Can I Survive Stage 4 Breast Cancer?

The Breast Cancer Paradigm 

Breast Cancer is very common. Statistics show that 1 in 8 women will be diagnosed with breast cancer. The stage at which breast cancer is diagnosed is usually early stage. Unfortunately, when breast evaluation is neglected for a long period of time it may present at a later stage. Surviving Stage 4 Breast Cancer means different things to different people – see previous blog HERE. To learn more about breast cancer watch via videos and review short reads about early stage breast cancer.  See the different types of surgery for breast cancer, staging of breast cancer, radiation treatment for breast cancer, chemotherapy for breast cancer and more. Visit the Breast Cancer Courses by clicking HERE. Having a basic understanding of breast cancer is essential before continuing beyond this point. 

How Do I Know If I Have Stage 4 Breast Cancer? I Am Very Young … 

Age does not determine if a lump in the breast is cancer, or not.  It is true, that younger patients may commonly have “lumpy breast” or a lump is merely a “cyst” or “adenoma”. However, bear in mind, the youngest I have treated is age 27 … oldest 95. Age is a myth. It never hurt to speak with your Primary Care and get a baseline mammogram. We treat the disease … not the age. 

Now that you have completed the course, you know breast cancer has 5 stages. Knowing the stage will dictate the treatment recommendations.  Lets take a look at what makes stage 4 breast cancer different and answer the question, “Why do all all stage 4 breast cancer behaves differently?”

The components that are considered in staging breast cancer, assist your team in making the beast recommendations. Each patient’s recommendation is unique and tailored to the breast cancer characteristics.  In describing breast cancer at diagnosis your team will consider:

• TNM (Tumor, Node, Metastases)
• Grade (1, 2 or 3)
• Receptor status (ER, PR and HER2)

In previous blog we spoke about TNM, which describes the Tumor (T) in the breast, if the cancer spread to the Lymph Nodes close by (N), or elsewhere in the body (M = metastases). The course clearly outlines these definition with videos and notes.  The Grade tells us how “aggressive” the cancer appears under the microscope. Receptor status tells us what type of chemotherapy or immunotherapy can be used to specifically target the breast cancer cells.  Sometimes, all the receptors are negative and specific target is available. Within the lessons for the Breast Cancer Course, the meaning of “Triple Negative” is clearly explained. Many find the “soil-seed-sun” relationship a great simplistic way to make Triple Negative Breast Cancer easy to understand.

Stage 4 Cancer vs Recurrent Cancer

Friends are good for support, but ask your doctors about the cancer treatments!

Cancer terminologies can be very confusing for patients. You may be told that you do not have stage 4 breast cancer, but instead recurrent breast cancer that has now spread.  Why is recurrent cancer different from stage 4 breast cancer?

• Initial stage 4 breast cancer diagnosis: This means that at the very first diagnosis, you were found to have disease in
  • the breast
  • also usually in the axilla (under the armpit) as well as
  • elsewhere (brain, bone, liver, etc.,)
• Recurrent breast cancer: This means you were initially diagnosed with breast cancer and had treatment. Unfortunately, the cancer has come back. The treatments you had included:
  • surgery
  • +/- chemotherapy
  • +/- radiation therapy

See this blog on recurrent cancer. The treatment recommendations will require evaluating the characteristics of the recurrent tumor. Is this cancer the same or different from the original? A battery of cancer staging tests will be required: CT scan, PET-CT scan, Bone scan, Brain MRI, biopsies, etc., You have learned about what these different types of tests are in the cancer course, but be sure to engage your cancer team. Ask them, “why are you ordering this test? What will the result tell us? Will it help you make a certain decision?”  There are many more questions you can ask from the cancer question books on Amazon 

Treatment for Stage 4 Cancer

It use to be that a stage 4 breast cancer diagnosis warrants an end-of-life discussion. People would call it a “death sentence”.  This is not the routine case anymore. Yes, it is true that some are diagnosed with far advance cancer and nothing can be done. However, many women are living with stage 4 breast cancer for many, many years as well. Thanks to the advancement in medicine, we are now able to treat patients with the intent of eradicating most of the cancer, especially if there are less than 4-5 sites of metastases. Low tumor burden may equal longer years. Of course, with every treatment, side effects must be discussed. There are risk and benefits to everything in life – even driving a car. 

Common Treatments:

• Radiation therapy:  Do you only have a few brain lesions and disease elsewhere in the body is being treated and/or controlled?  Then Stereotactic RadioSurgery (SRS) is very successful at treating small brain metastases. If there are lots of brain lesions and “starry sky” is used to describe it, then SRS/SBRT may not be suitable. Whole Brain Radiation Therapy (SBRT) may be recommended instead. Ask about Memantine with WBRT. This drug may slow memory loss, per recent study. We have also performed SRS/SBRT to lung lesions, adrenal gland (above the kidney), vertebral body (spine)/Bone, etc., We can spot treat these areas to slow down and most time stop the cancer growth…
• Chemotherapy/Immunotherapy – depending on the receptor status, there are novel treatment that we can use and have proven helpful. We use Herceptin for Her2 positive cancer, Endocrine Therapy (Tamoxifen, Aromatiase Inhibibitor (Arimidex, Letrozole, etc.,)) as well and many immunotherapy now available. Medication to strengthen the bone may also be give
• Surgery – in some cases, surgery remain an option, not just for the breast cancer, but also for areas that may be the only area of metastases (liver, lung, etc.,) Each patient’s case will be different, but those who are otherwise in good health and not surgical risk (high risk of dying from the surgery), may engage surgeons on most suitable surgeries.

How Do I Talk To My Cancer Team?

I could write on this topic for a very long time on each of the above and breaking it down even further. However, the goal here is to provide you with enough information to supplement the Breast Cancer Courses and Books on Amazon, so that you may have a good conversation with your Cancer Team.  Look, let’s b realistic. Would you buy a computer, or phone, or car without doing research on the best product for you? Why should taking care of yourself be any different? Arm yourself with knowledge and advocate for yourself the best you know how!  Your cancer team should fill in the blanks. It is my prayer that these blogs will help you on your journey …

In our next blog, we will continue to peel away at the many layered question on Stage 4 Cancer. We will discuss Stage 4 Prostate Cancer. In preparation, consider taking the Prostate Cancer Course – you will find it very enlightening and the videos very engaging. The questions to ask journal on Amazon is also very helpful.

You may register for the FREE course HERE and test your cancer knowledge HERE 

Until next time know that,

Life is beautiful and God is awesome. And know, you are pure awesomeness!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit our website … HERE

Queen, Your Family Friendly Cancer Doc!