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Treating symptoms of advanced cancer

Read about how to treat symptoms of advanced breast cancer.

Symptoms of advanced cancer can be difficult to cope with. But doctors and nurses can offer support and treatment to help you.

Treatments such as chemotherapy, hormone therapy, radiotherapy or targeted treatments (biological therapy) can help to shrink the cancer, reduce symptoms and help you feel better.

Tell your doctor or nurse about any symptoms that you have so they can help you.

This is the most common symptom. You might also feel as though you don’t have any energy. 

Let your doctor or nurse know if you’re very tired as they might be able to prescribe medicine to help. 

If you’re tired due to anaemia (low red blood cell levels) a blood transfusion can give you more energy.

Resting

It’s important to set yourself a few rest times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise

Exercising can be hard when you feel very tired. But research shows that daily light to moderate exercise can give you more energy. Going for a gentle walk is very good. Gentle exercises in bed or standing up can help if you can’t move around easily. 

Your hospital physiotherapist can help you plan an exercise programme that suits your needs.  

Sleeping

You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

You might not feel like eating and may lose weight. It is important to eat as much as you can.

Tips:

  • Eating several small meals and snacks throughout the day can be easier to manage.
  • Ask your doctor to recommend high calorie drinks to sip if you are worried about losing weight.
  • Eat whatever you feel like eating rather than what you think you should eat.
  • Eat plenty of calories when you can to make up for times when you don’t feel like eating.
  • Drink plenty of fluids even if you can't eat.
  • Don't fill your stomach with a large amount of liquid before eating.
  • Try to eat high calorie foods to keep your weight up.
Talk to your dietitian about having high calorie drinks to boost your calorie intake if you need them.

Swelling in the arm or around the site of your breast cancer is called lymphoedema. It develops because:

  • your lymph glands have been removed or affected by your radiotherapy
  • cancer has blocked your lymph glands

If you have cancer in your liver, fluid may collect in your abdomen, making it swell. This fluid is called ascites.

If you get pain, it can often be helped by cancer treatment. For example, an enlarged liver may cause pain in your right side or shoulder. The pain can be reduced by hormone therapy, chemotherapy or biological therapy that shrinks the cancer in the liver. Bone pain from bone secondaries can be treated with radiotherapy or chemotherapy or with drugs called bisphosphonates.

If you have pain that is not controlled with cancer treatment, there are many painkillers available. Pain can usually be well controlled. With good pain control, most people should be able to be free of pain when they are lying or sitting. The first step is to tell your doctor or nurse that you have pain so that they can find the right painkillers for you.

You might feel breathless if your cancer has spread to your lungs or if you have low red blood cell levels (anaemia). You can learn breathing techniques that can help. You might need a blood transfusion to give you red blood cells if you have anaemia.

Tell your doctor or nurse if you feel breathless. They can prescribe medicines to make your breathing easier.

With advanced breast cancer you may become constipated if:

  • you take certain painkillers (including morphine)
  • there is too much calcium in your blood (hypercalcaemia)
  • your treatment has made you lose your appetite and you are not eating as much as usual
  • you are not able to move about as much as usual

Don't be embarrassed to ask for help with constipation. The longer you leave it the more problems it can cause. Fibre in your diet and plenty of fluids will help, but you may also need to take a laxative. Your doctor can prescribe one. Many hospital and community nurses know about constipation. Ask them to tell you how to prevent or relieve it.

It is important to know that if you have constipation with severe abdominal pain and vomiting, you should not take laxatives. Your bowel may be blocked. Contact your doctor or breast care nurse as soon as possible.

Treatment for sickness depends on what is causing it. Some painkillers or cancer treatments can cause sickness. You will also feel sick if you are constipated.

It is a good idea to talk this over in detail with a doctor or nurse. Then, you can get the treatment you need.

Some people find that ginger is a good natural remedy for sickness. Try eating stem ginger or crystallised ginger if you like it. Or you can slowly sip ginger beer or ginger ale.

If you have cancer cells in your bone, the damaged bone can release calcium into your bloodstream. A high level of calcium in the blood is called hypercalcaemia and can cause:

  • sickness
  • tiredness
  • confusion
  • irritability

If you have hypercalcaemia, you will need treatment from your specialist. You may have to spend a day or two in hospital to get your calcium levels down.

You will have fluids through a drip into your bloodstream. This helps to flush the extra calcium out of your system. Drinking plenty will also help, if you are able to.

You are likely to have a drug called a bisphosphonate. These medicines can help to control hypercalcaemia. You have the bisphosphonate by drip or as tablets.

You might have bone pain if your cancer has spread to your bone. Your bones might be weaker, so they could break more easily.

Possible treatments include:

  • hormone treatment
  • radiotherapy
  • surgery
  • bisphosphonates
  • radiofrequency ablation (RFA)
  • painkillers

Cancer that has spread into the spinal bones can cause pressure on the spinal cord. This is called spinal cord compression. The pressure on the spinal cord stops the nerves working normally. This can lead to:

  • back pain
  • changes in sensation, such as tingling or numbness
  • changes in the way your bowel or bladder work
spinal cord compression.jpg
Spinal cord compression is an emergency. It is important to get treatment as soon as possible.

You might have pain if the cancer has spread to your bones. Your doctor and nurse can help you to be pain free most of the time.

Painkillers can usually control pain well. You might also have treatment with medicines called bisphosphonates. Radiotherapy to the area of bone where the cancer has spread can help to relieve pain.

You might find that complementary therapies, such as relaxation or gentle massage also help.

If the breast cancer has spread to your liver you may often feel ill and tired. You may also have:

  • discomfort on the right side of your abdomen (where the liver is)
  • sickness (nausea)
  • loss of appetite
  • a swollen abdomen

Secondary breast cancer in the liver can cause pain if the cancer presses on the fibrous tissue covering the liver (the capsule). 

The liver has a lot of functions in the body. One is to make bile to help digest food in the intestine. If the drainage channels leading from the liver are blocked by secondary cancer, bile may build up in the blood. This causes jaundice, where the skin and whites of the eyes become yellow and your skin may feel itchy.

The liver can still work well when part of it, or even most of it, is affected by cancer cells. And the symptoms of secondary breast cancer in the liver can usually be well controlled.

The thought of cancer spreading to and affecting the brain can be very frightening. But the brain can work well even if part of it is put out of action by secondary cancer cells.

Secondary breast cancer in the brain can cause different symptoms depending on which part of the brain is affected.

  • You may have headaches and feel sick.
  • The part of the body controlled by the area of the brain where the cancer cells are may not work properly, for example, an arm or a leg may be weaker than usual or may feel numb.
  • You may have memory problems.
  • You may find yourself behaving in a way that is not usual for you.

Very rarely, you may have eyesight problems. Tell your doctor straightaway if you have any changes to your vision. But remember that eye problems can have many causes so it may not be due to cancer. If you are having some types of hormone therapy, chemotherapy or biological therapies, these can occasionally affect your vision.

Treatment for secondary cancer in the brain includes:

  • steroids
  • cancer treatment such as radiotherapy or chemotherapy

Even when you feel tired you may find it hard to sleep. There are different reasons for this, including anxiety and having a lot on your mind. You may want to ask your doctor for sleeping pills. These can help to break a pattern of poor sleep and get you back into a better routine.

You can also try some other remedies for sleeplessness such as:

  • warm milk drinks before bed
  • natural sleep remedies (for example, homeopathic remedies)
  • a warm bath in the evening
  • a relaxing body massage to relieve muscle tension
  • a little more exercise during the day, if you can manage it

Controlling symptoms

Symptoms can usually be well controlled. 

Your doctor or specialist nurse can help you. They can

  • give you medicines
  • get equipment that you need
  • suggest other ways of controlling your symptoms
  • tell you about things that you or your friends and family can do
  • refer you to a symptom control team (a palliative care team)

Symptom control team

Members of the team are experts at controlling symptoms. They can help you to stay as well as possible for as long as possible. There are symptom control teams in most cancer units. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

Last reviewed: 
18 Aug 2014
  • ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2)
    F Cardoso and others
    Annals of Oncology, 2014. Volume 25, Issue 10

  • Advanced breast cancer: diagnosis and treatment
    National Institute of Health and Care Excellence (NICE), 2009 (updated 2014)

  • Metastatic breast cancer
    British Medical Journal (BMJ) Best Practice Online. August 2016

  • Sleeping well
    Royal College of Psychiatrists. August 2016

Information and help

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