Even though metastatic breast cancer cannot be cured, treatment may extend life. However, the side effects of some treatment may affect your quality of life. Palliative care reduces cancer-related symptoms and should always be a part of metastatic breast cancer treatment. Supportive care helps people with cancer and their caregivers cope with the disease and its treatment.

Bone strengthening therapy is part of standard treatment for cancer that has spread to the bone. Bisphosphonates and the RANK ligand inhibitor denosumab are two types of drugs that can lower the risk of fractures and help reduce pain caused by bone metastases. Bisphosphonates are given by IV and denosumab is given by an injection under the skin. Some people experience bone, joint or muscle pain when taking these drugs. This type of pain usually only lasts for 1-2 days, and only with the first treatment. You should report any of these side effects to your health care provider right away.

Some people taking bisphosphonates need to increase their intake of vitamin D and calcium. In rare cases with either drug, a disorder called osteonecrosis of the jaw may occur. Having a full dental exam before beginning treatment may reduce the risk of this disorder, and an oncologist should be consulted before having any dental procedure while being treated.

Loss of appetite is common for people with metastatic breast cancer. Although loss of appetite can make it hard to eat, it’s important to get adequate nutrition to strengthen your body.

Nausea is also a common side effect of treatment, but your health care provider can prescribe medication to ease nausea caused by chemotherapy.

For most people with metastatic breast cancer, major weight loss isn’t a problem until the cancer is very advanced.

Fatigue is common with metastatic breast cancer. When fatigued, people feel tired and lack energy all of the time. Often, getting enough rest doesn’t help. Two common causes of fatigue are depression and trouble sleeping. If you feel overly tired or have trouble sleeping, talk with your provider to find the best ways to manage your fatigue.

For some people, fatigue is caused by anemia or a drop in red blood cells. Chemotherapy destroys red blood cells and it can lead to anemia and then fatigue. Sometimes anemia can be treated by increasing iron or folate in the diet. Severe anemia may be treated with a blood transfusion.

Erythropoietin or similar growth factor drugs can increase the number of red blood cells and reduce the need for transfusions. However, these drugs increase the risk of blood clots and strokes and appear to shorten survival. They are not recommended for treatment after chemotherapy ends, and some safety studies have questioned whether people with breast cancer should be treated with erythropoietin.