What are my breast cancer treatment options now?
I am a 64 y.o. female with metastatic breast cancer. The tumor cells are ER(+), PR(+), HER-2(-), GCDFP-15(+), and TTF-1(-). My cancer treatment started with anastrozole and I have been taking it for 2 years and 3 months now. I had radiation therapy done on my spine 6 months ago and so the doctor temporarily stopped the anastrozole and continued it again after the radiation ended in 2 weeks. My upper-back and shoulders stopped hurting after radiaton therapy. However, my CEA and CA15-3 BR CA markers have now started to move up significantly. This has made my doctor conclude that anastrozole is no longer working for me. Could this have occurred because of the radiation therapy where I stopped the anastrozole and restarted it?
What treatment options do I have now? Should I continue with hormone therapy? If so, which is the next recommended drug after anastrozole? I am dreading chemotherapy because of the hair-losing aspect. What options do I have?
Currently, I am getting fever daily, like I did when I was initially diagnosed with cancer. This is in addition to significant pain while standing or walking.
Expert Answer
In reading your question, it appears that you are well informed with staging information and treatment details related to your cancer diagnosis.
Based on all the details you have included in your question and your current comments about your daily fevers and significant pain, I would recommend a second opinion both with a medical and radiation oncologist.
You have also included many details about your previous treatment for cancer, with that in mind, one source of information I would offer for your review prior to additional discussion with either your physician and or a second opinion is the following.
The NCCN (National Comprehensive Cancer Network) clinical practice guidelines are considered a gold standard, and are a national recognized resource which identifies standards in care for the treatment of cancer.
Based on the description of your cancer, and recommendations within the NCCN guidelines, you could have the opportunity to review some additional treatment ideas.
I am including the link to help you access some of the detailed information you could reference when speaking to either your current physician and or when seeking a second opinion.
Begin with accessing this link and then follow the specific information related to treatment for stage IV breast cancer. You will find a detailed decision tree regarding additional testing and treatment options for someone with your cancer diagnosis.
http://www.nccn.com/
I wish you the best in seeking additional treatment options.