Advanced Breast Cancer
Monitoring Your Cancer
Ongoing testing will now become a very important part of your world. Your doctors will watch you closely to learn about any symptoms you have, detect new signs of cancer growth, check for treatment resistance (when cancer no longer responds to a certain treatment) and identify other changes in your health.
Keep Your Follow-up Appointments
This part of your treatment is a team effort. Your doctor will rely on you to be diligent about making and keeping your follow-up appointments. The earlier changes in your condition are identified, the faster they can be addressed. As a result, your treatment plan may change, and this may include a change in dosage, therapy or treatment type.
Before your visits. Stay organized to get the most out of your appointments. Keep a file of medical records related to your cancer, as well as a list of your drugs. Bring them to each appointment. Track any symptoms you are having and their severity at specific times of the day or week. Write down questions to ask your doctor. Find someone to go with you if possible. This person may take notes or record the conversation, which may help you remember what has been said.
Get your lab work and other tests done so the results are available to discuss with your doctor at your appointment. Lab and imaging tests will be done to see how well treatment is working, plan treatment and find if and where cancer has spread.
Blood tests will be performed to check for signs of disease and see how well your organs are working. This may include:
- A complete blood count
- A comprehensive metabolic panel, which measures many substances in your blood
- Liver function tests
Periodically, your doctor may order a biopsy to determine whether the biomarkers in the cancer have changed (mutated), which may alter future treatment options.
Some biomarkers your doctor may test include estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), cancer antigen 125 (CA-125), carcinoembryonic antigen (CEA), cancer antigen 15-3 (CA 15-3), cancer antigen 27. 29 (CA 27. 29) and circulating tumor cells, which are pieces of the tumor that break off and move throughout the bloodstream. Higher numbers indicate the cancer may be growing.
You may need more than one type of imaging test to monitor for and detect the cancer’s size and spread. Your doctor may use some or all of the following:
- A bone scan uses small amounts of radiation and a special camera to help spot areas of bone damage from treatment or from cancer that has spread.
- Computed tomography (CT) uses X-rays and a computer to take many images of a body part from different angles. Contrast material (a dye) may be used to make pictures clearer.
- Magnetic resonance imaging (MRI) combines a powerful magnet and radio waves to create pictures. You may receive contrast (dye) before the test.
- Positron emission tomography (PET) uses a tracer (radioactive drug) to see how and where cancer is growing. Sometimes doctors combine PET with CT.
- Ultrasound uses high-energy sound waves to create images. It is helpful for spotting small areas of cancer on or near the body’s surface.
- An X-ray uses low-dose radiation to take one picture at a time.
During your visits. Your doctor will perform a physical exam and ask how you are feeling, both emotionally and physically. Be sure to answer honestly, and don’t hesitate to ask questions.
Describe your symptoms and any changes in your health. Know that symptoms may be from treatment or from the cancer itself. And always be honest when providing this information.
Tell your doctor if:
- You have any new symptoms such as bone pain or trouble breathing after treatment.
- Side effects have not gone away or are not being managed to your satisfaction.
- You are having any trouble with your day-to-day activities.
In between visits. Ensure you have access to information you may need.
- Keep a record of phone numbers to call. You might need to get in touch with someone for routine care, change an appointment or see someone right away. Add these phone numbers to your file.
- Call your doctor’s office if you are really worried about something. Don’t wait until your next scheduled office visit.
How to Cope with Scanxiety
Most people feel anxious before scans or other tests and while waiting for results. Here are a few things that may help you cope:
- Learn how to recognize “scanxiety.” Pay attention to how it shows up in your body. For instance, you might breathe more quickly or feel tension in certain parts of your body.
- When this happens, use techniques to manage it. You might watch a funny movie, call a friend, go for a walk in nature or meditate.
- Find out when to expect results, how you will receive them, and who will deliver them to you. This may give you some sense of control.
- Have a friend or family member with you when you receive your test results.
- Above all, go easy on yourself! This is tough stuff, and it really is normal to have feelings like these.
