Brenda Spriggs, MD, MPH, MBA
Metastatic breast cancer, also known as stage IV breast cancer, is the most advanced form of breast cancer. If breast cancer is not diagnosed and treated early, it can spread to nearby organs or enter the bloodstream and spread to distant organs in a process known as metastasis. Once breast cancer has turned metastatic, the disease is usually incurable. Only 1 to 3 percent of patients with metastatic breast cancer recover from the disease, notes the California Breast Cancer Research Program. The symptoms of metastatic breast cancer generally continue to worsen until death.
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Depression and Anxiety
Psychological symptoms including depression and anxiety increase greatly in patients shortly before dying of metastatic breast cancer, reports a study published in the European Journal of Cancer Care. In this study of 44 patients with metastatic breast cancer, 66 percent of women met the diagnostic criteria for anxiety in the last interview before death. In addition, 50 percent of the patients met the criteria for depression. The incidence of depression and anxiety was not correlated with the severity of other physical symptoms. The study highlights the need for psychological support for women facing end-stage metastatic breast cancer.
Metastatic breast cancer frequently causes symptoms of pain. The pain can occur in several locations depending on where the cancer has spread. Cancer that has metastasized in the bone often causes a deep, dull ache in the bones or joints. When the cancer spreads to the lungs, it can cause unexplained chest pain. If cancer spreads to the liver, abdominal pain often results, explains BreastCancer.org. However, the study published in the European Journal of Cancer Care found that most of the women were able to control their pain in the final stages of death, and pain was not the worst physical symptom they experienced.
Depending on where the cancer has spread, end-stage metastatic breast cancer can cause a variety of other symptoms, including shortness of breath, fatigue, constipation, urinary or bowel incontinence, swelling of the abdomen, feet or legs, nausea, vomiting, loss of appetite and unintentional weight loss, the University of Michigan Health System reports. Cancer that has spread to the brain can cause many neurological symptoms such as memory loss, confusion, vision problems, headache, and difficulty walking or making other movements. The study in the European Journal of Cancer Care found that women reported fatigue and gastrointestinal symptoms as the most severe symptoms they were experiencing in their last interview before death.
- California Breast Cancer Research Program: Treatments for High-Risk and Metastatic Breast Cancer
- BreastCancer.org: Metastatic Recurrence
- University of Michigan Health System: Breast Cancer, Metastatic or Recurrent
- "European Journal of Cancer Care"; The Physical and Psychological Symptoms Experienced by Patients With Metastatic Breast Cancer Before Death; Fulton C. L., et al; December 1997
- Breast Cancer Resource Directory of North Carolina: Advanced (Metastatic) Breast Cancer And Recurrences