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No matter where you are on your journey with metastatic breast cancer — whether you are newly diagnosed, facing a recurrence of the disease or assessing your current treatment plan — making decisions around treatment can often leave you feeling overwhelmed and confused. Although you may feel surrounded by uncertainty, one of the best ways to feel confident in your treatment decision is by having an open and honest conversation with your doctor and healthcare team. We talked to Virginia Kaklamani, MD, DSc, Associate Director Clinical Research, and leader of the breast oncology program for UT Health San Antonio MD Anderson Cancer Center, to share some guidance in approaching the treatment conversation with your doctor.
Think About Your Priorities
A big part of deciding on the right treatment plan for you is knowing what your priorities for living are — managing side effects, or extending life. According to a survey conducted in 2011 in Europe of 230 women with locally advanced or metastatic breast cancer or their adult caregivers published in the British Journal of Cancer, 64 percent of those living with local or metastatic breast cancer judged a treatment was worthwhile if it prolonged survival, despite potential side effects. Furthermore, 67 percent said life-extending treatment is important in order to spend more time with family and friends.
“As doctors, once we’ve discussed realistic treatment goals for metastatic breast cancer and available treatment options based on the line of therapy, we want to know what matters most to you so that we can figure out a treatment plan,” says Dr. Kaklamani. Here are some questions Dr. Kaklamani recommends thinking about to help determine what matters most to you:
- What do you want your treatment to help you achieve?
- How do you want to spend the time you have?
- How aggressive do you want to be with treatment?
- How do you weigh the benefit versus the risk of treatment?
Start by taking the time to figure out what’s most important to you, set goals and write them down to bring to your next doctor’s appointment.
Do Your Research
The more you know and plan, the more comfortable you will be talking to your doctor. Become educated about metastatic breast cancer and treatment options, but try not to overwhelm yourself with statistics. Remember, each person will have a different treatment approach, and what may have worked for one person may work differently for you.
Part of the planning process is gathering information about yourself. No one knows more about you and your body than you do, and this is information that your doctor and healthcare team can use when considering treatment options. Keep track of any changes in your body, and any issues you may experience, no matter how seemingly small they may be.
“I always appreciate when my patients come prepared with information about themselves and voice any questions and concerns they have with me,” says Dr. Kaklamani. “It is all critical as we assess the risks and benefits of each treatment choice to find an option that would be suitable for each patient’s health status and treatment goals.”
Gather information about your health concerns, then research some treatment options and come prepared with questions to ask your doctor at your next visit.
Get Involved in Treatment Decision Making
Metastatic breast cancer can be treatable, and some patients continue to live for years after being diagnosed. Treatment decisions should be a joint effort between you and your doctor. Listen carefully to your doctor, but also make sure you’re being heard. Remember, this is your journey. You should feel empowered to voice how you are feeling, what is important to you, and what concerns or questions you may have. Talk about the risks and benefits of each option, which treatments you have had before, your health status, and your treatment goals. Then, together, develop a plan that you both feel good about.
“Every patient is different, so I choose to take a personalized approach and actively involve my patients in making treatment decisions,” states Dr. Kaklamani. “Sharing the decision making ensures that we meet our patients’ goals. It’s important to explore all treatment options with your doctor to find the option that may work best for you.”
One treatment option that Dr. Kaklamani discusses with many of her patients living with metastatic breast cancer and after having received two prior chemotherapies is HALAVEN® (eribulin mesylate). HALAVEN is a prescription medicine used to treat adults with breast cancer that has spread to other parts of the body, and who have already received other types of anticancer medicines after the cancer has spread.
In a clinical study of more than 750 women, HALAVEN was compared to other chemotherapies or hormone therapies commonly used to treat mBC. Although some women lived longer and some women did not live as long, women who were treated with HALAVEN lived on average 25 percent longer than those who received a different treatment (13.2 vs 10. 6 months respectively). HALAVEN was studied in women with all types of tumor receptors including ER+/-, PR+/-, HER2/neu +/- and Triple negative. Results for each individual patient will vary.
HALAVEN can cause side effects, including serious side effects that you should discuss with your doctor. For example, HALAVEN can cause low white blood cell counts (neutropenia), and numbness, tingling or pain in your hands or feet (peripheral neuropathy). This Important Safety Information is discussed in more detail below. Make sure you understand the potential benefits and risks before starting HALAVEN or any other treatment.
Doctors have prescribed HALAVEN to over 50,000 women in the US.
To learn more about HALAVEN, a treatment for adults with metastatic breast cancer who have already received other types of anticancer medicines after the cancer has spread, visit www.Halaven.com or check out the HALAVEN community on Facebook at www.facebook.com/halaven.
This story is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. Experiences with treatment may vary and change over time.
Who is HALAVEN (eribulin mesylate) Injection for?
HALAVEN is a prescription medicine used to treat adults with breast cancer that has spread to other parts of the body, and who have already received other types of anticancer medicines after the cancer has spread.
Important Safety Information for HALAVEN®
What safety information do I need to know about HALAVEN?
HALAVEN can cause serious side effects, including
- Low white blood cell count (neutropenia). This can lead to serious infections that could lead to death. Your health care provider will check your blood cell counts. Call your health care provider right away if you develop fever (temperature above 100.5°F), chills, cough, or burning or pain when you urinate, as any of these can be symptoms of infection
- Numbness, tingling, or pain in your hands or feet (peripheral neuropathy). Peripheral neuropathy is common with HALAVEN and sometimes can be severe. Tell your health care provider if you have new or worsening symptoms of peripheral neuropathy
- Your health care provider may delay or decrease your dose or stop treatment with HALAVEN if you have side effects
Before you receive HALAVEN, tell your health care provider about all of your medical conditions, including if you
- have liver or kidney problems
- have heart problems, including a problem called congenital long QT syndrome
- have low potassium or low magnesium in your blood
- are pregnant or plan to become pregnant. HALAVEN can harm your unborn baby. Tell your health care provider right away if you become pregnant or think you are pregnant during treatment with HALAVEN. Females who are able to become pregnant should use an effective form of birth control during treatment with HALAVEN and for at least 2 weeks after the final dose of HALAVEN and males should use an effective form of birth control when having sex with female partners who are able to become pregnant during treatment with HALAVEN and for 3½ months (14 weeks) after the final dose of HALAVEN
- are breastfeeding or plan to breastfeed. It is not known if HALAVEN passes into your breast milk. Do not breastfeed during treatment with HALAVEN and for 2 weeks after the final dose of HALAVEN
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of HALAVEN?
HALAVEN can cause changes in your heartbeat (called QT prolongation). This can cause irregular heartbeats. Your health care provider may do heart monitoring (electrocardiogram or ECG) or blood tests during your treatment with HALAVEN to check for heart problems.
The most common side effects of HALAVEN in adults with breast cancer include low white blood cell count (neutropenia), low red blood cell count (anemia), weakness or tiredness, hair loss (alopecia), nausea, and constipation.
Your health care provider will do blood tests before and during treatment while you are taking HALAVEN.
For more information about HALAVEN, please see full Prescribing Information.
