Moments That Count has been developed and funded by Novartis Pharmaceuticals UK Limited and is intended for a UK general public audience.

What to expect

Before your treatment

Before you begin any treatment, your doctor will carry out biomarker testing, which will help them to determine the type of treatment for your unique cancer. You will discuss the aims and potential side effects with your doctor, and they will talk you through whichever treatment or therapy they think would be best for you, so you can learn all about the implications and possible side effects. Some treatments may require you to express your consent by filling in a form stating that you give permission for the hospital to proceed. Before you agree to any treatment, you should be given information about:
 

  • The type and extent of the treatment
  • The advantages (e.g. extended survival) and disadvantages of the treatment
  • Any notable side effects or risks
  • Alternative treatment options and the associated side effects and risks
  • Biomarkers - learning about biomarkers and how healthcare professionals use them can help you understand why you are being offered a certain treatment

If there is something you have not understood after your doctor has discussed the treatment options with you, you may want to share this with them. Out of fear of bothering their multidisciplinary team (MDT), some patients unfortunately may hesitate to ask questions. Cancer and its treatments can be complex, and your healthcare professionals understand this and are there to help you shed light on your cancer and treatment. You can find out more about your MDT here. Taking notes home with you to discuss with your support group can be helpful too. If your doctor does not have an answer it might be a good idea to consult a patient advocacy group, click here to find out more.

For more information about topics to bring up with your MDT at your appointments, download our Planning for Your Next Appointment Guide.

Download the appointment guide
Key considerations

What is overall survival?

Overall survival (or OS) is the length of time from date of diagnosis or beginning of treatment that a patient is still alive.1

Different cancer treatments offer varying rates of overall survival and quality of life may differ. This is a term used in clinical trials, where researchers measure how well a treatment works.1 Your healthcare professionals will be able to give you more information about the overall survival statistics and quality of life with a particular treatment.

Download the terminology guide
Key considerations

What is quality of life?

Throughout your journey, you will be faced with several tough decisions. One of the biggest decisions you will make regarding your treatment is how much you want your quality of life to be affected. Sometimes the more aggressive treatments can be more effective when fighting your cancer but have more severe side effects. It's up to you to agree your treatment plan with your healthcare professional.

You should speak to your multidisciplinary team (MDT) about the effect treatments have on your quality of life and make your decisions based on what they share with you.

Download the terminology guide
Treating primary and secondary breast cancer

What breast cancer treatments are available?

Many treatment options exist for breast cancer at all stages, from primary through to secondary. Not all tumours will respond to the same therapies, so your options will be guided by your biomarkers which should have been tested by your MDT. It's not uncommon for patients to try multiple therapy options.2-4

The goal of treating primary breast cancer is to cure the cancer and reduce the risk of recurrence. However, it is not possible to be sure that the cancer will never come back.13 The goal of treating secondary breast cancer is to slow the growth or spread of cancer while helping you to maintain and improve your quality of life.3 Some treatments can have an impact on your quality of life. The following information may not include all possible side effects for treatment options in breast cancer. For more information on your specific treatment, you should speak with your multidisciplinary team.

Hormone (endocrine) therapy⁵

What it does

Hormones can stimulate some breast cancer cells to grow. Hormone therapy works by either lowering the amount of hormones in the body or by blocking them getting to breast cancer cells.

Why or when used

May be used by men and women of any menstrual status for Hormone Receptor positive (HR+) cancer.

How is it taken

Orally (pill) or via injections, before or after surgery.

Possible side effects

Hot flushes and sweating, changes to your periods if you are pre-menopausal, less interest in sex, vaginal dryness or discharge, feeling sick, painful joints, mood changes and tiredness.

This list of possible side effects is not exhaustive. Your healthcare professional will talk you through the possible side effects of any prescribed treatments.

Immunotherapy and targeted therapy⁶

What it does

Immunotherapy uses our immune system to attack the cancer. Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive.

Why or when used

You might have these drugs with other types of treatment, for example chemotherapy. Not all the targeted and immunotherapy drugs will be suitable for you. You may only be able to have a particular drug if other drugs haven't worked, or your breast cancer cells have certain receptors.


For secondary breast cancer you might have these drugs to: relieve symptoms; reduce the size of the cancer or; maintain or improve your daily quality of life.

How is it taken

How you have this treatment depends on the individual drug. You have them as: a drip in your arm; an injections under the skin or; a tablet.

Possible side effects

Tiredness (fatigue), loss of appetite, low levels of blood cells, feeling or being sick, skin changes such as red and sore skin or an itchy rash, flu-like symptoms such as chills, fever, dizziness and/or diarrhoea.

Chemotherapy⁷

What it does

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is a common treatment for secondary breast cancer. It can help control or shrink the cancer and relieve symptoms. For some people, treatment can control the cancer for many months or years. 

Why or when used

You usually have chemotherapy as cycles of treatment. This means that you have one chemotherapy drug or a combination of drugs then a rest to allow your body to recover. Each cycle of treatment varies depending on what you are having.

How it is taken

May be given as an infusion into a vein (IV) or as an oral therapy.

Possible side effects

Feeling sick, loss of appetite, losing weight, feeling very tired, lower resistance to infections, bleeding and bruising easily, diarrhoea or constipation and/or hair loss.

Radiation therapy⁸

What it does

Radiotherapy uses high energy x-rays to treat cancer cells. It can shrink the cancer, relieve symptoms, and help you feel more comfortable.

Why or when used

You can have radiotherapy to different areas of the body at the same time. Radiotherapy is helpful for treating breast cancer that has spread to one or more areas of bone, the skin and/or, parts of the brain.


You usually have radiotherapy after surgery to lower the risk of the cancer coming back. You might also have it if you have secondary or advanced breast cancer.

How it is taken

Radiotherapy is given to any part of the body where it is needed, via an external beam.

Possible side effects

Radiotherapy for secondary breast cancer can make you tired. It can also make your skin in the treatment area red, darker and/or sore. You can also have other side effects depending on the area of your body having treatment.

Surgery⁹

What it does

Attempts to remove cancer from the body.

Why or when used

Surgery is not usually an option for treating secondary breast cancer. But in some situations it can be used to relieve symptoms.

For example, you might have surgery before radiotherapy to remove a small cancer that has spread to the brain.

This type of surgery will not be suitable for everyone. The cancer needs to be small and you also have to be fit enough to have surgery.

Sticking to the treatment

Sometimes sticking to a treatment can be difficult. In this video, Alistair explores the reasons why this happens and how changing the way we think about our health and treatment can lead to better persistence.

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how is treatment monitored

How is treatment monitored?

You may be monitored regularly to see if your breast cancer is responding to treatment or progressing. How well a treatment works may depend on location and progression of the cancer, and what treatments have already been used. Monitoring tests can include:10,11
 

  • Physical exam
  • Blood tests and lab tests
  • Imaging tests (such as X-ray, CT scan, PET scan, bone scan)
  • Biomarker testing

Getting these tests on a regular schedule can also help you and your doctor determine any side effects that you may have, so you can better manage them.

Your body may stop responding to some medications over time, so you may need to change treatments. It is important to talk with your doctor about the goals of each treatment and what symptoms and side effects you might expect while receiving the treatment.

The future of cancer care

What are clinical trials?

Clinical trials are medical research studies involving patients. Doctors may use these clinical trials to:12
 

  • Test new treatments to see if they work better than current treatments
  • Find which treatments have fewer side effects
  • Find new ways to combine treatments to see if they work better than a single treatment
  • Test new cancer drugs to find out more about them and their side effects
  • Improve the way treatments are given to try to reduce side effects

Results from clinical trials can improve cancer treatments and help people live longer. Trials can also look at improving other aspects such as diagnosis and symptom management.

Taking part in clinical trials

Your healthcare team may talk to you about taking part in a clinical trial. If they don't, you can take it upon yourself to ask them if you would like to be involved in any upcoming trials. Should you wish to be enrolled in a clinical trial, you will need to be assessed for suitability and provide written consent beforehand. Your research doctor or nurse will be able to explain in detail what taking part in a specific trial entails and answer any queries you have.

They will also explain the possible benefits and risks of receiving the treatment under investigation. Participants are able to pull out of clinical trials at any point. Sometimes participants won't know which treatment they are on. The researchers will monitor you closely during and after the trial. If you are offered to participate in such a study, there is absolutely no obligation to take part. Whatever your decision may be, it will be respected. Should you wish to not be involved in a trial, no explanation will be expected. Your care will be the same regardless.

Clinicaltrials.gov is a database of privately and publicly funded clinical studies conducted around the world.

Click here to view.

Understanding your treatment

The importance of open conversation

Behind every cancer treatment there are countless hours of research, data and testing. If you are living with breast cancer, you have the right to know everything about whichever treatment you are prescribed. We highly recommend asking your healthcare professional for some reading materials and more information about your prescribed treatment. For example side effects and overall survival.

Take a look at Crucial Conversations for insight into the types of important topics you can and should discuss with your MDT.

Find out more
importance of open conversation

Engaging with your healthcare team

Alistair provides insight into why it is important to develop a good relationship with your healthcare team and how this can lead to successful management of your condition

You know you best

Make your next appointment count

Your healthcare team is your best resource throughout your treatment. Talk openly and often with them about your doubts, questions and concerns. We have developed a guide to support you in having these conversations with some tips to help you find the information you need.

Download the appointment guide
appointment guide

Learn move about...

biomarkers guide

Biomarkers guide

Read the biomarkers guide to understand the role they play in treatment options.

Download the guide
terminology guide

Terminology guide

Use our glossary of medical terminology so you're not left in the dark at appointments.

Download the guide
crucial conversations meeting

Crucial conversations in breast cancer

Watch our panel discuss the importance of two-way dialogue in breast cancer care.

Watch now

References

  1. National Cancer Institute. Overall survival. Availlable online at: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/overall-survival [Last accessed: October 2023]
  2. American Cancer Society. Hormone Therapy for Breast Cancer. Available online at: https://www.cancer.org/cancer/breast-cancer/treatment/hormone-therapy-for-breast-cancer.html [Last accessed: October 2023]
  3. American Society of Clinical Oncology. Breast Cancer - Metastatic: Treatment Options. Available online at: https://www.cancer.net/cancer-types/breast-cancer-metastatic/treatment-options [Last accessed: October 2023]
  4. BreastCancer.Org. Local Treatments for Distant Areas of Metastasis. Available online at: http://www.breastcancer.org/symptoms/types/recur_metast/treat_metast/options/local [Last accessed: October 2023]
  5. Cancer Research UK. Hormone Therapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/hormone-therapy [Last accessed: October 2023]
  6. Cancer Research UK. Targeted and Immunotherapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/secondary/treatment/targeted-immunotherapy-cancer-drugs [Last accessed: October 2023]
  7. Cancer Research UK. Chemotherapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/secondary/treatment/chemotherapy [Last accessed: October 2023]
  8. Cancer Research UK. Radiotherapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/radiotherapy/radiotherapy-treatment [Last accessed: October 2023]
  9. Cancer Research UK. Treatment Options for Secondary Breast Cancer. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/secondary/treatment/treatment-options [Last accessed: October 2023]
  10. American Society of Clinical Oncology. Breast Cancer: Follow-up Care and Monitoring. Available online at: https://www.cancer.net/cancer-types/breast-cancer/followcare-and-monitoring [Last accessed: October 2023]
  11. American Cancer Society. Imaging (Radiology) Tests for Cancer. Available online at: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/imaging-radiology-tests-for-cancer.html [Last accessed: October 2023]
  12. American Society of Clinical Oncology. Clinical Trials. Available online at: https://www.cancer.net/research-and-advocacy/clinical-trials/about-clinical-trials [Last accessed: October 2023]
  13. Breast Cancer Now. Primary breast cancer prognosis. Available online at: https://breastcancernow.org/about-breast-cancer/diagnosis/primary-breast-cancer-prognosis/ [Last accessed: November 2023]

UK | January 2024 | 124221-1

 

 

 

 

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Moments That Count has been developed and funded by Novartis Pharmaceuticals UK Limited. It has been created in collaboration with secondary breast cancer patients whose knowledge and insights have informed the content and direction for the campaign.

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Reporting side-effects
If you get side effects with any medication you are taking, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the information leaflet that comes in the pack. You can report side effects via the Yellow Card Scheme at https://yellowcard.mhra.gov.uk/. By reporting side effects, you can help provide more information on the safety of your medication.

©2024 Novartis Pharmaceuticals UK Ltd - UK | January 2024 | 124182-3 This site is intended for a UK general public audience.