Physical Health

Talking to Your Doctor about Clinical Trials and Treatment Options

Cancer research is always changing. Currently, there is no cure for metastatic breast cancer (MBC), so staying up-to-date about new treatments and talking to your doctor about your options may help you identify appropriate treatment plans. Treatments do not work the same for everyone, so you and your doctor will discuss potential treatments that may work for you. During these conversations, you may talk about clinical trial results to help make your choice.

Understanding what clinical trial results mean – and how they may impact your care – can be difficult. The first step in talking to your doctors about clinical trial results is to understand the words he or she may use – this information may help.

Understanding Clinical Trial Results

When talking about clinical trials results, your treatment team and oncologist may use technical terms, such as “overall survival” (OS) or “progression-free survival” (PFS). Watch this video or read below to learn more about what these terms mean.

Hear from MBC Physicians

Dr. Fatima Cardoso and Dr. Ana Casas are oncologists who treat people living with MBC. They spoke about the endpoints used in clinical trials, and the difference between “overall survival” and “progression-free survival” – including what it may mean for you.

Know the Different Types of Treatment

  • Hormonal Therapy

    There are different types of MBC. In some types, the hormones estrogen or progesterone can promote the growth and spread of the tumor. Your doctor may refer to this as hormone receptor-positive (HR+) breast cancer.

    Hormonal treatment, also called endocrine therapy, blocks estrogen and stops it from driving cancer progression. This kind of treatment is a primary treatment for HR+ advanced breast cancer. For many, it helps control the cancer and prevents it from getting worse for a period of time.

    If you have HR+ MBC, there may be other drugs that can be added to your hormonal therapy. These drugs work to block certain protein cells. Blocking these cells helps stop cancer cells from growing and/or dividing to make new cells, which may slow cancer growth and progression. Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

  • Targeted Therapy

    Targeted therapies are treatments designed to identify and attack (or "target") specific characteristics of cancer cells. Such therapies focus on certain molecules that are known to be involved in tumor growth and spread; some of these molecules are also present in normal, healthy cells. Your doctor may refer to these types of therapies as "molecular-targeted drugs," "molecularly targeted therapies" or “immune targeted therapies.” These treatments may also affect healthy, non-tumor cells.

    Targeted therapies may be given alone (monotherapy), depending on the tumor characteristics; or in combination with either hormonal treatment or chemotherapy (combination therapy). Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

  • Combination Therapy and CDK4/6 inhibitors

    CDK stands for cyclin-dependent kinases, which are a family of proteins found in all cells in the body. CDKs are important in controlling the normal life cycle of cells as they grow and divide into new cells. CDK4/6 inhibitors work by interfering with the kinases and preventing cells from multiplying, especially in tumor tissue, where these cells are replicating very rapidly.

    CDK4/6 inhibitors work in combination with hormonal therapy to slow cancer progression by reducing cancer growth. Other pathways continue to be topics of research, which may lead to additional combination therapies in the future.

    Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

  • Biological Therapy

    Biological therapies use the body's immune system to fight cancer or to lower the side effects that may be caused by some cancer treatments. Biological response modifiers (BRM) change the interaction between the body's immune defenses and cancer cells to boost, direct, or restore the body's own ability to fight the disease.

    Biological therapies include interferons, interleukins, colony-stimulating factors, monoclonal antibodies, vaccines, gene therapy, and nonspecific immunomodulating agents. A nonspecific immunomodulating agent is a substance that stimulates the immune system in a general way and boosts the body's ability to fight cancer, infection, or other diseases.

    Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

  • Chemotherapy

    Chemotherapy is the use of drugs to kill cancer cells. Some ways that chemotherapy may be given are by mouth (orally) or infused into a vein (intravenously). It is usually given in cycles. A cycle includes treatment days that are followed by periods of rest. Treatment generally does not require a hospital stay; it is often given in an outpatient or clinical setting.

    In advanced or metastatic HR+ breast cancer, chemotherapy is usually given to people with HR+ disease who have become resistant to hormonal treatment (hormonal treatment stops working). People with life-threatening metastases may also receive chemotherapy. Chemotherapy may also be prescribed as neoadjuvant (before surgery to remove a tumor) or adjuvant (after surgery to remove a tumor) therapy.

    Read through the information below to get a better understanding of chemotherapy, including treatment, side effects, support, and questions you may want to ask your doctor.

    Additional Information

  • Immunotherapy

    Immunotherapy is a type of biological therapy. Immunotherapy uses the body's own immune system to fight cancer. It works by either stimulating your immune system to attack cancer cells or giving your immune system what it needs, such as antibodies, to fight cancer. Immunotherapy may be used alone or with other treatments, such as radiation, chemotherapy, or targeted therapy.

    Talk to your doctor about whether immunotherapy is a treatment you should consider.

    Additional Information

  • Radiation

    Radiation therapy, also called radiotherapy, uses high-energy rays to kill cancer cells. Radiation for advanced or MBC is largely done to reduce pain from bone metastases, which may relieve symptoms and may reduce specific spots where the cancer has spread.

    Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

  • Surgery

    Surgery is often the first line of attack against early-stage breast cancer. Most people with early-stage breast cancer will have surgery to remove their tumor. The two most common kinds of surgery for breast cancer patients are a mastectomy and lumpectomy. However, surgery for people living with advanced or MBC is not always part of their treatment plan. You should consult your doctor to determine the appropriate treatment approach for your individual situation.

    Additional Information

  • Clinical Trials

    Research is ongoing and new treatments are constantly being developed and studied. If you have been diagnosed with advanced or MBC, you can talk to your doctor about the possibility of joining a clinical trial. Your doctor should be able to tell you which clinical trials you might qualify for and those that are available in your area.

    Additional Information

  • Complementary & Alternative Medicine

    Complementary and alternative medicine (CAM), as defined by the National Center for Complementary and Alternative Medicine (NCCAM), is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine can be used together with conventional medicine. Alternative medicine can be used in place of conventional medicine. Other terms for conventional medicine include allopathy, Western, mainstream, orthodox, regular medicine, and biomedicine.

    Talk to your doctor about the different treatment options and which ones may be appropriate for you.

    Additional Information

Some women with MBC wish they had more time to talk to their health care providers about their needs.

In 2014, we commissioned the Make Your Dialogue Count survey to better understand how we can help you work with your health care team and loved ones to improve talks with your health care provider.

The focus of your visits with your health care provider may change over time—from your diagnosis, to treatment switches or to managing treatment side effects. No matter what the focus, it is important to be honest and to speak up about your needs.

We used results from the 2014 Make Your Dialogue Count survey to create a personalized discussion guide to help you make the most of your time with your health care providers (eg physician, oncologist, nurse, psychologist).

This information can help you prepare for your health care provider visits. We encourage you to come back and get a new discussion guide when you feel your emotions, concerns or priorities change.

Click here for more on clinical trials and treatment options.
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To create your personal discussion guide:
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    Click the "Take it Now" button below to start the questionnaire

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    Answer the 6 brief questions that follow

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About the survey

This survey was conducted by Harris Poll on behalf of Novartis between June 19 and August 22, 2014. A total of 359 surveys were collected among women age 21+ diagnosed with advanced breast cancer (that is, breast cancer that has spread to distant parts of the body) in addition to 234 caregivers to women with advanced breast cancer and 252 licensed oncologists who treat at least five advanced breast cancer patients per month within the United States. Please note that some questions were only asked of patients who have received treatment for their advanced breast cancer (n=347). Similarly, for caregivers, some questions were only asked of caregivers whose loved one has received advanced breast cancer treatment (n=230). Patient and caregiver interviews were collected via a variety of methods including online, phone, and paper methodologies. Patient and caregiver data were not weighted and therefore representative only of the individuals interviewed. All oncologist interviews were conducted online. Oncologist data were weighted by sex, years in practice and region where necessary to reflect the population of licensed oncologists practicing within the United States. No estimates of error can be computed.

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