Treatment for Symptoms of Breast Cancer Metastasis

Metastatic breast cancer (MBC) is breast cancer that has spread to other parts of the body. The most common sites where breast cancer metastasizes to include:¹

• Bones
• Brain
• Liver
• Lungs

Because MBC is in multiple places in the body, systemic treatments are often recommended. These are treatments that work throughout the body to treat cancer cells wherever they may be. Systemic treatments used to treat MBC include:¹

• Hormone therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy

Other treatments may also be used to treat the symptoms of MBC. These treatments are based on specific factors for each person, including their area(s) of metastases, symptoms, and general health.^1,2

Treatment that focuses on relieving the symptoms is palliative care. This is sometimes called supportive care or symptom management. While palliative care does not focus on curing the disease or prolonging life, it can help improve quality of life. It can be used in combination with other breast cancer treatments.^1,2

Treatment for symptoms from bone metastases

Bones are the most common site where breast cancer metastasizes. Roughly 70 to 80 percent of people with metastatic breast cancer have bone metastases.³

When breast cancer spreads to the bone, it can cause:³

• Bone pain
• Too much calcium in the blood (hypercalcemia)
• Bone fractures
• Spinal cord compression

Some treatments used for bone metastases relieve symptoms by shrinking or slowing the growth of the tumors. Systemic treatments like chemotherapy, hormone therapy, targeted therapy, and immunotherapy may help slow tumor growth or shrink the tumors.⁴

Other treatments used to reduce or relieve symptoms from bone metastases include:^4-7

• Bisphosphonates – Osteoclasts are a type of bone cell that normally absorb bone tissue during growth and healing. Osteoclasts can become overactive when breast cancer spreads to the bones. This causes bones to become more easily fractured. Bisphosphonates are a type of drug that slow down osteoclasts and can help ease the symptoms of bone metastases.
• RANKL inhibitors – Receptor activator of nuclear factor kappa-B ligand (RANKL) is a protein that can trigger osteoclasts to absorb bone. RANKL inhibitor drugs block this protein, which can decrease bone loss caused by bone metastases.
• Radiation therapy – This treatment uses high doses of radiation to kill cancer cells in a specific area. Radiation therapy can help relieve pain from bone metastases.
• Radiopharmaceuticals – These are drugs that have radioactive components. The radioactive materials are drawn to places in the body that have cells with high turnover, such as areas of bone metastases. They then give off radiation that kills breast cancer cells. Because these drugs go throughout the body, radiation may be secreted through sweat, saliva, blood, and/or urine. Safety measures are needed to protect others for the first few days after receiving these drugs.
• Ablation – This procedure uses a needle or probe to deliver heat, cold, electricity, or a chemical to destroy cancer cells. Examples include radiofrequency ablation, which uses an electric current, and cryoablation, which freezes the cells.
• Bone cement – Bone cement may be used to strengthen or stabilize a bone that is weakened from bone metastases. Strengthening the bones often reduces pain.
• Surgery – In some cases, surgery may be used to stabilize bones and prevent fractures. It may also be used to stabilize a bone that has fractured. Surgery to a bone with metastases may use screws, rods, plates, or other devices.

Treatment for symptoms from brain metastases

When breast cancer spreads to the brain, it can cause swelling (edema). This can lead to symptoms like:³

• Headaches
• Nausea
• Seizures
• Neurological problems

Treatment may include:³

• Pain relief
• Anti-nausea drugs
• Anticonvulsants for seizures
• Radiation therapy or surgery to treat a tumor in the brain

Treatment for symptoms from liver metastases

Metastasis to the liver can cause:

• Pain
• Jaundice (yellowing of the skin or whites of the eyes)
• Nausea
• Itching

Treatment may include:³

• Anti-nausea drugs
• Antihistamines
• Surgery or embolization, which cuts off the blood supply to a tumor

Treatment for symptoms from lung metastases

When breast cancer spreads to the lungs, symptoms include:³

• Shortness of breath
• Difficulty breathing
• Chest pain
• Cough
• Fluid build-up around the lungs (pleural effusion)
• Airway blockages

Treatment may include:³

• Medicines like pain relievers, steroids, or anti-anxiety drugs
• Oxygen
• Removal of fluid build-up
• Surgery
• Radiation therapy