Treatments for secondary breast cancer

Here are short descriptions of several available treatments for secondary breast cancer.

Hormone therapy

You may be offered hormone therapy if your breast cancer is hormone receptor positive. This type of breast cancer has receptors within the cell that latch onto the female hormone oestrogen, which stimulates the cancer cell to grow.

If your breast cancer has no hormone receptors, hormone therapy will not work for you.

Drugs used as hormone therapy treatment:

• tamoxifen
• anastrozole (Arimidex)
• letrozole (Femara)
• exemestane (Aromasin)
• goserelin (Zoladex)
• fulvestrant (Faslodex)
• megestrol acetate (Megace).

These hormone therapies are all taken as tablets, apart from goserelin and fulvestrant which are injections.

Chemotherapy

The aims of chemotherapy are to slow down the growth of secondary cancer and to relieve symptoms such as pain.

Many different types of chemotherapy are used, but all the drugs are designed to stop the cancer cells from growing and dividing. There are several ways of having chemotherapy, including tablets and injection.

You may have combinations of different drugs according to the type of cancer you have. And sometimes these drugs are given as single agents. These drugs also have different side effects, which may be something to consider when deciding on your treatment.

Drugs used in chemotherapy treatment

• Cyclophosphamide.
• 5 fluorouracil (5FU).
• Epirubicin.
• Methotrexate.
• Paclitaxel (Taxol).
• Docetaxel (Taxotere).
• Doxorubicin (Adriamycin).
• Capecitabine (Xeloda).
• Gemcitabine (Gemzar).
• Vinorelbine (Navelbine).
• Carboplatin.

Bisphosphonates

Bisphosphonates are a group of drugs mainly used to treat secondary breast cancer in the bone. They help reduce the breakdown of bone, relieve pain and help to prevent broken bones.

These drugs can be given as tablets or through a drip into a vein. Bisphosphonates are usually prescribed for as long as your doctor thinks you will benefit from them.

Drugs used as bisphosphonates treatment

• Sodium clodronate (Bonefos).
• Disodium pamidronate (Aredia).
• Zoledronic acid (Zometa).
• Ibandronic acid (Bondronat).

Targeted therapies

This is the name of a group of drugs that block the growth and spread of cancer by changing the biology of the cancer cells. Around 20 per cent of breast cancer patients have cancers that show high levels of HER2, a protein that makes cancer cells grow.

The most well known targeted therapy at the moment is trastuzumab (Herceptin). Trastuzumab blocks the HER2 proteins and aims to stop the cancer cells from growing. It also helps the body's immune system to destroy cancer cells. Trastuzumab can be given alone or alongside chemotherapy.

Others drugs such as lapatinib (Tyverb) and bevacizumab (Avastin) have been developed for secondary breast cancer, so it is likely that more targeted therapies will be available in the future.

Radiotherapy

The aim of radiotherapy in secondary breast cancer is to control the progress of the disease and relieve symptoms such as pain. It is mostly used where the cancer has spread to the bones, lungs or brain or to control recurrence in the skin or armpit (axilla).

When radiotherapy is used to treat secondary breast cancer it will be given as a single dose or as a short course over several days. The side effects will vary depending on which part of the body is being treated. Radiotherapy carries on working after the treatment has finished, so you may not feel the benefits until one or two weeks later.

Surgery

This is rarely an option for treating secondary breast cancer and would not be curative; however there can be times when your oncologist may refer you for a surgical opinion to assist in the management of your symptoms. For example, orthopaedic surgery can be appropriate for painful and or weakened bones.