Stage 4 breast cancer, or advanced breast cancer, is a condition in which the cancer has metastasized. This means it has spread from the breast to one or more other areas of the body.

In other words, cancer cells have separated from the original tumor, traveled through the bloodstream, and are now growing elsewhere.

Common sites of breast cancer metastases include the:

The symptoms of stage 4 breast cancer can vary and often depend upon where the cancer has spread. However, it’s not uncommon for a person to experience symptoms like:

There’s no current cure for stage 4 breast cancer. But in many cases, options are available to enhance quality of life and extend life. Such options include palliative and hospice care.

Lots of misconceptions exist around these types of care. Here’s what you need to know to better understand these options.

Palliative care involves treating unpleasant symptoms of the cancer, both physical and emotional ones. Some examples of palliative care include:

The goal of palliative care is to help a person feel better rather than to cure or treat the cancer itself. It can be used alone or along with any standard cancer treatment options.

It can be a difficult decision, but the earlier hospice care begins, the more benefit a person receives. It’s important not to wait too late to begin hospice care if it’s needed.

When hospice workers have longer to get to know a person and their unique situation, the hospice worker can create a better individualized plan for care.

Hospice care helps ease a person’s transition from actively treating the cancer to focusing on staying as comfortable as possible and preparing for their death.

When no treatment options remain, it can be a great relief for a person to know that professional hospice workers will be there to make their remaining time more comfortable.

Hospice care is also a big help to family members, as they don’t have to handle the responsibility of end-of-life care for their loved one all alone. Knowing a loved one isn’t in pain can also help make this challenging time more bearable for family and friends.

Hospice is end-of-life care for people with a terminal diagnosis who either have no treatment options or choose not to prolong their lives with standard treatments.

This type of care involves medications and other treatments to manage symptoms, manage side effects, and keep a person as comfortable as possible during the last days of their life. Hospice care can be administered in the following settings:

  • one’s own home
  • a hospital
  • a nursing home
  • a hospice facility

Deciding between palliative or hospice care — and deciding whether to utilize these options at all — can be difficult. Here’s how to decide which is best for you or your loved one.

Questions to ask yourself

Consider these questions when determining the best care for your current situation:

Where am I on my cancer journey?

Palliative care is appropriate at any step of a metastatic breast cancer diagnosis.

Most people choose hospice care when their doctor has indicated that they have six months or less to live. The timing can help you determine which approach may be best.

Am I ready to stop some treatment?

Palliative care focuses on keeping a person comfortable. They may still receive treatments to shrink tumors or limit the growth of cancer cells.

However, hospice care usually involves stopping antitumor treatments. It focuses solely on comfort and finishing your life on your own terms.

It may take time to conclude that you’ve reached an end point in your treatment and life. If you’re not ready for that yet, palliative care may be the way to go.

Where do I wish to receive care?

While this isn’t always the case, palliative care programs are often offered at a hospital or short-term care facility, such as an extended-care facility. Hospice is typically offered in one’s home as much as possible.

Questions to ask your doctor

There are also questions you may want to ask your doctor that can help ease the decision-making process. Examples of these questions include:

  • In your experience, how long do you think I have left to live?
  • What services do you think could benefit me most at this point in my treatment?
  • What are some ways you’ve seen others benefit from palliative or hospice care that I may not be thinking about right now?

Discussing these questions with a doctor who’s advised others under similar circumstances can be very helpful.

Unlike hospice or palliative care, end-of-life care isn’t a particular type of service. Instead, it’s a shift in approach and mindset.

End-of-life care is appropriate when a person or their family knows end of life is nearing and time is limited. At this difficult time, there are actions a person may want to take to ensure their final wishes are known.

Here are some examples:

  • Seek out a religious or spiritual counselor to answer questions about death and dying.
  • Talk to family members about thoughts, feelings, and final wishes for them.
  • Speak with a lawyer about updating or writing a will as well as completing any advance directives.
  • Discuss treatments focused on managing symptoms and that could enhance your life, such as taking pain or nausea medications.
  • Speak with your doctor about what you can expect in the last few days of life, given your overall diagnosis. You may also want your doctor to speak with your family members to help them prepare.
  • Utilize at-home nursing staff who can provide care when you may be unable to do some things for yourself.

These are just some of the ways a person can make their wishes known and live their life most fully.

Both palliative and hospice care are important parts of caring for someone with stage 4 breast cancer. These types of care having nothing to do with giving up and everything to do with helping people feel comfortable and comforted while living the best life they possibly can.

The process of palliative or hospice care will usually begin with a referral from your oncologist. It may also come from a caseworker or social worker in your oncologist’s office.

These referrals are often needed for insurance purposes. Each individual palliative or hospital care organization will likely have their own requirements in terms of paperwork or information needed following this referral.

Communication in all aspects is so important when deciding on hospice or palliative care. This includes communication with your doctor, family, and loved ones so you can live out your life on your terms.

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