Breast Cancer, Metastatic Or Recurrent: Medications

Content provided by Healthwise

Medications

Metastatic or recurrent breast cancer is treated with a variety of medicines, including chemotherapy and hormone therapy. The treatment regimen your doctor suggests for you depends on your symptoms, characteristics of your breast cancer, location, degree of spread, and prior treatment you have had.

Medication Choices

Medicines that may be used include:

• Hormone therapy with aromatase inhibitors, tamoxifen, antiestrogens (such as fulvestrant), or Megace.
• Chemotherapy. Usually a combination of medicines is used.
  • The most commonly used combinations are AC (which combines Adriamycin and Cytoxan) and CMF (which combines Cytoxan, methotrexate, and 5-FU).
  • Other medicines that may be used to treat advanced breast cancer include Taxol, Navelbine, Taxotere, gemcitabine, lapatinib (Tykerb), and capectabine.
• Biological therapy with Herceptin to block the protein HER-2.
• Corticosteroids, which may be used if metastatic disease involves the brain or spinal cord. They are also used with other medicines to treat nausea and vomiting caused by chemotherapy.
• Bisphosphonates, such as Zometa, Didronel, or Aredia, may be used to reduce bone pain, high calcium levels, fractures, and spinal cord compression cause by metastatic breast cancer that involves the bones.

Treatment can often cause nausea and vomiting. Your doctor will prescribe medicines to be taken with your treatments and when you get home to help relieve any nausea that you may have. Medicines to control and prevent nausea and vomiting may include:

• Serotonin antagonists, such as ondansetron (Zofran), granisetron (Kytril), or dolasetron (Anzemet). These medicines work by blocking the effects of a chemical (serotonin), which is produced in the brain and the stomach and controls vomiting. They are more effective when they are combined with corticosteroids, such as dexamethasone, which reduce swelling in the part of the brain that controls nausea.
• Aprepitant (Emend), which is used in combination with ondansetron and dexamethasone as part of a 3-day program.
• Phenothiazines, such as Compazine and Phenergan. These medicines stop nausea and vomiting by reducing the activity of the central nervous system.
• Metoclopramide (Reglan), which increases the movements or contractions of the stomach and intestines. This decreases the amount of time it takes for the stomach contents to move through the digestive tract.
• Dimenhydrinate (Dramamine), which is often used to treat motion sickness. It relieves nausea by blocking motion signals to the brain.

Clinical trials are ongoing to test new chemotherapy and hormone therapy and new combinations of medicines. If you have been diagnosed with metastatic or recurrent breast cancer, talk with your doctor about participation in a clinical trial.

What To Think About

Although chemotherapy and hormone therapy are not likely to cure metastatic breast cancer, they can reduce symptoms and increase your quality of life, and they may help you live longer.

Talk to your doctor about prescription medicines to help you manage pain and other symptoms that may occur with metastatic or recurrent breast cancer. For more information, see the topic Cancer Pain.

Last updated:	August 31, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Douglas A. Stewart, MD - Medical Oncology
Editors:	Cynthia Tank, Pat Truman, MATC