Tag: treatments

What is metastatic cancer? – HealthyWomen



Hearing the words, “You have cancer,” has become an unfortunate reality for many women in the U.S. Research shows 4 out of 10 women will be diagnosed with cancer at some point in their lifetime — and an estimated 972,000 new cases will be diagnosed this year.

Everything about cancer is scary — especially the fact that almost all cancers have the potential to spread throughout the body. When this happens, it’s called metastatic cancer, also known as stage 4, and it’s harder to treat than cancer that hasn’t spread.

Despite the challenges of metastatic cancer, research shows advancements in treatment options are helping people live longer and have a better quality of life overall.

Read: Do You Know Someone Who Has Cancer? Here’s How You Can Help. >>

In an effort to spread awareness about the disease, we asked oncologist Shikha Jain, M.D., about the facts and what you need to know about metastatic cancer.

What is metastatic cancer?

Cancer is a disease that starts when cells in the body begin to grow and make copies of themselves. Metastatic cancer is cancer that has spread from the site where it began. One analogy would be to think of your body as a neighborhood and each organ is a house. Each house has its own set of residents (cells) that usually stay in that house. But if some residents start to misbehave (cancer cells) and decide to move to another house and cause trouble, those would be metastatic diseases. For example, if breast cancer moves to a second location from where it started, like the lungs or bones, it is considered metastatic cancer. This is not a new lung or liver or bone cancer, but breast cancer that has metastasized.

Watch: Resources for Patients with Metastatic Breast Cancer >>

How does cancer spread?

Cancer can spread in different ways depending on the type of cancer. Some cancers spread through the bloodstream and some through the lymphatic system, which are the tissues and organs in your body that help you fight diseases. When they leave the original site of the tumor and find a new place to make copies of themselves, they can create tumors in new locations and can continue to spread to other organs.

What are the most common sites of metastasis?

In general, it’s most common for cancer to metastasize to the lungs, liver, brain and bones. However, the most common sites of metastasis also depend on the type of cancer. For example, colon cancer most commonly spreads to the liver and then to the lungs. Breast cancer commonly spreads to the bones.

Does metastatic cancer cause symptoms?

Metastatic cancer can cause symptoms depending on where the cancer has spread to. For example, if the cancer spreads to the bone it can cause pain and, in some cases, weakened bones and fractures. Cancer that spreads to the liver can cause abdominal pain, fluid buildup in the abdomen, jaundice (yellowing of the skin and eyes) and loss of appetite and weight. Cancer that has spread to the lungs can cause shortness of breath, chest pain and coughing up blood. Brain metastatic disease can cause headache attacks, dizziness, blurry vision and other neurologic symptoms. Symptoms of metastatic cancer can sometimes be vague or mimic other conditions. This can make getting a diagnosis challenging.

How is metastatic cancer treated?

Metastatic cancer can be treated in a variety of ways and can include whole-body therapies such as chemotherapy, targeted therapy or immunotherapy, surgery, radiation or other local therapies. The treatment of metastatic cancer depends on the location as well as the type of cancer being treated.

Chemotherapy uses drugs to directly kill cancer cells or stop them from growing. These drugs can either be given via an IV or as pills. They then travel through the bloodstream making them especially effective in treating cancer that has spread to other parts of the body.

Hormone therapy can be used for cancers that are sensitive to hormones, such as some types of breast cancer and prostate cancer. These therapies can block the hormones that can fuel cancer growth.

Targeted therapy is a type of treatment that uses drugs to target specific molecules that can impact cancer growth and spread. They are designed to attack cancer cells and cause less damage to normal cells, with a goal of minimizing side effects.

Immunotherapy agents are drugs that help a person’s own immune system to fight cancer cells.

Read: New Treatments for Metastatic Breast Cancer >>

Radiation and surgery are sometimes options for localized disease. Radiation uses high energy rays to kill cancer cells or shrink tumors. Surgery can be performed in certain cases to remove specific tumors, especially if they are causing symptoms or complications.

What are tips to engage in shared decision-making about treatment options for metastatic cancer?

Shared decision-making is about working together with your healthcare team to find the best treatment plan for you. Communicating openly and researching the type, stage and treatment options available to you can help you take an active role in your healthcare decisions.

When doing your research, use reliable sources such as the American Cancer Society and National Cancer Institute and write down a list of questions and concerns for your healthcare provider (HCP) to discuss at your office visit. Also write down your treatment goals and what’s most important to you during treatment (quality of life, managing side effects, etc.).

During the visit, ask about all available treatment options and any clinical trials, including the benefits, risks and potential side effects to each one. Don’t be afraid to ask the HCP to explain something you may not understand, and be open and honest about any fears or concerns. The more details you can share about your life, work and your day-to-day schedule, the easier it will be to create a personalized plan that will fit into your life.

What are ways to manage symptoms of metastatic cancer?

There are many ways to manage symptoms of metastatic cancer including medication and lifestyle choices.

For mild pain, over-the-counter (OTC) medications such as ibuprofen and acetaminophen can help. Severe pain may require prescription pain medications or a procedure like a nerve block or an epidural.

For fatigue, try conserving energy by prioritizing tasks and pacing yourself throughout the day. A balanced diet and light exercise can also help boost energy levels. If weight loss and loss of appetite are a problem, try eating smaller, more frequent meals throughout the day or ask your HCP about appetite stimulants and/or working with a dietician to help create a meal plan that works for you.

Dietary changes like avoiding spicy foods and foods with a strong smell can also help reduce nausea. And OTC or prescription anti-nausea medications may help with an upset stomach and vomiting.

Breathing problems can happen when cancer moves to the lungs. Inhalers and steroids can help open up airways and reduce inflammation. Supplemental oxygen can help people breathe more comfortably.

Living with metastatic cancer affects mental health too. Support groups and talking to a therapist or counselor can help with the emotional challenges. And mind-body exercises such as meditation and mindfulness can help reduce stress and improve overall well-being.

Is palliative care an option for people with metastatic cancer?

Palliative care is an excellent option for people with metastatic cancer. This specialized type of medical care focuses on providing relief from symptoms and its goal is to improve overall quality of life.

Read: What’s the Difference Between Hospice and Palliative Care? >>

Palliative care can be included in a care plan at any time or stage of a diagnosis or illness. Palliative care teams can help with everything from symptom management and emotional and psychological support to communication and decision-making, coordinating care and support for families.

This educational resource was created with support from Exelixis, a HealthyWomen Corporate Advisory Council member.

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The Facts About Cold Capping



I was diagnosed with breast cancer in 2015, right around the same time the first FDA-approved cold cap came out. I’d heard about the potential hair-saving helmet on the news, and I crossed all my follicles that it could work for me as I prepared to start chemotherapy.

Unfortunately, I wasn’t a candidate for scalp cooling therapy. Back then, the cooling devices were only approved for early-stage breast cancer and less potent types of chemo. I was stage 3 and taking doxorubicin, also known as the “red devil.” So, yeah, pretty potent stuff.

Although I was disappointed that I couldn’t try cold capping to reduce hair loss during chemo, just knowing it was out there made me hopeful for advancements in cancer treatments. Hair loss may seem like a small thing when talking about disease, but it can be really devastating. One recent report cited up to 14% of women won’t consider chemotherapy because of hair loss.

Cold caps don’t work for everyone, and results vary from person to person depending on a lot of different factors. But new research shows using cold caps can help some people keep a good amount of hair during chemo — even people getting the red devil: In one study, 71.4% of people on doxorubicin saw successful hair retention. That’s a hair flip in the right direction.

If you or someone you know is interested in cold caps for chemo-induced hair loss, here’s what you need to know.

What is cold capping?

Cold capping involves wearing a helmet-like device to lower the temperature of the scalp during chemotherapy. The cold temperature decreases blood flow, which can reduce the amount of chemo that reaches the hair follicles and may reduce hair loss for some people.

What are the types of cold caps?

Scalp cooling therapy includes two types of devices:

  • Automated: The insulated cold cap is hooked up to a machine that circulates cooling liquid or gel inside the cap. Once the device is hooked up, the cooling system will keep the temperature where it needs to be. Automated cold caps are regulated by the FDA.
  • Manual: The frozen gel caps are stored in a freezer or with dry ice. Because the gel will start to warm once it’s on the scalp, a new frozen cap will have to be replaced about every 30 minutes. Manual cold caps are not regulated by the FDA.

How do cold caps work?

Both types of cold caps work by reducing the temperature of the scalp before, during and after chemo.

Typically, the person administering the chemo will help set up the automated cold cap machine and make sure the temperature is correct and that the cap is secured tightly around your head.

People using manual caps also need an outside pair of hands to help with the caps, although it doesn’t have to be a nurse — family or friends can help during treatment.

Who can use cold caps?

People with solid tumors (breast, colon, lung, gynecological) can use cold caps to help reduce hair loss during chemo.

Who shouldn’t use cold caps?

Cooling caps are relatively safe overall, but some people with certain health conditions shouldn’t use cold caps.

For example, people with blood cancers like leukemia or lymphoma shouldn’t use cold caps because the restricted blood flow may stop the chemo from getting to where it needs to go.

You also shouldn’t use cold caps if you:

  • Have central nervous system cancer
  • Are getting chemo for a bone marrow transplant
  • Had radiation to the head or will have radiation to the scalp

Cold capping is not recommended for people who have cold-agglutinin disease, cryoglobulinemia and post-traumatic cold dystrophy.

What are the side effects of cold caps?

Cold caps live up to the name, so if you’re sensitive to cold temperatures, you may feel uncomfortable during the sessions. Other side effects of cold capping can include:

  • Dry skin
  • Feelings of claustrophobia when wearing the cap
  • Headache attacks
  • Nausea
  • Cold thermal injury (burn) from manual caps

Do I need a prescription for scalp cooling therapy?

Whether you need a prescription depends on which type of cold cap you want to try. The automated systems require a prescription, and the manual systems do not. Always be sure to ask your healthcare provider before using any type of scalp cooling device.

Is cold capping covered by insurance?

Manual frozen caps are not covered by insurance, but automated cold caps are covered by Medicare and may be covered by other insurance plans.

If you need help paying for the cooling therapy, nonprofit organizations such as HairToStay and The Rapunzel Project may be able to help cover the cost of cold capping.

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Facts About Digital Therapeutics – HealthyWomen



If you’re sick of hearing about all the ways technology is bad for us, here’s some good news to consider: Prescription digital therapeutics (PDTs) are among the latest digital health products helping to increase access to quality healthcare.

PDTs and digital therapeutics in general are used to help prevent, treat and manage a range of mental and physical conditions via mobile devices like your smartphone. The difference between PDTs and other health apps is that PDTs are authorized by the Food and Drug Administration (FDA) and require a prescription from your healthcare provider (HCP).

PDTs offer unique options not traditionally seen during your typical office visit. Some PDTs provide custom treatments such as a video game for ADHD and a wearable device that uses vibrations to interrupt nightmares. Other PDTs use cognitive behavioral therapy (CBT) to help with conditions such as insomnia or irritable bowel syndrome. The evidence-based treatments backed by clinical research can be used alone or in combination with other treatments.

The current PDTs approved by the FDA apply to both mental and physical conditions. These include:

PDTs may be especially helpful for women and people assigned female at birth considering many of these health conditions affect more women than men. For example, women are nearly twice as likely to be diagnosed with depression compared to men. The latest PDT approved by the FDA in April treats major depressive disorder.

Through the app, people are asked to identify and compare emotions displayed on a series of faces as part of cognitive-emotional training. Research shows this type of therapy may help stimulate the parts of the brain involved in depression and have antidepressant effects.

Read: The Life-Changing Hope of New Treatments for Clinical Depression >>

PDTs may also be particularly beneficial for people with substance use disorder. A recent study of people with opioid use disorder, mostly women, found that those who used a PDT had significant reductions in medical care visits, including inpatient stays and trips to the emergency room.

Benefits of prescription digital therapeutics

In addition to unique treatment options, PDTs can offer benefits including:

  • Convenience. You can access treatment on your schedule wherever you want.
  • Access. People who have a difficult time getting to in-person office visits can still get the care they need.
  • Equality: Digitized therapies that rely on a standard, evidence-based format ensure that people who use them receive the same quality and level of care.
  • Privacy: PDTs offer an option for people who feel stigma or shame about their health condition.

Although PDTs can help increase access to quality care, health insurance coverage for PDTs can vary and insurance may not cover them at all. And despite the FDA stamp of approval, some experts say more research is needed before making PDTs a mainstay in the healthcare system.

If you’re interested in PDTs, talk to your HCP about your options.

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