In Germany, metastatic breast cancer can be treated in certified breast cancer centers (Brustkrebszentren) or tumor centers as well as practices that are specialized in oncology. There, specialists from different disciplines work together to treat the various effects that both the disease and the treatment have on your body and mind. Metastatic breast cancer can also be treated in hospitals or practices without this certification.
If breast cancer has spread to other parts of the body, the entire body is usually treated with medication (systemic therapy) to limit tumor growth. Either hormone treatment or chemotherapy can be used for this purpose. Certain types of breast cancer can also be treated with targeted therapies, for example antibody therapy.
Usually, different treatments are used one after the other or combined with each other. If tumor cells stop responding to a certain drug after a while, another drug or treatment approach can be used. This step-by-step approach is known as sequential therapy.
Depending on where they are growing, some metastatic tumors can be treated individually – they can be targeted with radiation, for instance, or perhaps removed surgically.
Because the type of breast cancer and the way it progresses varies so much from woman to woman, there is no such thing as “the” best treatment. It is important to find suitable, individually tailored treatments for each phase of the disease and to coordinate the different treatments in the best possible way. That requires close cooperation between the doctors and within the treatment team.
Questions often arise in these situations – about the various treatments options, the expected symptoms or participation in clinical studies, for instance. It can help to write these questions down before going to an appointment or have someone you trust come with you to speak with the doctor so that you don't forget anything.
There is usually no immediate time pressure when deciding whether or not to have (further) treatment because starting treatment a bit later hardly influences the outcome of treatment. So you can take your time to consider the pros and cons of the suggested options and think them over for a few days or weeks. If necessary, you can get additional information or a second opinion too. You also always have the right to refuse having a treatment or to stop it – no matter whether it has been offered or started at a doctor‘s practice, in a hospital, or as part of a study.
Some people set their hopes on alternative approaches if conventional medicine can't guarantee a cure or significant improvement (anymore). But constantly trying out new therapies can lead to repeated disappointments. You should be particularly careful when it comes to remedies or methods that are meant to be used instead of medical treatment rather than alongside it, that promise to cure the cancer and/or that are very expensive and that you have to pay for yourself. People making these kinds of promises may turn out to be charlatans.