How can my 45-year-old wife manage her breast cancer?

Question

Hello doctor,

My wife just turned 45, and we received devastating news that her breast cancer has spread to her liver and bones. The oncologist mentioned that it is HER2 (human epidermal growth factor receptor 2)-negative and triple-negative, which sounds really bad. She has been on chemotherapy for six weeks, but she is so exhausted that she can barely get out of bed. The bone pain in her spine is getting worse, even with Morphine patches.

Our 12-year-old keeps asking why mommy sleeps so much, and I do not know what to tell him. The doctor mentioned clinical trials, but we live three hours from the cancer center. Should we consider moving closer? She has already lost 18 pounds and has no appetite. I am scared that we are running out of time and options. The side effects have been brutal: nausea, mouth sores, and neuropathy.

Are there newer immunotherapy treatments we should ask about? What is realistic for someone her age with this extent of disease? How can we help our son cope with watching his mother get sicker?

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I truly understand and appreciate the extent of your fear and anxiety about her condition, especially now that the disease has become metastatic and is triple-negative. However, I want to reassure you that every day brings new hope. New medications are constantly being developed, and there are many treatments that can significantly improve survival and quality of life.

Regarding the bone metastases, we should consider starting a medication such as Denosumab, given once monthly, to help reduce skeletal complications and strengthen the bones, along with calcium and vitamin D supplementation. If she has specific painful areas, localized palliative radiotherapy may help relieve pain and allow a reduction in the doses of analgesics, so she does not remain drowsy most of the time. From a nutritional standpoint, she should try to eat small, frequent meals and maintain adequate fluid intake.

If she is enrolled in a clinical trial, treatment is typically administered on an outpatient basis, meaning she can return home the same day. Therefore, there may be no need to change your place of residence solely for treatment.

Regarding your son, given his young age, it is important to speak with him openly and honestly in an age-appropriate manner. This is an evolving field, with new therapies emerging every day that offer renewed hope. Immunotherapy, in appropriate cases, can be effective and is often better tolerated than traditional chemotherapy.

In addition, we must pay close attention to her well-being, as strong psychological support is essential at this stage.

I hope this explanation is clear. Please feel free to contact us at any time; we are always here to support you.

Thank you.