9 Factors to Consider When Deciding on a New Breast Cancer Treatment Plan

There are many reasons why you may be considering a switch when it comes to your breast cancer treatment plan. Your cancer may be spreading too fast or your treatment isn’t as effective as you’d hoped. Maybe your current treatment side effects are becoming too difficult to manage. Or maybe you’re more interested in learning more about palliative care. Talking to your oncologist about all your options and their pros and cons can give you more clarity. Here are some factors to consider when thinking about a switch. 

Breast cancer has five stages, from 0 to IV. Your cancer’s stage depends on tumor size. It also depends on whether your breast cancer has spread to your lymph nodes. If your breast cancer is locally advanced, that means it has progressed without spreading from your breast or nearby lymph nodes into other parts of your body. Your cancer stage can help your doctor figure out how likely it is your cancer will grow and spread, which helps when picking a new treatment plan.

Your breast cancer’s type and other features will affect your treatment options. For example, when your cancer is hormone receptor-positive (HR+), that means it carries protein receptors that respond to estrogen and progesterone hormones. Treatment for hormone-positive breast cancer will likely include hormone therapy drugs. These drugs help keep it from growing by lowering your hormone levels. Your treatment options also will depend on whether your breast cancer has any other specific changes for which targeted treatments may help.

Your doctor may recommend genetic testing to look for changes, or mutations, that affect the way the cancer grows and how treatments work. If cancer runs in your family, you may also have genetic testing to see if you carry a mutation that puts you at higher cancer risk. Certain changes, including the BRCA gene, may also affect your treatment options and your treatment plan, including whether you need to consider your risk for other cancers.

Researchers are still studying how age can affect breast cancer diagnosis and treatment. Some studies have linked age to differences in breast cancer and treatment outcomes. Before age 40, breast cancer may be more likely to have features that make it grow aggressively. As a result, your treatment may be more likely to include:

• Mastectomy
• Radiation
• Chemotherapy

When you’re much older, breast cancer may grow more slowly. Depending on your health and treatment goals, your doctor may not recommend surgery or chemotherapy. Your new treatment plan should take your age and wishes into account.

Most women in the U.S. go through menopause between ages 45 and 55, and the average age of someone diagnosed with breast cancer is 62. While many get their breast cancer diagnosis after menopause, there are special considerations when you have get diagnosed before menopause. Hormone therapy or chemo can lead to early or temporary menopause. They can also trigger side effects such as hot flashes. If you want to have children in the future, ask about how a new treatment plan will affect your fertility. 

Your general health may impact your decision to consider a new treatment plan. You’ll need to think about any potential side effects and how well you may tolerate a new treatment. Some treatment options may not work for you if you have health problems, such as kidney or liver problems. Your overall health may play into your treatment expectations and goals. Don’t forget to consider how a new treatment plan will affect your quality of life and mental health.

Ask about the side effects that are most likely with a new treatment plan and how they compare to your current or past treatments. Chemotherapy, radiation, hormone therapy, and targeted therapy all come with side effects. These include:

• Hair loss
• Tiredness (fatigue)
• Feeling sick or throwing up
• Nail changes
• Pain and numbness
• Menopausal symptoms
• Rashes

Ask about medicines or other supports that can be added to your plan to help you with any side effects that come with your new cancer treatment.

Your treatment goals and prognosis can help you decide how aggressively you want to treat your cancer. More aggressive treatment may come with more side effects. Ask about how your new treatment plan will affect your risk that the cancer will spread or come back. Make sure your doctor understands your goals for symptom management and how any side effects of treatment will affect you and your ability to live your life to the fullest while undergoing treatment. 

Many people living with cancer — including early or locally advanced breast cancer — struggle with their finances. Ask how much a new treatment plan will cost and what your health insurance will cover. Ask your oncologist how likely it is you’ll be able to work through treatment or whether you’ll need special accommodations that may affect your income. Many places where you’d get cancer treatment also have a specific department to handle any financial concerns. Ask if there are any programs available to help you pay for your treatment or assist with your other everyday costs.