Deciding on a treatment for secondary breast cancer

With secondary breast cancer, the aim of treatment is to:

• prolong life
• control the cancer
• relieve symptoms
• improve quality of life.

Different treatments can be given, often in combination with each other. These include:

• hormonal therapy
• chemotherapy
• radiotherapy
• bisphosphonates
• biological therapy
• surgery.

Newer treatments are also being developed and your doctor may talk to you about taking part in a research trial.| If the treatment you’re having stops working, your cancer specialist will usually change to another treatment. Different treatments can be given, one after the other.

Your specialist will consider the following when planning your treatment: 

• the part of the body the cancer has spread to 
• whether the cancer is oestrogen-receptor positive or negative - hormonal therapy is commonly used if the cancer is ER positive
• whether the cancer is HER2 positive - if so, you may have treatment with a biological therapy
• whether you’ve been through the menopause or not - the choice of hormonal treatment usually depends on this
• the grade of the cancer (how slow or fast-growing the cells are) - if the cancer is fast-growing, chemotherapy may be given first 
• any breast cancer treatment you’ve already had and how long it’s been since you had it
• your general health.

Chemotherapy drugs, hormonal and biological therapy drugs are carried around in the bloodstream treating cancer cells wherever they are in the body. This is known as systemic therapy. The treatments work against cancer in many areas of the body at one time.

Local treatments, such as radiotherapy and surgery, treat cancer in one particular area in the body. Radiotherapy can be helpful in treating individual areas of cancer in the bones|. Occasionally, surgery can be used to remove a small tumour in the brain or to help strengthen a weak bone.

Even if, at some stage, you decide not to have further treatment, a lot can be done to improve your symptoms.| You may be referred to doctors and nurses who specialise in controlling different symptoms and providing additional support (palliative care).