The diagnosis of metastatic TNBC is frightening for women and the people who love them. These cancers can be treated. There are increasing numbers of therapies that are helping women with metastatic TNBC and hundreds of clinical trials testing new approaches. At this time, if the cancer has spread to distant organs, it is not usually considered curable. The goal of treatment becomes to control the cancer and its symptoms.
A difficult diagnosis
Treating metastatic TNBC
Once TNBC has spread, the primary treatment remains chemotherapy. The FDA has approved a number of drugs to treat metastatic TNBC. Many patients receive a single drug for as long they respond and then move onto to second and third lines of therapy, often using one drug at a time as well. This is called sequential single drug therapy. In other cases, drugs are combined with each other. Your doctor will discuss the options and make the decision about your treatment based on your cancer, your previous treatment and your individual goals and preferences.
About one-third of patients with metastatic TNBC will have an initial response to chemotherapy. Their tumors will either shrink or stop growing. The problem is that the cancer often becomes resistant--meaning that the cancer cells stop responding to the therapy. With each new drug, the chances of responding go down and the response time becomes shorter as the ability of the cancer cells to resist the treatment goes up. That’s why it is so important to find effective new approaches to treating metastatic TNBC.
The reality is that there is an urgent need for new and better therapies for metastatic TNBC. Those therapies are developed in research studies, known as clinical trials, that compare existing treatments to new approaches. These trials are designed to determine if the new treatments are safe and effective for patients. Women who have been diagnosed with metastatic TNBC should discuss the possibility of participating in a clinical trial with their physician. Patients who participate in trials have access to the newest therapies, receive excellent care and make a real contribution to the future of treating metastatic TNBC.
With the emergence of studies using new agents and combinations of drugs, it is often advisable to think about a trial before you begin first line therapy for metastatic TNBC. Patients who have undergone multiple courses of therapy are often still eligible for trials but these patients may have more symptoms and medical problems and decreased chances of benefiting from the trial. Any doctor treating metastatic TNBC should either be participating in clinical trials or be aware of ongoing trials and be willing to refer patients to these studies.
Palliative and Supportive Care
Living with advanced TNBC is often difficult, emotionally and physically. It’s important to identify and make use of the support that is available, whether it be family, friends, therapists, support groups, financial counselors, social workers or members of the community. Let people know your concerns and what you need from someone, whether it is to watch the kids, provide a ride to your appointment, be another set of ears or a friend who can listen.
It’s also important to know what services are available to help deal with any physical symptoms that you have. Request a referral to Palliative Care as soon as you get your diagnosis. Palliative Care is there to help with the full range of emotional and physical issues you may encounter throughout the course of your illness.
If you are experiencing financial problems, either related to your treatment or to your life, let your health care team know. There are resources that can help with those issues as well.