Used mainly for hormone receptor-positive breast cancer, hormonal therapy aims to block estrogen that fuels cancer growth. It is typically the first choice for such cases. Drugs may be given as injections or oral medications. Premenopausal women may undergo ovarian suppression to reduce estrogen levels through surgery or medication. Postmenopausal women generally receive anti-estrogens or inhibitors, as ovaries no longer produce significant estrogen. Multiple sessions may be needed, but if hormonal therapy becomes ineffective, chemotherapy may be suggested.
Chemotherapy
This treatment is recommended for various breast cancer subtypes, including hormone receptor-negative and HER2-positive types. Chemotherapy is effective in rapidly reducing tumor size by destroying cancer cells with drugs. Treatment duration is typically 3 to 6 months, with short breaks. Patients often undergo several treatment lines, with effectiveness declining over time. Side effects like fatigue, nausea, and hair loss are common but usually temporary, although some may persist long-term.
Targeted Therapy
For HER2-positive cancers, targeted drugs using antibodies are employed to attack HER2 proteins that promote tumor growth. These drugs are administered intravenously and specifically target cancer cells, often combined with chemotherapy. Unlike traditional chemotherapy, targeted therapies usually have fewer side effects, although some may experience nausea, headache, dry skin, or rashes.
