Your biopsy or other tests clearly show you have recurrent breast cancer. Now what?
Take some time to gather the information and strength you need so you can meet the challenge and let the healing begin.
To come up with a battle plan, you need to pull together your medical team. The doctors on your team may include a number of specialists:
- a surgeon, who performs biopsies and other procedures, and removes single metastases
- a medical oncologist, who specializes in chemotherapy, hormonal (anti-estrogen) treatment, immune therapies, pain medications, and nutritional support
- a radiation oncologist, who specializes in radiation therapy to treat specific problems such as pain, bleeding, loss of strength or sensation due to nerve involvement, weakened bone at risk of fracture, bone pain, blocked airway, or brain involvement
- a radiologist, who takes and interprets mammograms, ultrasound, bone scans, CT scans, MRIs, PET scans, etc. to determine the extent of the cancer and to help assess your response to treatment
- a pathologist, who examines the biopsy material and conducts special tests on cancer tissue to learn as much as possible about the nature of the problem
Each of these doctors needs to be very involved with your care and in touch with one another about your treatments. You may have to insist that your health insurance provider allow you to see each of these treatment specialists. It's unusual to have a consultation with the pathologist. But it's common to have your pathology results reviewed by more than one pathologist, particularly when you seek a second opinion from a team of cancer doctors at more than one hospital.
Count on your primary care doctor and your nurse practitioner to help you coordinate your cancer treatment with your overall medical care and support.
When you were first treated for breast cancer, you got to know many cancer specialists. If you developed a good relationship with these doctors, you may want to stick with them. But many people seek outside or second opinions from additional experts if cancer recurs or spreads. Some women might choose a whole new team. These doctors may have the same amount of training and experience as those on your first team. But they may approach your case with a fresh eye and a different perspective.
The doctors on your new team may work at a different hospital or cancer center. They may be able to offer you a new, experimental treatment that your other doctors don't have access to. Getting another doctor's opinion can also be very helpful, even if you decide to stay with your original doctors.
Take your time. You can't rush these important discussions. You can usually take a few weeks to gather all your facts so you can make the best decisions for you.
Get the information and attention you need, even if it means extra office visits and phone calls to go over things again. It's hard to be practical and organized when you are very frightened, and you may not process what you heard during the first conversation. Each new person may give you new information, to help complete the whole picture. You have to think about each piece of information and put the puzzle together. Once you have an idea of what weapons will work the best for fighting this round of breast cancer, then move on to the battle.
Dealing with the fear can be as time-consuming as getting yourself organized to take the necessary next steps. Be sure you let your friends, family, and medical experts know that this is a time when you need more support.
In the following pages you can explore the treatments for local, regional, or metastatic recurrences. Jump ahead to the section that applies to you.
"When you're dealing with breast cancer, you often feel out of control. Not knowing what it all means, what's going to happen next, and what you can do to help yourself feels very uncomfortable. The best way to get back in control is to know what to expect, who's going to help you, how to contact them, and what you can do. It also helps to have a full treatment plan. Once you have these things in order, and get going with treatment, you'll feel so much better."-- Marisa Weiss, M.D., president and founder, Breastcancer.org