Metastatic Cancer: Your Treatment Options

When cancer spreads beyond its primary site, to distant parts of your body, such as your lungs, liver or bones, some questions are probably top of mind. Things like, What's going to happen to me? Will I see my children grow up? Am I going to be in pain? You may even wonder if anything can be done for you. Happily, the answer is a resounding YES!

Treatments have come a long way and are getting better every day. Treatment for metastatic cancer has two important objectives: (1) to shrink or reduce the amount of cancer and control its growth in order to prolong survival, and (2) to give you the best quality of life possible.

To accomplish these, your doctor has a range of options, including therapies that can shrink tumors and slow the progression of cancer, medication that eases pain and procedures that work on healing the places where tumors have spread.

Along the way, it can help to remember this: Your doctors, nurses, counselors and, of course, your loved ones are with you on this journey. And in this Internet age, there is the gift of being able to connect with people online who have experience with the therapies you are contemplating and who can offer suggestions for making life more comfortable right now.

How is metastatic cancer treated? The treatments you and your healthcare team decide upon depend on several factors—your age and general health, the type of cancer you have, where the cancer has spread and how extensively it has spread. Your doctor also considers your response to previous treatments, if you've had them.

Systemic therapies
Systemic therapies treat cancer throughout the entire body at once. They include:

Hormone therapy, which may be used if your cancer has hormone receptors on it. Hormone therapy is often used in patients whose cancer has spread to the bone or soft tissue. For breast cancer, hormone therapies include antiestrogen medications that stop cancer cells from getting estrogen, aromatase inhibitors that stop or inhibit estrogen from being produced and ovarian suppression treatments that stop the ovaries from producing estrogen. For prostate cancer, androgen deprivation therapy may be used to stop or lessen the production of androgens or block the ability of the body to use androgens.

Chemotherapy (chemo), which may be used if hormonal therapies are not appropriate for you or if they've been used and no longer control your cancer. Chemo medication, administered by mouth or into a vein, can kill cancer cells, slow cancer's growth and control your symptoms, but also can harm or kill normal cells along with cancer cells.

Immunotherapy, which uses agents that work with the body's immune system to fight cancer. Immunotherapy stimulates your immune system to attack cancer cells or mark them so they're more easily found and destroyed. Treatments are in the form of pills, injections or infusion.

Biologic or targeted therapy, which may be used if your cancer has an excess of a special receptor on its surface that can easily be targeted. Targeted therapy uses medication to block the signals or proteins that cancer cells need in order to grow, while sparing healthy cells.

Local therapies
Local therapies (which target a specific body area) to treat cancer include:

Radiation therapy, which uses high-energy rays to target tumors, treat bone pain and spinal compression, and relieve pain and swelling.

Surgery, which may be used to remove a tumor, relieve pressure on tissues, or treat or prevent a bone fracture or spinal compression, or potential fracture or compression.

Your doctor may recommend either a single therapy or a combination of therapies. Over time, it's possible that you will use a series of different treatments—each selected to shrink tumors, cause cancer regression and address your symptoms.

How will I feel? It's not easy to predict how your cancer or your treatment will affect you. But it's vital to tell your healthcare team about all of your symptoms—especially pain. Therapies are available that can ease the symptoms of metastases throughout your body and make life more comfortable.

How will I know the treatment is working? Scans and blood tests can help your doctors assess how you are responding to treatment. Your doctors will also consider the history you report and may physically examine you to determine whether your treatment needs adjustment.