ACADEMY PUBLIC POLICIES

Faces of Metastatic Breast Cancer

I haven’t had surgery yet of any kind because when my cancer was discovered it was also found to have already spread to my bones. Based on my scans, the cancer is now in control. Will the doctor consider doing breast cancer surgery and radiation now?

When breast cancer is in control or only small amounts of disease have been found in another organ site, more and more women are having breast cancer surgery. The size of the original tumor in the breast determines if a lumpectomy or mastectomy would be most appropriate.

This rids the body of the source of the disease and some studies have shown that, when it is possible to do this type of procedure, it may prolong survival. The clinical circumstances have to be very specific, however, so not everyone is a candidate.

 Decisions About Radiation to Treat Metastatic Breast Cancer

 Radiation is considered local treatment and is designed to treat the area where the radiation is being given. Women who have had a lumpectomy for treatment of their original breast cancer more than likely had radiation of the breast following that surgery, to prevent local recurrence of the breast cancer. Now you are dealing with a different situation. The breast cancer has returned in a distant organ outside of the breast where it first began.

 How is radiation used for treatment or control of metastatic breast cancer?

 In a variety of ways. To shrink the tumors, to control pain caused by the tumors, and, for small tumors, to actually shrink the tumor until it disappears. Cancers that have spread to the bone are sometimes treated this way if they are causing pain and/or are limited to just a few specific spots. Radiation is also used to treat and control brain metastasis.

 Emily’s comments:

 The pain I was having in my back was unbearable for a while until the doctor decided to do radiation. I would never hadve imagined that doing a couple weeks of daily radiation would have taken nearly all of my back pain away but it did. What a relief to feel more like myself and regain my quality of life.

 How does the doctor protect the rest of my body from getting radiation it doesn’t need?

 With the help of 3D imaging, CAT scans, MRIs, and a physicist, the radiation oncology team can plan your radiation so that it targets the specific areas that need treatment.

“Blocks” are also created to help protect other vital organs and tissue from receiving radiation. Some tissue may be radiated that is at the edge of the radiation field.

The doctor will discuss with you what side effects you may experience, if any, and how long they will last. Radiation in general is well tolerated with the primary side effect being fatigue.

  I’ve had radiation already to shrink my cancer in the spine and it has regrown. Can I have radiation again?

 Your radiation oncologist needs to carefully review the amount of radiation you have received thus far to determine if you can have more. There is a maximum dosage that it is recommended that you not exceed. Records are kept of the dosages you received for each treatment so that this can be tracked and factored into the decision making about further radiation if and when it is needed.