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If your cancer is Stage 4, it means that there is either a strong suspicion, or a biopsy proven spread of your cancer to other organs, such as the liver, lungs, bone, or brain. No matter what organ the cancer has spread to, the Stage is the same, Stage 4. Although we would love to have a treatment that could routinely cure this group of cancers, there is no known cure for Stage 4 cancer, no matter where the spread is seen.

In these cases, priority is given to treating the cancer in the organs where it has spread. Sometimes, even though there is still cancer in the breast, your doctors may not necessarily recommend removal of the cancer in the breast. If there is going to be cancer remaining in other parts of the body, then removing just the cancer in the breast will not have any definite impact on your overall survival. Removal of the cancer in the breast may be recommended if it would make it easier to manage, for instance, if it seems to be getting larger despite treatment, or if it is going to break through the skin. Treatment in such cases tends to be very individualized, so it is not easy to give a summary of what should be recommended.

Although there is no known cure for stage 4 breast cancer, the disease can often be controlled so that it either does not grow, or only grows slowly, with appropriate treatment. There are a number of clinical trials available for treating Stage 4 breast cancer, and we at DeKalb Surgical strongly recommend considering any trials that may be available to you. The oncologists we work with can discuss these options further with you. Dr. Kennedy has served on the board of GA CORE, a network of cancer specialists across Georgia, who are committed to making clinical trials available to all Georgia citizens. If you are interested in more information, you can follow this link to the GA CORE website.

Treatment of Stage 4 breast cancer includes primarily chemotherapy, hormone blocking therapy (only for hormone sensitive cancers, determined by testing for estrogen receptors [ER]) and radiation therapy for disease spread to the brain, or to the bones. Surgery is not commonly used for this group.

The choice of chemotherapy is dependent on a number of factors. We can now test your cancer to see in advance if it will be sensitive to certain types of chemotherapy, so it is critical to do these tests before deciding on which specific drugs to use. Whatever drugs are recommended, they are typically given in “cycles”. A “cycle” is typically a two or three week interval. Carefully calculated doses of the selected drugs are given at the beginning of the cycle, and you are monitored for side effects as the drugs work on the cancer. The drugs also affect normally dividing cells in your body, and this is the source of the potential side effects. The cells in the body that are dividing the most include blood cells in the bone marrow, hair cells, and the cells lining the digestive tract, from the mouth all the way through the rectum. Knowing this, it is no surprise that the side effects include anemia, and other changes in the blood, like lowered white blood cell count, hair loss, and nausea and vomiting. Fortunately, oncologists are good at preventing or at least managing these potential side effects in most cases. Prior to initiating the treatments, your oncologist will no doubt discuss the potential side effects with you, and any alternative regimens that might be used. The various chemotherapy drugs have different potential side effects, so you should discuss these issues with them prior to your starting your treatment.

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