Stage four breast cancer describes cancer that has spread outside the breast tissue. Common areas for breast cancer to spread include lymph nodes, lungs, bone, liver and brain. According to the National Cancer Institute, stage four breast cancer is rarely curable, but chemotherapy often increases survival time and decreases symptoms from the disease.
Hormone Therapy
Many times, estrogen encourages the growth of breast cancer. Several hormone medications work to block or eliminate estrogen in the body. The American Cancer Society lists tamoxifen, toremifene and fulvestrant as hormone medications given to women who are pre-menopausal. Post-menopausal women may be put on letrozole, anastrozole or exemestane. In some cases of advanced-stage breast cancer, megestrol acetate works when other hormone therapy has failed.
Cytotoxic Chemotherapy
Traditional chemotherapy remains the longest-used therapy for stage four breast cancer. Chemotherapy medications directly attack cancer cells, causing them to be unable to grow and divide. The National Cancer Institute lists numerous chemotherapy drugs for the treatment of stages three and four breast cancer. These include doxorubicin, epirubicin, liposome doxorubicin, mitoxantrone, paclitaxel, docetaxel, cyclophosphamide, capecitabine, 5-fluorouracil, methotrexate, carboplatin, cisplatin, vinorelbine, vinblastine, vincristine, gemcitabine and mitomycin C. These medications may be used alone or in combination.
Tratuzumab (Herceptin) and Lapatinib (Tykerb)
A version of chemotherapy called targeted therapy is used commonly for advanced breast cancer. These medications work by slowing the growth of aggressive breast cancer tumors and also promoting the body's immune system to fight the cancer on its own. Targeted therapy drugs generally carry fewer side effects than traditional chemotherapy. Tratuzumab and lapatinib are the standard for treatment with targeted therapy. According to the American Cancer Society, lapatinib is used after tratuzumab has been found ineffective at fighting the breast cancer.
Biophosphonates
Although not considered chemotherapy, these medications often combine with other treatments in patients with breast cancer that has spread to the bones. Biophosphonates strengthen bones and prevent fractures in bones weakened by cancer. The National Cancer Institute lists pamidronate, zoledronate and clodronate as commonly used biophosphonates in stage four breast cancer that has spread to the bones.
