Working with your doctor when you have metastatic breast cancer: Interview with a Mayo Clinic expert.

A cancer expert answers common questions about making treatment decisions and preparing for the future when you have metastatic breast cancer.

Hearing your doctor tell you that you've got metastatic breast cancer can be shocking. Once you've had a chance to gather your thoughts, make time to have a conversation with your doctor and your loved ones about next steps.

Here, Mayo Clinic oncologist Timothy J. Moynihan, M.D., shares his advice on what issues to discuss with your health care provider and loved ones.

Many different treatment options for metastatic breast cancer exist. What factors should guide my treatment choices?

Discussing treatment goals is a critical conversation to have with your health care provider and loved ones. Some questions to get the conversation started include:

  • How aggressive do you want to be? Depending on how you are feeling right now, age or other factors, you may or may not be able to tolerate more-aggressive treatment.
  • Aside from the cancer, how is your health otherwise? Do you have other medical conditions to consider?
  • Is having children in the future a concern for you? Talk to your doctor about your fertility options and how that may affect your treatment plans. Ask for a referral to a fertility specialist if you have questions.
  • What quality-of-life issues are most important to you during this time? Are you willing to put up with side effects of treatment such as fatigue and nausea that may negatively affect your day-to-day life but could prolong your life and time with loved ones?
  • How important is pain and symptom control to you? Discuss with your doctor how your pain will be managed or if there are complementary medicine methods that may help you cope.
  • Do you have health insurance? If the cost of treatment is a concern for you, let your doctor know. There may be lower cost options, such as generic drugs, or financial assistance available.

I hear about new cancer treatments in the news all the time. Are there any experimental treatments I should consider?

Ask your doctor if you're a candidate for a clinical trial. Eligibility depends on many factors, including where you live, previous breast cancer treatments and individual characteristics of your condition. A searchable listing of clinical trials is available at

What if the treatment isn't working? How will I know?

Talk to your doctor about how to measure the success of your treatment plan and when to discuss stopping or changing treatments.

If treatments to slow the growth of the cancer aren't working, it may be time to discuss switching your treatment focus to reducing pain and other symptoms through palliative care, hospice care or home care.

How can I make sure my treatment wishes are respected?

Talk about your wishes with your loved ones as well as your health care team in advance.

An advance directive, such as a living will or durable power of attorney for health care, can let you decide ahead of time about how you will be treated. Laws regarding these documents vary by state. Talk to your doctor, social worker or lawyer for more details.

I don't want my loved ones to suffer. How can I prepare them?

Planning for the future may seem daunting, but it can also bring you peace of mind. Having a plan in place can ease the emotional, financial and legal burden your family will face after you're gone.

Talk to your lawyer or social worker about creating two different wills. One is for financial purposes; the other is for medical decision-making. Assigning someone to help make your decisions for you, if you are ever unable to speak for yourself, can make sure that you are treated the way you wish to be treated.

It's also a good time to get your affairs in order by gathering your financial records, insurance policies and other important documents. Put them in a safe place, such as in a safety deposit box, in a fireproof box or with your lawyer. Be sure your loved ones know where to find them and can access them in case of an emergency.

You may also want to help your family make funeral arrangements or plan a celebration of your life with your own personal input.

Get the latest health information from Mayo Clinic’s experts.

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Feb. 05, 2020 See more In-depth

See also

  1. 3D mammogram
  2. Alternative and complementary medicine for metastatic breast cancer
  3. Biopsy procedures
  4. Blood Basics
  5. Bone scan
  6. Brachytherapy
  7. BRCA gene test
  8. Breast cancer
  9. Breast cancer chemoprevention
  10. Breast Cancer Education Tool
  11. Common questions about breast cancer treatment
  12. Breast cancer prevention
  13. Breast cancer radiation: Can it cause dry skin?
  14. Infographic: Breast Cancer Risk
  15. Breast cancer staging
  16. Breast cancer supportive therapy and survivorship
  17. Breast cancer surgery
  18. Breast cancer types
  19. Breast implants: Do they interfere with mammograms?
  20. Breast implants and cancer
  21. Evaluating breast lumps
  22. Breast lumps
  23. Breast MRI
  24. Infographic: Breast Reconstruction Options
  25. Breast self-exam for breast awareness
  26. Chemo Targets
  27. Chemotherapy
  28. Chemotherapy and hair loss: What to expect during treatment
  29. Chemotherapy and sex: Is sexual activity OK during treatment?
  30. Chemotherapy for breast cancer
  31. Chemotherapy nausea and vomiting: Prevention is best defense
  32. Chest X-rays
  33. Complete blood count (CBC)
  34. Conflicting mammogram results: What can I do?
  35. Coping with pain after breast surgery
  36. COVID-19 vaccine: Should I reschedule my mammogram?
  37. CT scan
  38. CT scans: Are they safe?
  39. Dense breast tissue
  40. Does soy really affect breast cancer risk?
  41. Dragon Boats and Breast Cancer
  42. Gene expression profiling for breast cancer: What is it?
  43. Genetic Testing for Breast Cancer
  44. Genetic testing for breast cancer: Psychological and social impact
  45. Get ready for possible side effects of chemotherapy
  46. Get the support you need when you have metastatic breast cancer
  47. Ginger for nausea: Does it work?
  48. Hormone therapy for breast cancer
  49. Metastatic breast cancer
  50. Lower your risk of breast cancer
  51. Lumpectomy
  52. Magic mouthwash
  53. Mammogram
  54. Mammogram: Can it find cancer in dense breasts?
  55. Mammogram guidelines: What are they?
  56. Mastectomy
  57. Metastatic breast cancer: Should you get a second opinion?
  58. Modified radical mastectomy
  59. Molecular breast imaging
  60. Infographic: Molecular Breast Imaging
  61. MRI
  62. MRI-guided breast biopsy
  63. What is breast cancer? An expert explains
  64. Nipple discharge
  65. Nipple-sparing mastectomy
  66. Oncoplastic breast surgery
  67. Palliative care for metastatic breast cancer
  68. Palliative care: Who is it for?
  69. PALS (Pets Are Loving Support)
  70. Paulas story A team approach to battling breast cancer
  71. Pink Sisters
  72. Positron emission mammography (PEM)
  73. Positron emission tomography scan
  74. Precision medicine for breast cancer
  75. Preventive (prophylactic) mastectomy
  76. Prophylactic oophorectomy: Preventing cancer by surgically removing your ovaries
  77. Radiation therapy
  78. Radiation therapy for breast cancer
  79. Relationships and metastatic breast cancer
  80. Infographic: Scalp Cooling Therapy for Cancer
  81. Seeing inside the heart with MRI
  82. Sentinel node biopsy
  83. Skin-sparing mastectomy
  84. Stereotactic breast biopsy
  85. Support groups
  86. Tai chi
  87. The Long Race Beating Cancer
  88. Thyroid guard: Do I need one during a mammogram?
  89. Tomosynthesis-guided breast biopsy
  90. Treatment options for metastatic breast cancer
  91. Ultrasound
  92. Sentinel node biopsy for melanoma
  93. Mammogram for breast cancer — What to expect
  94. MRI
  95. Tai chi
  96. Weight Loss After Breast Cancer
  97. What is metastatic breast cancer?
  98. X-ray
  99. Your secret weapon during cancer treatment? Exercise!