100 Questions & Answers About Advanced and Metastatic Breast Cancer

Title......Page 3
Copyright......Page 4
Contents......Page 5
Foreword......Page 9
Part One: Suspicions of Metastatic Breast Cancer......Page 11
1. So what is metastatic breast cancer?......Page 13
3. I have heard that breast cancer grows more slowly in older women and doesn’t need to be treated. Is that true?......Page 14
4. How will my oncologist decide how to treat my metastatic breast cancer?......Page 16
5. My doctor waited for me to have symptoms before doing any scans. Couldn’t he have found my cancer earlier if he did regular scans after my first diagnosis?......Page 18
7. How did this happen? Should I have had more treatment originally when I was diagnosed?......Page 20
8. I want to get under way with treatment immediately and everything is taking too long. Why can’t I start treatment immediately?......Page 21
Part Two: Ensuring You Are in Good Hands—Selecting the Oncology Team to Take Care of You......Page 23
9. How do I know I’m receiving the best and most appropriate care for my current situation?......Page 24
10. I want to be able to participate in the decision making about my treatment. How can I do this?......Page 27
11. I’ve heard the term “multidisciplinary care,” or “tumor board,” used. What is this and should I be requesting this?......Page 28
13. My surgery was done when I was originally diagnosed with breast cancer. Will I still need a breast surgeon to be involved now?......Page 29
15. Do I need a radiation oncologist?......Page 30
16. I want to make sure that my doctors are communicating with one another and not relying on me to give them updates. How do I make sure my medical oncologist, radiation oncologist, and family doctor are talking?......Page 31
18. The stress of thinking about what may lie ahead is overwhelming to me. Who can help me with these feelings?......Page 32
Part Three: Decisions Regarding Surgery and Radiation for Treatment of Metastatic Disease......Page 33
19. I had a lumpectomy and axillary node dissection done 3 years ago and now the cancer has returned to my bones. Will the doctor need to do a mastectomy now?......Page 34
21. I have disease in my liver. Can I get a liver transplant as my treatment?......Page 35
22. I haven’t had surgery yet of any kind because when my cancer was discovered it was also found to have already spread to my bones. Based on my scans, the cancer is now in control. Will the doctor consider doing breast cancer surgery and radiation now?......Page 36
24. How does the doctor protect the rest of my body from getting radiation it doesn’t need?......Page 37
25. I’ve had radiation already to shrink my cancer in the spine and it has regrown. Can I have radiation again?......Page 38
Part Four: Chemotherapy for Treatment of Metastatic Disease......Page 39
26. What is chemotherapy and how does it work?......Page 40
27. I got several drugs before, why am I only getting one now?......Page 41
28. When I was first diagnosed with breast cancer, I was treated with adjuvant chemotherapy. Will I get the same drugs again?......Page 42
30. Do I have to be hospitalized to get my treatments?......Page 43
31. How is chemotherapy given?......Page 44
32. What are ports and vascular access devices? Do I need one?......Page 45
34. What is a chemotherapy cycle?......Page 48
35. How will the doctors determine if the chemotherapy is working?......Page 49
36. My doctor just told me that my cancer is in remission. Does that mean that I’m cured?......Page 50
37. What are my chances of remission, and how long will it last?......Page 51
38. I feel pretty good during my chemotherapy treatments, and I worry that the treatment isn’t strong enough. Is it more likely to work if I get more severe side effects?......Page 52
39. How often will I see my oncologist during my chemotherapy treatments?......Page 53
40. Since the chemotherapy affects my immune system, is it still okay for me to work while taking it? Are there any precautions I should use in the work place or in other social settings?......Page 54
41. My doctor checks my blood count just before I get my next dose of chemotherapy. Why does he also need to check it 1–2 weeks later?......Page 55
42. Is there anything that I can do to bring my counts up?......Page 56
43. When I have a problem, shouldI call my primary care doctor or my oncologist?......Page 57
44. Why do I need intrathecal chemotherapy?......Page 58
46. Is it safe to travel while I am getting chemotherapy?......Page 59
Part Five: Hormonal Therapy......Page 61
47. How does the doctor determine if I should get hormonal therapy instead of chemotherapy?......Page 62
48. Are there different types of hormonal therapies? How does my doctor decide which to use?......Page 63
49. I have osteoporosis. Is it safe to take an aromatase inhibitor?......Page 64
50. I am taking hormonal therapy for treatment of my metastatic breast cancer. Is it true that chemotherapy is better than hormonal therapy since it is given intravenously?......Page 65
Part Six: Side Effects of Metastatic Breast Cancer and Its Treatment and How to Control Them......Page 67
51. What kind of side effects might I expect to experience as a result of getting treatment for my metastatic breast cancer?......Page 68
52. Why do I feel so tired most of the time?......Page 69
54. It seems harder to remember things, especially doing math or trying to recall where I put my keys. What is causing these symptoms?......Page 70
55. Where did my energy go, and what can I do to get it back?......Page 71
56. I’ve been in treatment for my metastatic breast cancer that spread to my lungs. Lately I’ve noticed it is getting harder to breathe. What might this be?......Page 72
57. What is lymphedema and how can I manage it if I develop it?......Page 73
58. What can I do to manage hair loss?......Page 74
59. My doctor mentioned that he would check my calcium levels periodically. What is this for?......Page 75
60. It seems harder to fight off colds and flu viruses than it did before. How come?......Page 76
61. My chemotherapy and hormonal therapy have caused me to develop symptoms of menopause. How can I manage these symptoms and feel more like myself again?......Page 77
63. I’m taking so many different medications now that my stomach is always upset. What can I do to feel better and be able to eat and enjoy food again?......Page 78
64. My feet and hands have gotten tingly. What is this, and how can I make it go away?......Page 80
65. I am feeling more joint pain and backaches that make it difficult to walk around. What can I do to manage my pain?......Page 81
66. I am so worried about pain. Will Isuffer a lot?......Page 82
68. Is it true that the bis phosphonates that I take for my bones will damage my jaw?......Page 83
70. My husband and I have enjoyed an active sex life. Since my treatments have gotten more intense, this has been more difficult. What can we do to be able to still be sexually intimate? We both miss it.......Page 85
Part Seven: Targeted Therapy......Page 87
72. What is HER2-positive breast cancer, and how do I know if I have it?......Page 88
73. What is targeted therapy, and how does it work?......Page 89
74. I have been taking trastuzumab (Herceptin), but the doctor says that my cancer is not responding to this treatment anymore. Do I have any other options?......Page 92
Part Eight: Clinical Trials......Page 93
76. What are the various study phases of clinical trials?......Page 94
77. What questions should I ask the doctor about a specific clinical trial she has recommended for me?......Page 96
78. How do I find out about clinical trials that might be appropriate for me to consider?......Page 97
Part Nine: Complementary and Alternative Medicine......Page 99
80. I’ve heard that some alternative medicine treatments may actually cure cancer. Is this true?......Page 100
81. What are examples of some complementary and alternative treatments that I might hear about or want to learn more about?......Page 101
83. My disease is progressing and I’m running out of options for treatment. Can I embark on alternative medicine and do it on my own?......Page 103
84. Where can I go to get credible, up-to-date information about research studies that have been done regarding complementary and alternative medicine?......Page 104
85. How do I make the decision if I should or shouldn’t use one of the complementary or alternative therapies my family and friends are recommending?......Page 105
Part Ten: Other Common Questions......Page 107
86. My family wants me to stop smoking, but I already have incurable cancer. Do I have to stop?......Page 108
88. I have liver cancer. Is it true that it is a death sentence?......Page 109
89. A friend of mine who has metastatic disease says that periodically she gets to stop treatment for a while. How does my oncologist decide if I can have a drug holiday? How long does it usually last?......Page 110
90. Should I still get my annual screening mammogram?......Page 112
Part Eleven: End of Life, Treatment, Crossroads, Making Plans......Page 115
92. What is an advanced directive and how can I make sure my wishes are known?......Page 116
93. What is a living will? Is it the same as a healthcare proxy?......Page 117
94. I don’t know how to approach such decisions with my family. How do I do this?......Page 119
96. How and when will the doctor recommend that I stop treatment?......Page 120
97. My doctor says that it’s time to get hospice involved and stop my treatment. What is hospice and what can I expect them to help me with?......Page 121
98. I want my children to remember me. I also want to help them cope with my having to leave them. What can you suggest to help us with both?......Page 123
99. I feel very stressed about my medical situation and need time to clear my head and think about what I want to do. How can I do this?......Page 125
100. How do I decide what is the best way to be spending my time if the doctor tells me that my time is limited? Do I still work as much as I can? Do I take a trip? How do I make these decisions?......Page 127
Drug Tables......Page 129
Appendix......Page 137
Glossary......Page 141
Index......Page 151