You’re not in this alone: Here’s the team that will be with you every step of the way during metastatic breast cancer treatment.
After a getting a diagnosis of metastatic breast cancer—the most advanced stage of breast cancer, in which the cancer has spread to other parts of the body, most commonly the bones, lungs, liver, lymph nodes, and brain—you may feel alone and that no one understands exactly what you’re going through.
That’s why having the right care team by your side—as well as family, friends, and maybe a metastatic breast support group—is essential to not only getting the proper treatment, but to helping you cope and improving your quality of life.
Meet Your Metastatic Breast Cancer Team
Your MBC treatment team usually consists of multiple oncologists (a medical oncologist, a radiation oncologist, and maybe a surgical oncologist), nurses and nurse practitioners, and palliative care specialists.
Medical oncologist: “Once someone develops metastatic disease, the real go-to person is the medical oncologist,” says Amy Tiersten, MD, a hematologist and oncologist at the Mount Sinai Hospital in New York City. This doctor specializes in chemotherapy, hormonal therapy, pain medications, nutritional support and targeted therapies for metastatic breast cancer.
“Typically patients are seen at a minimum of monthly,” says Dr. Tiersten. “We want to check the blood work, check the tumor markers if they’re elevated, check their electrolytes and their blood counts, and do a full assessment of side effects and other new systems that may arise from the cancer itself.”
Surgical oncologist: This doctor typically performs biopsies and other procedures, and removes single metastatic cancers.
Radiation oncologist: This doctor specializes in radiation therapy. “Sometimes we do need to reach out to the radiation oncologist to help alleviate a particular symptom, and sometimes we use the expertise of the palliative care group of doctors,” says Dr. Tiersten.
Nurses and nurse practitioners: “We work with nurses and nurse practitioners who are a really important part of the team helping to manage symptoms,” says Dr. Tiersten.
Palliative care team: This group of specialists focus on relieving or preventing symptoms (like pain) in patients with certain conditions. Palliative care is especially important for those living with metastatic breast cancer.
The goal of palliative care is to maximize quality of life. It focuses on symptom control, rather than control of the cancer, and treats physical, emotional, social and spiritual needs.
Palliative care and pain specialists (physicians, nurse practitioners, and nurses) have special training in treating pain and other symptoms, such as fatigue, anxiety, and depression. They can help people weigh the burdens and benefits of different treatments for symptoms as well as for medications or other therapies to treat the cancer.
Working with Your Team to Find the Best MBC Treatment
Finding an oncologist that you can talk openly to and who is a good listener is very important, says Dr. Tiersten. “It has to be someone that you’re really comfortable talking to about your fears, whatever side effects you might be uncomfortable talking about, [and] what alternative therapies you may be using,” she says. “Someone who listens to you without judgement, who’s able to support you, who’s able to alleviate some of your anxieties.”
Throughout your treatment, tell your doctors exactly what's important to you—whether it's quality of life, pain control, or being as aggressive as possible. Talk about the risks and benefits of each treatment choice. Listen to your doctor's recommendations and then, together, develop a treatment plan that works best for you.
Dr. Tiersten is a professor of medicine, hematology, and medical oncology at the Icahn School of Medicine at Mount Sinai. She sees patients at the Dubin Breast Center.
Systemic treatment for metastatic breast cancer: General principles. UpToDate. (Accessed on May 24, 2018 at https://www.uptodate.com/contents/systemic-treatment-for-metastatic-breast-cancer-general-principles)
Metastatic Breast Cancer Treatment and Planning. Breastcancer.org. (Accessed on May 24, 2018 at http://www.breastcancer.org/symptoms/types/recur_metast/treat_metast)