Treatment options for secondary breast cancer

Secondary breast cancer means that a breast cancer has spread to another part of the body. It is also called advanced or metastatic breast cancer.

Deciding about treatment can be difficult when you have advanced cancer. Treatments such as chemotherapy or radiotherapy can help to reduce symptoms and might make you feel better. But they also have side effects that can make you feel unwell for a while.

It helps to understand:

• what treatment can do for you
• how it might affect your quality of life
• what side effects it has

Your doctor or specialist nurse can talk to you about the benefits and possible side effects. You can ask them questions.

You might also find it helps to talk things over with a close relative, a friend or a counsellor at the hospital.

Types of treatment

Treatment depends on:

• the size of the cancer and where it is in the body
• the treatment you have already had
• your general health

There are a number of treatments for secondary breast cancer. You might have:

• hormone therapy
• chemotherapy
• radiotherapy
• targeted therapy
• bisphosphonates to treat spread to the bones
• electrochemotherapy for breast cancer that has spread to the skin
• a combination of some of these

Controlling symptoms

Breast cancer that has spread to other parts of the body might cause symptoms. This might include problems with pain in your bones or feeling breathless. The symptoms you have depend upon where the cancer has spread to.

Treatment can help to control symptoms. This might be:

• bisphosphonates to help with bone pain
• a small tube to drain fluid from your lungs
• medicated dressings if you have a wound at your tumour site

Bisphosphonates can slow down bone damage and also lower calcium levels in the blood. 

Chemotherapy, hormone therapy, radiotherapy and targeted cancer drugs can all help to control symptoms as well.

Surgery

Surgery is not usually an option for treating secondary breast cancer. But in some situations, surgery can help 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.

Electrochemotherapy

Electrochemotherapy uses a combination of chemotherapy and an electric pulse. It can be used to treat breast cancer that has come back in the skin of the operation scar. Or to treat breast cancer that has spread to the skin in other parts of the body. It might help to shrink the cancer and also relieve symptoms such as pain.

Your doctor will talk to you about all the options you have and the pros and cons of each.

Your choices

Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

• whether you need extra appointments
• if you need more tests
• the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as tablets to relieve sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.

Support at home

Finding out cancer has spread can be a big shock. It might help to talk to a close friend or relative about how you feel.