Stage 4 breast cancer is regarded as the crucial stage of cancer, where the cancer cells have spread to the bones, beyond the lymph nodes and the breast. Hence, the options for the treatment for stage 4 breast cancer are more aggressive than the options for treatment for stage 1 breast cancer, treatment for stage 2 breast cancer and treatment for stage 3 breast cancer.

The treatment regimen generally consists of a combination of chemotherapy, hormone therapy and targeted therapy. As the patient experiences bone pain and discomfort in this stage, radiation therapy may be given to the patient to relive them from this pain. If the cancer cells have spread to the bones then bisphosphonates are also given along with other treatment options to such patients. Below, we discuss in detail, about the different methods of treatment for stage 4 breast cancer.

Targeted Therapy for Stage 4 Breast Cancer

Targeted therapy for the treatment for cancer is given when the cancer is found to be HER-2 positive. In this method, trastuzumab or lapatinib, a targeted monoclonal antibody, is given in combination with chemotherapy agents, to kill or shrink the cancer cells. For patients with stage 4 breast cancer, an additional targeted therapy, bevacizumab, can also be given to kill the tumor cells. Bevacizumab blocks the function of the blood vessels that supply blood to the cancer cells, thus helping them grow. When the functioning of these blood vessels is blocked, the cancer cells do not receive blood and hence die eventually.

Hormone Treatment for Stage 4 Breast Cancer

If the cancer cells are found to be progesterone or estrogen receptor positive, then hormonal treatment for breast cancer is prescribed as a method of treatment for breast cancer. In this method, tamoxifen or aromatase inhibitors will be given in combination with target therapy or chemotherapy. This method of treatment is started immediately after the diagnosis.

Chemotherapy Treatment for Stage 4 Breast Cancer

Chemotherapy treatment for breast cancer in stage 4 is mostly given in combinations of different drugs, injected intravenously or given in the form of pills. Some of the chemotherapy combinations used to cure cancer in stage 4 are - AC {Doxorubicin and Cyclophosphamide}, CEF (FEC) {Cyclophosphamide, epirubicin, and 5-fluorouracil}, A – CMF {Doxorubicin followed by cyclophosphamide, methotrexate and 5-fluorouracil}, AC – T {Doxorubicin and cyclophosphamide followed by paclitaxel or docetaxel}, CMF {Cyclophosphamide, methotrexate and 5-fluorouracil}, EC {Epirubicin and cyclophosphamide}, CAF (FAC) {Cyclophosphamide, doxorubicin, and 5-fluorouracil}, TCH {Docetaxel, carboplatin, and trastuzumab}, TAC {Docetaxel, doxorubicin, and cyclophosphamide} and TC {Docetaxel and cyclophosphamide}. Besides these chemotherapy combinations, some other agents like ixabepilone, albumin-bound paclitaxel, vinorelbine, pegylated liposomal doxorubicin, capecitabine, gemcitibine, mitoxantrone and cisplatin are also used to treat stage 4 breast cancer.

Bisphosphonates for Stage 4 Breast Cancer

Bisphosphonates is given to strengthen the affected bones, as the cancer cells spread to the bones in stage 4. These are usually given along with vitamin D and calcium supplements. Some commonly given bisphosphonates are zoledronic acid and pamidronate.

Other Options of Treatment for Stage 4 Breast Cancer

Surgery and / or radiation therapy for the treatment of breast cancer are used mostly to cure cancer in the earlier stages. But in stage 4, these methods help to relieve the bone pain and discomfort caused due to bone pain. Surgery is also sometimes used to remove the cancer cells spread to a specific area of the body. Recommending this type of treatment depends on the biopsy and other reports of the patient.

Sadly, cancer in stage 4 is painful and the treatment options in this stage are also aggressive. Hence, the treatment for stage 4 breast cancer is effective if it is diagnosed in its early stages.

Note: The medications, drugs and therapy combinations given above should be taken under a proper supervision of a cancer specialist.