Understanding stage 4 cancer

Breast cancer is categorized by stages that describe the nature of the disease and the person’s outlook.

Stage 4, or metastatic, breast cancer means the cancer has spread — or metastasized — beyond its point of origin to other organs and tissues. For women who received a diagnosis between 2009 and 2015, the 5-year survival rate for stage 4 breast cancer is 27.4 percent.

There’s no current cure for stage 4 cancer. Still, it can be treated and managed.

Most people with stage 4 breast cancer live with alternating periods of stable disease and disease progression.

It isn’t clear why some people with stage 4 cancer live with disease that doesn’t further progress and others who have the disease don’t survive. For most, stage 4 cancer is likely to return, even if a person enters remission.

Remission is an encouraging word, but it doesn’t mean the cancer is cured. When cancer is in remission, it means the disease can’t be seen on imaging tests or other tests. There’s still a chance the disease is in the body, but it’s just at a level that’s too small to detect.

When a treatment destroys all cancer cells that could be measured or seen on a test, it’s called a pCR. This stands for pathological complete response or pathological complete remission.

A partial response or partial remission means the cancer partly responded to the treatment somewhat, but it wasn’t completely destroyed.

There’s still room for hope. Continued improvements in chemotherapy and other breast cancer treatments have led to improved survival rates for people with stage 4 cancer.

Advanced therapies are extending the time before the cancer becomes detectable again. There’s reason to believe that further improvements, especially in areas such as immunotherapy, will increase the number of people living with stage 4 cancer.

Recurrence means the disease has returned after it was undetectable for a period of time. It may return only in the same breast where the cancer was first diagnosed. This is called local recurrence.

Regional recurrence is when the cancer comes back in the lymph nodes near the spot where the tumor first developed.

Cancer can be an unpredictable, frustrating disease.

You may be treated for stage 4 breast cancer with targeted therapies, hormonal therapies, or immunotherapy. A comprehensive and exhaustive treatment plan may rid your breast tissue and surrounding lymph nodes of cancer.

However, cancer may spread to another organ, such as the liver, brain, or lung. If the cancer cells in other organs outside the breast are breast cancer cells, it means the cancer has metastasized. Even though cancer is growing in one of those organs, you’re still considered to have stage 4 breast cancer.

If the cancer cells in the liver are different from the breast cancer cells, it means you have two different types of cancer. A biopsy can help determine that.

A breast cancer recurrence can be scary and upsetting.

If you have a breast cancer recurrence and find yourself feeling overwhelmed and distressed, consider joining a support group. Most people find it helpful to talk openly about their fears and frustrations.

You may find inspiration and camaraderie in sharing and hearing other people’s stories. If you’re having depressive symptoms or troubling treatment side effects, it’s a good idea to talk to your doctor.

You may be eligible for a clinical trial that’s testing a new procedure or therapy. Clinical trials can’t promise success, but they may allow you to try a new treatment before it hits the market.

Dealing with stage 4 breast cancer is difficult, but remember that cancer treatments are improving every year.

People with stage 4 cancer are living longer than ever before. Be proactive with your health and follow your treatment plan. You’re the most important member of the treatment team, so don’t be afraid to ask all the questions you need to feel comfortable.