Metastatic Breast Cancer Treatment: Essential Information to Understand
Palliative care, a misunderstood concept often equated with hospice care, plays a crucial role in the treatment of metastatic breast cancer. This form of care is not only appropriate at the end-of-life stage but can be initiated early on in a patient's journey to improve their quality of life and manage symptoms effectively.
Palliative care is an integral part of standard cancer treatment, with most cancer treatment guidelines recommending its early involvement [1]. It is a continuous layer of support that emphasizes living well, symptom relief, emotional resilience, and individualized care planning.
The Role of Palliative Care
Palliative care is initiated soon after diagnosis and continues alongside disease-directed therapies. Its key aspects include early integration, symptom management, multidisciplinary coordination, psychosocial and emotional support, advanced care planning, and facilitating patient-centered decision-making [1][2][3].
Starting palliative care early enhances patients' coping abilities and overall quality of life without implying treatment cessation [1]. It addresses physical symptoms such as pain, nausea, neuropathy, and treatment side effects to maintain function and comfort [1][2][3].
Palliative care teams work alongside oncologists, pharmacists, social workers, and other specialists, providing holistic, coordinated care addressing physical, emotional, psychosocial, and spiritual needs [2][4]. They offer counseling, support groups, and spiritual care to patients and families to help them navigate the stresses of advanced cancer [1][3].
Discussing goals of care, patient wishes, and advanced directives ensures that care aligns with patient values and preferences [1][3]. Palliative care teams inform patients thoroughly about treatment options, potential benefits, side effects, and financial implications, enabling choices consistent with their quality-of-life goals [3].
The Impact of Palliative Care in Metastatic Breast Cancer
In metastatic breast cancer specifically, the focus of palliative care is on symptom control and maintaining functional ability during ongoing systemic, targeted, hormonal, or immunotherapies [5]. This approach balances extending survival with preserving dignity and daily living activities.
Palliative care is often used in conjunction with the oncology team for breast cancer patients. It can be delivered in either the hospital or the clinic, depending on the patient's symptoms. Palliative care is delivered at the same time as medical care, often during chemotherapy [5].
The interdisciplinary palliative care team consists of nurse practitioners, doctors, social workers, nurses, and chaplains. As a patient's breast cancer journey evolves, navigating complicated treatment plans, symptoms, emotions, and changing goals, the palliative care team evolves with them [5].
Coping Emotionally with Metastatic Breast Cancer
Living with metastatic breast cancer can affect a person's emotional health, including their emotional well-being, body image, and sexuality. To cope emotionally, patients can prioritise self-care, learn relaxation techniques, explore guided imagery and breathwork, try massages or acupuncture, journal, connect with a support group, meet with a social worker or counselor, and talk honestly with others about how they are doing [6].
Resources for Palliative Care
For more information and resources about palliative care, the Center to Advance Palliative Care is a valuable resource. Ideally, palliative care starts at the time of diagnosis to help patients cope with their diagnosis and discuss their hopes, worries, and challenges [7].
Many patients and doctors worry that referring someone to palliative care implies that they are not doing well or are not responding well to treatment. However, palliative care aims to help people living with metastatic cancer have the best possible quality of life throughout their illness experience [7].
[1] National Comprehensive Cancer Network (NCCN). (2021). NCCN Guidelines for Patients: Breast Cancer, Version 4.2021. [2] National Institute for Health and Care Excellence (NICE). (2019). Metastatic breast cancer: assessment and management in adults. NICE guideline NG107. [3] American Society of Clinical Oncology (ASCO). (2021). ASCO Answers: Palliative Care for Patients with Advanced Cancer. [4] World Health Organization (WHO). (2018). Palliative care for adults in a resource-limited setting. WHO Guidelines. [5] National Cancer Institute (NCI). (2021). Palliative Care and Supportive Care for People with Cancer. [6] National Cancer Institute (NCI). (2021). Coping with Cancer: Support for People with Cancer. [7] Center to Advance Palliative Care (CAPC). (2021). What is Palliative Care?
- Palliative care, which focuses on symptom control and maintaining functional ability, plays a significant role in the treatment of metastatic breast cancer.
- Early integration of palliative care can enhance patients' coping abilities, improve their quality of life, and address physical symptoms such as pain, nausea, and treatment side effects.
- Palliative care teams provide holistic, coordinated care that includes psychosocial and emotional support, advanced care planning, and patient-centered decision-making.
- Discussing goals of care, patient wishes, and advanced directives ensures that care aligns with patient values and preferences, a crucial aspect of palliative care, especially in metastatic breast cancer.
