Making the most of your advanced breast cancer treatment conversations

The average doctor’s visit lasts around 15 minutes¹, so every minute counts. Imagine being one of the approximately 150,000 people in the United States living with advanced breast cancer, -­locally advanced (stage III) or metastatic (stage IV) breast cancer² – and trying to get all of your questions answered in the short amount of time you have with your doctor.

While there is no cure, advances in scientific research have made it possible for many advanced breast cancer patients to manage their disease with treatments for several years. However, with each new treatment comes a new set of side effects, a different schedule, and lots of questions.

“Advanced breast cancer is complicated. Each person living with the disease has a unique situation that influences how their healthcare team may approach treatment,” says Robyn R. Young, M.D. “Understanding your specific type of tumor is important for women with advanced breast cancer and can help patients actively participate in treatment discussions and decisions.”

Tips for getting the most out of your doctor visits

Know your breast cancer tumor type: Each tumor’s genetic makeup helps doctors identify the best approach to treatment. Understanding the different types of tumors is important for people living with advanced breast cancer to become more involved in treatment discussions with their physicians. Currently there is no cure for advanced breast cancer and most women with the disease may be on treatment for the rest of their lives³ and will probably have to switch treatments over time to best manage their disease. For example, if a patient’s tumor type is hormone receptor-positive (HR ) and human epidermal growth factor receptor-2 negative (HER2-) and their certain initial treatment with letrozole or anastrozole is no longer effective, postmenopausal women may benefit from a hormonal therapy combination⁴, like exemestane (an aromatase inhibitor) and Afinitor® (everolimus)⁵.

o Afinitor can cause serious side effects, including lung or breathing problems, infections, increased risk of type of allergic reaction called angioedema and kidney failure which can lead to death. Mouth ulcers or sores are the most common side effect seen with Afinitor. For more information on Afinitor and to learn more about advanced HR /HER2- breast cancer visit Afinitor.com⁵.

• Write down your side effects before you meet with your doctor so you can talk about them: The reality is that most patients will experience side effects at some point during their treatment for advanced breast cancer. It’s important to speak with your doctor about side effects so that they can better help you manage them.

• Take notes: You may go over a lot of information with your doctor in a short amount of time and having notes or a recording of the conversation to review later may help you better understand what your doctor told you, look up resources or get a second opinion.

• Bring someone you trust with you: This person can provide emotional support and may help you remember important information. If you have someone with you, ask them to take notes so you can concentrate on listening.

• Ask your doctor to use simple words: Doctors try their best to make sure they are explaining information as best as possible, but sometimes they may use medical jargon. If you find yourself confused, don’t hesitate to stop them and ask for clarification. This will help you better understand your disease and possible treatments.

• Talk to a nurse/social worker/patient hotline after you talk to the doctor: While doctors would love to spend as much time as possible with their patients, sometimes that isn’t possible and you may leave your appointment with lingering questions. Consider reaching out to a nurse or a patient support hotline; they can also help explain what the doctor told you and may have ideas to help you manage your disease. For example, they may refer you to a support group or informational website.

Afinitor is a prescription medicine used to treat advanced hormone receptor-positive, HER2-negative breast cancer, along with the medicine exemestane, in postmenopausal women who have already received certain other medicines for their cancer⁵.

Important Safety Information

Patients should not take AFINITOR if they are allergic to AFINITOR or to any of its ingredients. Patients should tell their health care provider before taking AFINITOR if they are allergic to sirolimus (Rapamune^®) or temsirolimus (Torisel^®).

AFINITOR can cause serious side effects, including lung or breathing problems, infections, and kidney failure, which can even lead to death. If patients experience these side effects, they may need to stop taking AFINITOR for a while or use a lower dose. Patients should follow their health care provider’s instructions.

In some patients, lung or breathing problems may be severe and can even lead to death. Patients should tell their health care provider right away if they have any of these symptoms: new or worsening cough, shortness of breath, chest pain, difficulty breathing, or wheezing.

AFINITOR may make patients more likely to develop an infection, such as pneumonia, or a bacterial, fungal, or viral infection. Viral infections may include reactivation of hepatitis B in people who have had hepatitis B in the past. In some people these infections may be severe and can even lead to death. Patients may need to be treated as soon as possible. Patients should tell their health care provider right away if they have a temperature of 100.5°F or above, chills, or do not feel well. Symptoms of hepatitis B or infection may include the following: fever, chills, skin rash, joint pain and inflammation, tiredness, loss of appetite, nausea, pale stools or dark urine, yellowing of the skin, or pain in the upper right side of the stomach.

Patients who take an angiotensin-converting enzyme (ACE) inhibitor medicine during treatment with AFINITOR are at a possible increased risk for a type of allergic reaction called angioedema. Patients should get medical help right away if they have trouble breathing or develop swelling of the tongue, mouth, or throat during treatment with AFINITOR.

AFINITOR may cause kidney failure. In some people this may be severe and can even lead to death. Patients should have tests to check their kidney function before and during their treatment with AFINITOR.

AFINITOR can cause incisions to heal slowly or not heal well. Patients should tell their health care provider if their incision is red, warm, or painful; if they have blood, fluid, or pus in their incision; or if their incision opens up or is swollen.

Common side effects include mouth ulcers. AFINITOR can cause mouth ulcers and sores. Other common side effects include infections, feeling weak or tired, nausea and vomiting, skin problems, headache, weight loss, loss of appetite, cough, diarrhea, fever, swelling of the hands, arms, legs, feet, face, or other parts of the body, joint pain, abnormal taste, stomach-area (abdomen) pain, nose bleeds, increased blood cholesterol and sugar levels, decreased blood phosphate levels, low red and white blood cells, and the absence of menstrual periods (menstruation).

Please see full Prescribing Information for AFINITOR available at AFINITOR.com.

Rapamune^® (sirolimus) and Torisel^® (temsirolimus) are registered trademarks of Wyeth Pharmaceuticals Inc.

References
1. Medscape 2015 Physician Compensation Report. http://www.medscape.com/features/slideshow/compensation/2015/public/overview. Accessed September 9, 2015.

2. MBC Alliance. Changing the Landscape for People Living with Metastatic Breast Cancer. http://www.avonfoundation.org/assets/images/2014/mbca_full-report.pdf. Accessed October 7, 2015.

3. Eniu A. Weekly Administration of Docetaxel and Paclitaxel in Metastatic or Advanced Breast Cancer. The Oncologist. 2005.

4. Redmond C. Breast Cancer Hormone Therapy Options. http://christineredmond.suite101.com/breast-cancer-hormone-therapy-options-a197304. Accessed September 9, 2015.

5. Afinitor Package Insert

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