Talking about treatment options

Giving your consent

Before you begin any treatment, you will discuss the aims and potential side effects with your doctor. 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 and disadvantages of the treatment
  • Any notable side effects or risks
  • Alternative treatment options and the associated side effects and risks

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 healthcare team, 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. Taking notes home with you to discuss with your support group can be helpful too.

Use our appointment guide here.

Doctor and woman

Let us help you prepare

Many treatment options exist for secondary breast cancer (SBC). Not all tumours will respond to the same therapies. Because everyone responds differently to medication, it is not uncommon for patients to try multiple therapy options.1-3 The goal of any treatment for SBC is to slow the growth or spread of cancer while helping you maintain and improve your quality of life.2 The following information may not include all possible side effects for treatment options in SBC. For more information on your specific SBC treatment, talk with your doctor.

Hormone (endocrine) therapy

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 it is 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.4

 

 

Immunotherapy and targeted therapy

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 it is taken How you have this treatment depends on the individual drug. You have them as: a drip in your arm; an injection under the skin or; a tablet.
Possible side effects

Everyone is different and the side effects vary from person to person. You might have a few side effects. And they may be mild or more severe. The side effects you have depend on: which drug you have; whether you have it alone or with other drugs; the amount of drug you have (the dose) and; your general health.5

 

 

Chemotherapy

What it does Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
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.6

 

 

Radiation therapy

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.
How it is taken Radiotherapy is given to any part of the body where it is needed, via an external beam or as an injection e.g. for cancer that has spread to the bones.
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.7

 

 

Surgery

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.8

 

 

Woman being treated

Monitoring your treatment

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 may include9,10:

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

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.

Clinical trials

What are clinical trials?

Clinical trials are medical research studies involving patients. Doctors may use these clinical trials to:11

  • 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 trial. Clinical trials are designed to be as safe as possible and participants are able to pull out 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.

Genetic mutations and biomarkers

The role of biomarkers and genetic mutations in planning your treatment

A biomarker is a substance found in the blood, urine, or body tissue that can give your doctor useful information about your cancer. It helps your doctor know which treatments might work best for that specific cancer.12,13

Common biomarkers in breast cancer include HR and HER2 status of the cancer and also genetic mutations.12,13

Woman using laptop
Cancer researcher
Understanding data

Where there are treatments,
there is research

Behind every cancer treatment there are countless hours of research, data and testing. If you are living with secondary 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.

References:

  1. American Cancer Society. Hormone Therapy for Breast Cancer. Available online at: https://www.cancer.org/cancer/breast-cancer/treatment/hormone-therapy-forbreast-cancer.html [Last accessed: September 2021]
  2. American Society of Clinical Oncology. Breast Cancer - Metastatic: Treatment Options. Available online at: https://www.cancer.net/cancer-types/breast-cancermetastatic/treatment-options [Last accessed: September 2021]
  3. 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: September 2021]
  4. Cancer Research UK. Hormone Therapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/hormone-therapy [Last accessed: September 2021]
  5. 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: September 2021]
  6. Cancer Research UK. Chemotherapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/secondary/treatment/chemotherapy [Last accessed: September 2021]
  7. Cancer Research UK. Radiotherapy. Available online at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/secondary/treatment/radiotherapy/havingradiotherapy [Last accessed: September 2021]
  8. 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: September 2021]
  9. 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: September 2021]
  10. 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: September 2021]
  11. American Society of Clinical Oncology. Clinical Trials. Available online at: https://www.cancer.net/research-and-advocacy/clinical-trials/about-clinical-trials [Last accessed: September 2021]
  12. National Cancer Institute. Biomarker. NCI Dictionary of Cancer Terms. Available online at: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/biomarker [Last accessed: September 2021]
  13. American Society of Clinical Oncology. Breast Cancer – Metastatic: Diagnosis. Available online at: https://www.cancer.net/cancer-types/breast-cancer-metastatic/diagnosis [Last accessed: September 2021]

UK | SEPTEMBER 2021 | 124221

 

 

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. It might make you feel more in control if you take some time to plan for your appointment. Making notes before, during and after can help you retain information and make the most of your visits. We have developed a guide to support you in having these conversations with some tips to help you get the information you need.

Download your Moments That Count appointment guide.

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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.

©2022 Novartis Pharmaceuticals UK Ltd - UK | September 2022 | 124182-1 | This site is intended for an audience in the UK.