The treatment you need to control symptoms of advanced breast cancer depends on what symptoms you have.
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.
Tiredness is a common symptom of advanced cancer. It can feel a bit overwhelming and 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 or other treatments. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).
It’s important to rest a few 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.
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 might be able to help you plan an exercise programme that suits your needs.
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.
- 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.
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.
Treatment can often help reduce any pain. For example, an enlarged liver may cause pain in your right side or shoulder. Hormone therapy, chemotherapy or targeted drugs that shrink the cancer in the liver can treat the pain. And if you have pain in your bones caused by cancer in your bones radiotherapy, chemotherapy, targeted drugs such as denosumab and drugs called bisphosphonates can all help to get rid of or reduce bone pain.
Painkillers are also available if other treatments haven't controlled your pain or to control it until other treatments start to work.
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.
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.
Cancer cells in your bone can mean that the damaged bone releases calcium into your bloodstream. A high level of calcium in the blood is called hypercalcaemia and can cause:
You will need treatment from your specialist If you have hypercalcaemia. 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
- radiofrequency ablation (RFA)
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
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.
- problems with control of parts of the body, it depends on where in the brain the cancer cells are for example, an arm or a leg may be weaker than usual or may feel numb
- memory problems.
- changes in how you behave
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:
- 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
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.