Chemotherapy drugs are substances that kill cancer cells. However, they can harm normal cells too and this can cause side effects. Some chemotherapy drugs are given as a pill that you can take at home2. Others are given by intravenous infusion and you may have to go to hospital to receive them2.
Whether you receive chemotherapy will depend on your health, what medicines you have taken before and the type of cancer you have. There are many different types of chemotherapies2. If you have too many side effects with one kind, please consult your oncologist5.
Radiotherapy is the use of high-energy radiation that kills cancer cells. Radiotherapy may be given to control your cancer. It can also be used to relieve bone pain if cancer drug therapy does not relieve it fast enough. It is common to radiate metastases in the bone that are causing pain2.
Radiotherapy for metastatic breast cancer is usually given as a single dose or as a short course over a few days. If you are well enough, you are usually given radiotherapy as an outpatient, and do not have to stay overnight in hospital .
However, if you are having chemotherapy at the same time your oncologist may decide that you need to stay in hospital. The side effects of radiotherapy will depend on which part of your body is being treated.
Anti-hormonal drug therapy
Anti-hormonal therapies (or endocrine therapies) are used to treat breast cancer that is sensitive to hormones, particularly estrogen. Some types of breast cancer are stimulated to grow by hormones, such as estrogen. Anti-hormonal therapies work by blocking the actions of particular hormones in the body – by suppressing the production of the hormones estrogen and progesterone or by blocking the receptors for these hormones2,6.
There are several different hormone-based therapy drugs that work in different ways. Anti-hormonal therapies are usually given as pills, but some are given as injections. You may take them with or without chemotherapy2,6.
Whether you are given anti-hormonal therapy, and what type, will depend on whether you have gone through the menopause, how much time has passed since your diagnosis and what kind of treatment you took for your initial breast cancer (if you were diagnosed and treated previously for early breast cancer)2,6. If you have had anti-hormonal therapy in the past you may still take it again.
Targeted drug therapy
Targeted therapies work on specific types of breast cancer by blocking specific pathways that breast cancer cells use to multiply. To determine if any targeted therapies are right for you, your oncologist will have to determine what type of cancer you have2.
There are therapies which are used in the treatment of HR-positive breast cancer that specifically target the signaling pathways that are activated by hormones, such as estrogen2.
There are also several therapies that target HER2 receptors2. These drugs work in people with high levels of HER2 in the cancer cells, but they do not work in cancers that do not have this protein.
Bone stabilizing agents
These are drugs that are often used when there are metastases in the bone. They work by helping to strengthen your bones and help reduce bone loss.
They can help relieve bone pain and reduce the long-term risk of bone breaks3. They are taken as pills or injections.
Surgery is rarely used in metastatic breast cancer2. When it is used, it is because removing tumor tissue will help to improve your body function or relieve pain.
If you have surgery, you may receive drug therapy and/or radiotherapy.