Fig. 5. ALDH1A1 interacted with β-catenin. Co-localization of ALDH1A1...
Stage IV Breast Cancer Treatment Options
With stage IV, the breast cancer has spread to other parts of your body. Often the bones, brain, lungs, or liver are affected. Because multiple areas may be involved, focused treatments like surgery or radiation alone may not be enough.
Treatment of stage IV doesn't cure the disease. But by shrinking the cancer, it can often slow it down, help you feel better, and let you live longer. Patients with stage IV breast cancer may live for years, but it's usually life-threatening at some point.
Chemotherapy is often the main treatment for this stage. It can slow down the growth of the cancer. It's often used in combination with hormone therapy.
You can get chemo several different ways. You may take pills or liquids, but often the drugs are put right into your veins. Depending on the type of treatment, it may be given in cycles that allow your body breaks in between.
Hormone therapy can be helpful for women with hormone receptor-positive cancers. That means certain hormones stimulate growth of the cancer. In these women, medications can prevent the tumor from getting the hormone. These drugs include tamoxifen for all women and aromatase inhibitors such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) for postmenopausal women.
Fulvestrant (Faslodex), elacestrant (Orserdu) and toremifene (Fareston) are drugs that block hormone receptors. These medicines are sometimes given to women with metastatic breast cancer. Women who haven't reached menopause may consider having their ovaries removed to stop them from making hormones that help cancer grow.
Targeted therapy is a newer treatment. About 20% of women with breast cancer have too much of a protein known as HER2, and it makes the cancer spread quickly. Women with HER2-positive cancer that has spread often take trastuzumab (Herceptin). It stops the protein from making the cancer cells grow. Other targeted therapies for HER2-positive positive cancer that may be prescribed include ado-trastuzumab emtansine (Kadcyla), fam-trastuzumab deruxtecan-nxki (Enhertu), lapatinib (Tykerb), margetuximab (Margenza), neratinib (Nerlynx), pertuzumab (Perjeta), or tucatinib (Tukysa),
Abemaciclib (Verzenio), palbociclib (Ibrance), ribociclib (Kisqali) are targeted therapies that block certain proteins called CDKs and slow cancer growth. They are given in certain women who have hormone receptor-positive and HER2-negative cancers.
A new Class of drugs called PARP inhibitors has been found to help women who are HER2-negative but who have BRCA mutated breast cancer. PARP inhibitors include olaparib (Lynparza) and talazoparib (Talzenna) and target a protein that helps cancer cells grow.
Other types of targeted therapies include:
Immunotherapy drugs stimulate your immune system to find and destroy cancer cells. In women with advanced hormone receptor-negative and HER2-negative breast cancer the immunotherapy drug atezolizumab (Tecentriq) is sometimes given in combination with the chemotherapy paclitaxel (Abraxane). Atezolizumab blocks a protein called PD-L1.
Surgery and radiation are used in some cases. These treatments may help treat pain and other symptoms in areas where the cancer has spread.
Other drugs may help treat some of the side effects of breast cancer treatment, such as nausea and fatigue.
Clinical trials are open to many women with stage IV breast cancer. A clinical trial may give you access to cutting-edge treatments. Talk to your doctor to find out more about them.
Need help navigating metastatic breast cancer? Sign up for our free Advanced Breast Cancer Newsletter.
Doctors Kept Telling Mum She Had Constipation - Months Later She Was Dead
Toni Rankin's pancreatic cancer was repeatedly mistaken for constipation (Image: manchester evening news)
The heartbroken family of a mum whose pancreatic cancer was repeatedly mistaken for constipation are now urging other people to get checked out if they think there is something wrong with their body.
Toni Rankin first started experiencing pain in her abdomen in September 2024 and her symptoms meant she was unable to ride her bike or go out on walks in the countryside. The concerned mum-of-four, from Bollington in Cheshire, decided to visit her doctor, who told her not to worry as the pain was likely caused by constipation.
However, since the pain didn't go away, Toni continue visiting her GP - only to be given the same diagnosis. Since she trusted the advice she was given, Toni continued her life as normal until her pain became too severe.
Toni left behind four children (Image:
manchester evening news) The young mum started experiencing symptoms in September 2024 (Image:
manchester evening news)She was eventually given a pelvic scan which showed markers on her liver, prompting medics to investigate further. The mum was referred for an MRI scan just days before Christmas which confirmed her worst fears – she had stage 4 pancreatic cancer. Now, speaking on behalf of Toni's devastated family, her lifelong friend Clare Reoch has revealed the moment she discovered she was unwell. She told the Manchester Evening News: "It was shocking because she didn't really say much to me. She told me she was poorly, but I didn't know the severity of it.
"I moved away in November to Scotland, but we had made plans for the summer for her to come up here. It was shocking." Pancreatic cancer is often diagnosed late because symptoms can be vague or mistaken for other conditions. Symptoms include persistent abdominal or back pain, unexplained weight loss, jaundice (yellowing of the skin and eyes), loss of appetite, fatigue, nausea or vomiting and changes to bowel habits.
Sadly, during her diagnosis, Toni learned the cancer had spread to her liver. Later appointments showed it had also spread to a lymph node in her neck. As Toni's condition worsened, she was taken to the hospital with jaundice and underwent a procedure to remove a blockage from her bile duct, a tiny canal that connects some of the organs in the digestive system, but sadly this didn't ease her pain.
Due to her poor health, Toni only managed to have one round of chemotherapy. The mum stopped eating and kept vomiting, and she was rushed to hospital on the evening of February 9. Sadly, not long after she arrived, doctors called Toni's family and told them to say their goodbyes.
She passed away at the age of 45 in the early hours of February 10. Clare said: "They said it was constipation. This is why her family want to raise awareness and for people to get checked out if they think there's something wrong with their body. Chemo was the only thing offered. From the process of organising chemo, she was supposed to have it – they just didn't realise how fast she would decline. She barely got the chance to start chemo. There was no cure. We all made plans for summer for her to do things and see people.
"She declined rapidly and her pain was unbearable. She wasn't able to eat and was being sick constantly until her daughter called for an ambulance. She wasn't able to take medication. At 10pm on February 9, doctors phoned the family to say she had declined rapidly and it was time to come in and say goodbye.
"She passed away on the February 10 at 1.15am. Only a few hours later, she had gone. It happened so fast. There was nothing anyone could do to stop it." Mum-of-six Clare, who works as a carer, described Toni as "the most amazing friend ever" and said she "lit up a room" with her "contagious" laugh.
Clare added: "We were really good friends in college, then came apart for a decade. Then, through Facebook, we got back in contact. It was like we had never been apart. It was like it was always the same. She was funny and she loved going to the gym regularly. It was one of her hobbies. She loved to go and work out.
"She just loved to go out for walks. She loved living in the countryside. Toni lived and breathed for her children from the second she became a mum, and that was her life. She had a grandson, who she doted on as well. She was thrilled when he came along. She leaves him behind as well.
"She had so many amazing friends that will miss her dearly. Everyone is doing whatever they can to help at such a difficult time." A fundraiser has now been created to help support Toni's family. You can donate here.
This 'poop Pill' Could Be A Breakthrough For Cancer That Only Has A 10% Survival Rate
They're taking the plunge.
A small number of Canadian cancer patients are testing a pill that contains healthy bacteria from human poop to see if it can extend their lives.
"Pancreatic cancer has a poor survival rate of approximately 10% over five years," medical oncologist Dr. John Lenehan said. "Through this study, we aim to offer a new, innovative treatment to patients."
Saman Maleki, a scientist at the London Health Sciences Centre Research Institute, uses a microscope to investigate the interaction between tumor cells and immune cells. LHSCRICancerous tumors are believed to have a collection of bacteria, viruses and fungi that help the disease defend itself from treatments like chemotherapy.
Fecal transplants, which are usually done by colonoscopy, help restore healthy gut bacteria.
This is a 3D illustration of pancreatic cancer. About 67,400 Americans will be diagnosed with pancreatic cancer this year and nearly 52,000 will die from the disease, the American Cancer Society projected. Sebastian Kaulitzki – stock.Adobe.ComEarly studies suggest that fecal transplants delivered via an oral capsule known as LND101 could alter the microbial composition of tumors and make the body better able to fight advanced pancreatic cancer.
Lenehan's team is launching a two-year Phase 1 clinical trial involving 20 patients at the Verspeeten Family Cancer Centre at London Health Sciences Centre.
Scat from healthy donors is processed in the lab to generate tasteless, odorless pills. The hope is to enhance the patients' healthy microorganisms to boost their immune response and potentially make chemotherapy more effective.
"We will study how the gut bacteria of pancreatic cancer patients change after treatment with fecal transplants using the capsules and how this affects their immune system," said Saman Maleki, a scientist at the London Health Sciences Centre Research Institute (LHSCRI).
"Our goal is to determine whether a successful shift in the gut microbiome is connected to a better response to chemotherapy."
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"Poop pills" are not new. The US Food and Drug Administration (FDA) approved Vowst, the first pill form of fecal transplant therapy, in 2023.
LND101 pills have already shown promise in advanced melanoma, lung cancer and renal cell carcinoma, the LHSCRI researchers said, and they hope to achieve similar success with late-stage pancreatic cancer.
Dr. Michael Silverman of the Lawson Research Institute holds a bottle of LND101 pills and discusses research with Liesl De Silva from Lawson. LHSCRIPancreatic cancer is often discovered in advanced stages because it doesn't usually cause symptoms until it has spread to organs beyond the pancreas, limiting treatment approaches.
About 67,400 Americans will be diagnosed with pancreatic cancer this year and nearly 52,000 will die from the disease, the American Cancer Society projected.
The LHSCRI team is seeking poop donors. If you're interested, email Liesl De Silva at Liesl.DeSilva@sjhc.London.On.Ca or call (519) 646-6100, ext. 65739.
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