For many women living with metastatic breast cancer, which is breast cancer that has spread to other parts of the body—also known as mBC or Stage 4 breast cancer—the diagnosis often comes as a complete shock. Whether the disease is discovered via a routine mammogram or due to seemingly unrelated symptoms, those living with mBC move through life with an entirely different perspective. In mBC, breast cancer has spread to other parts of the body, and while treatments can slow its progression, there is no cure.
Now, imagine the shock of being a healthcare worker supporting people with cancer only to find out that you have Stage 4 breast cancer yourself. That’s what happened to Lisa, 56, of Reedley, CA, who works the front desk at a community cancer center. Lisa does more than checking people in and helping them sort out their insurance. As she guides them down the halls, she often hears about their experiences with cancer, helping them navigate questions, challenges, and fears—and sharing personal insight. Lisa was initially diagnosed with breast cancer at 39, when a mammogram revealed a Stage 1 lump. Following a lumpectomy, radiation, and chemotherapy, she remained cancer-free for nearly 17 years, but the disease returned as triple-negative breast cancer.
Following a bilateral mastectomy and chemotherapy, Lisa asked her doctor for one final CT scan, just to be sure she was in the clear. It was at this point that she learned the importance of being her own health advocate. “After the CT scan, the doctor never got back to me because she was busy moving practices,” Lisa recalls. “Because I worked at a cancer center, I had one of the doctors take the case. He read my scan and found that the cancer had come back—in my lung.” This discovery meant that she now had Stage 4 triple-negative breast cancer, or mTNBC. Since Lisa received the appropriate pretreatments, she and her doctor decided she would start on TRODELVY® (sacituzumab govitecan-hziy). Today, Lisa is not only receiving TRODELVY, but serving as one of the brand's ambassadors.
TRODELVY is a prescription medicine used to treat adults with triple-negative breast cancer (negative for estrogen and progesterone hormone receptors and human epidermal growth factor receptor 2) that has spread to other parts of the body (metastatic) or cannot be removed by surgery, and who have received two or more prior treatments, including at least one treatment for metastatic disease.
It is not known if TRODELVY is safe and effective in people with moderate or severe liver problems or in children.
Please click to see Important Facts, including Important Warning for low white blood cell count and diarrhea.
See below for Important Safety Information, including additional serious side effects for allergic and infusion-related reactions, and nausea and vomiting.
As she adjusted to her treatment plan, Lisa took some time off, then decided to keep working part-time at the cancer center, where she’s often the first person to greet women facing the same difficult diagnosis. Despite spending countless hours in the center for her own treatments, her shifts on the desk refuel her with a sense of purpose. “I continued to work in a healthcare setting because I felt like I could give people advice from my own experiences,” she explains. She sees friendships form around these shared experiences and watches natural community-building happen. “This is like a second home, and we feel like a big family,” she says. Given her unusual perspective from both a personal and professional angle, here are 6 things Lisa can share about what it’s really like to live with pretreated mTNBC.
Your visits with your healthcare team are for you.
There can be an intimidation factor—and a sense of being overwhelmed—when you’re suddenly meeting with oncologists, surgeons, and other healthcare providers to discuss different treatment paths for mBC. This is totally normal, but Lisa’s advice is to focus on the fact that it’s their job to support and educate you: “Don’t hold back. Ask away with all the questions that you have—there are no dumb questions.” It’s a great idea to write down a list of questions before your appointment, so you don’t forget any if you feel flustered, tired, or emotional. You can also consult helpful online guides for speaking with your healthcare team about mBC treatment. For example, when Lisa was considering whether TRODELVY might be right for her, she used the TRODELVY interactive tool to build a personalized doctor discussion guide to help plan conversations with her healthcare provider. “Using a guide helps a lot, because sometimes we can't even think of what kind of questions to ask, and we’re in and out of the room so fast,” Lisa says. At her job, she sees how busy doctors are; following a guide can help people better connect with their doctors and know they’re maximizing their appointment time. “Sometimes as patients, we can feel rushed,” she says. If you still leave feeling like you aren’t getting questions answered, it’s worth the effort to seek out a doctor that puts you more at ease.
Try to counteract worry with learning, planning, and communication.
As you begin treatment, it may be counterproductive to go down an internet rabbit hole worrying about complications that may or may not happen—you’re already stressed, and more anxiety will not benefit your health. Interactive tools like TRODELVY’s side effect communication guide can help you feel prepared with a plan. When worries arise, add to your list of questions for your care team at your next appointment, then try to focus on the present. “We all have that nervous and anxious feeling when we’re going to start treatment because we’ve heard about medication side effects and have questions about what to do if they come along,” Lisa says. “The best advice I can give is to just take it one day and one step at a time.” If you do experience side effects, let your healthcare provider know right away, so they can assess the best next steps. While some people play down symptoms to their care team because they don’t want to seem “difficult” or be taken off treatment, it's important to be upfront with them. Your honest input gives them the information they need to fine-tune your treatment plan.
Small moments of connection can be really impactful.
Through her work, Lisa regularly experiences how a moment of upbeat energy can help someone who is experiencing dark thoughts. She sees people with mBC on their hardest days, when they’re struggling emotionally and physically. Nonetheless, she always meets them with a warm, genuine greeting, and sees how this small moment of connection can break through. “It’s all in the attitude you approach them with. A smile goes a long way—a very long way.” She also finds that offering her personal perspective can help people feel less alone. “Sometimes I'll pull someone aside and share a little of my own experience,” she says. “I’ll tell them, ‘Look at me: I’m still working, and I come here because it motivates me to keep going, and because I know there are others here navigating their own challenges too.’”
It’s important to build a relationship with your infusion nurses.
While getting IV infusion treatment is not generally something people look forward to, the professionals who administer them often provide an unexpected source of comfort and connection. “I can't say enough about infusion nurses,” says Lisa. “I call them my guardian angels because they're there to help me when I'm feeling certain symptoms and they just give me so much love and attention. They really, really listen to my needs. Whether I'm experiencing any kind of side effect or just don't feel good, they're there for me. They’re one of the best connections I have.” As someone with both personal and professional experience with her diagnosis, Lisa has learned that building a strong relationship with your nursing team is just as crucial as building one with your doctor. She’s even experienced nurses offering support not just to her, but to family members who accompany patients during treatments. “They’re just so caring and attentive,” she says.
Peers living with mBC can be your best allies.
While support from family and friends is so important for people living with mBC—Lisa leans on her husband, daughters, grandkids, and mother-in-law—nobody understands what they’re going through better than other people with mBC. Lisa has found that new people coming into the cancer center seem to think of her as a kindred spirit. “I don’t have any hair, so they can see I’m going through treatment, too,” she says. “They’ll often come back to me with questions like, ‘What did you do for this symptom or side effect?’ And I'll say, ‘Well, this worked for me.’ They'll come back and say, ‘Well, hey that did work, thanks for the advice.’” (While Lisa shares her personal experience, it’s important that people living with mBC partner with their healthcare provider to determine what’s right for them.) Lisa also remembers comforting a woman who was overcome with anxiety before her mastectomy, then watching that acquaintance grow into a friendship over subsequent visits.
Finding purpose can provide a path forward.
Despite her contagious natural positivity, Lisa is honest about the fact that some days, life with pretreated mTNBC is very challenging, both emotionally and physically. Following her diagnosis, she cut back to 3 days a week at the cancer center so she could adjust to her new reality without the demands of a full work schedule. “There are days when I don’t feel good,” she says. “But I’ll get up and force myself to get dressed and go to work, and once I’m there, I know there’s a purpose for me—to encourage people to keep going.”
To hear more from Lisa and other people living with pretreated HER2- mBC, visit the Patient Stories page on https://www.trodelvy.com/patient/mtnbc/patient-stories
WHAT IS TRODELVY?
TRODELVY® (sacituzumab govitecan-hziy) is a prescription medicine used to treat adults with:
- triple-negative breast cancer (negative for estrogen and progesterone hormone receptors and HER2) that has spread to other parts of the body (metastatic) or cannot be removed by surgery, and who have received two or more prior treatments, including at least one treatment for metastatic disease.
- hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to other parts of the body or cannot be removed by surgery, and who previously received endocrine therapy and at least two additional treatments for metastatic disease.
It is not known if TRODELVY is safe and effective in people with moderate or severe liver problems or in children.
TRODELVY can cause serious side effects, including low white blood cell count and diarrhea:
- Low white blood cell count (neutropenia) is common and can sometimes be severe and lead to infections that can be life-threatening or cause death as early as the first cycle of treatment. Your healthcare provider should check your blood cell counts during treatment and may give a medicine to help prevent neutropenia starting in the first cycle of treatment if you have an increased risk for developing low white blood cell count with a fever (febrile neutropenia). If your white blood cell count is too low, your healthcare provider may need to delay treatment or lower your dose, give you a medicine to treat low blood cell count, or in some cases may permanently stop TRODELVY. Your healthcare provider may need to give you antibiotic medicines if you develop fever while your white blood cell count is low. Call your healthcare provider right away if you develop any of the following signs of infection: fever, chills, cough, shortness of breath, or burning or pain when you urinate.
- Severe diarrhea. Diarrhea is common and can be severe. Severe diarrhea can lead to loss of too much body fluid (dehydration) and kidney problems. Your healthcare provider should monitor you for diarrhea and give you medicine as needed to help control it. If you lose too much body fluid, your healthcare provider may need to give you fluids and electrolytes to replace body salts. If you develop diarrhea during your treatment with TRODELVY, your healthcare provider should check to see if it may be caused by an infection. Your healthcare provider may decrease your dose, delay treatment, or permanently stop TRODELVY if your diarrhea is severe and cannot be controlled with anti-diarrheal medicines.
Do not receive TRODELVY if you have had a severe allergic reaction to TRODELVY. Ask your healthcare provider if you are not sure.
Allergic and infusion-related reactions can be serious and life-threatening. Tell your healthcare provider or nurse right away if you get any of the following symptoms during your infusion of TRODELVY or within 24 hours after: swelling of your face, lips, tongue, or throat; hives; skin rash, itching, or flushing of your skin; fever; difficulty breathing or wheezing; lightheadedness, dizziness, feeling faint, or pass out; or chills or shaking chills (rigors).
Nausea and vomiting are common and can sometimes be severe. Before each dose of TRODELVY, you will receive medicines to help prevent nausea and vomiting along with medicines to take home with instructions about how to take them. Call your healthcare provider right away if you have nausea or vomiting that is not controlled with the medicines prescribed for you. Your healthcare provider may decide to decrease your dose, delay treatment, or permanently stop TRODELVY if your nausea and vomiting is severe and cannot be controlled with anti-nausea medicines.
Before receiving TRODELVY, tell your healthcare provider about all of your medical conditions, including if you:
- have been told that you carry a gene for UGT1A1*28, which can increase your risk of getting side effects with TRODELVY, especially low white blood cell counts, with or without a fever, and low red blood cell counts.
- have liver problems.
- are pregnant or plan to become pregnant. TRODELVY can harm your unborn baby. Your healthcare provider should check to see if you are pregnant before you start receiving TRODELVY. TRODELVY may cause fertility problems in females, which could affect your ability to have a baby. Talk to your healthcare provider if fertility is a concern for you.
- are breastfeeding or plan to breastfeed. It is not known if TRODELVY passes into your breastmilk and can harm your baby. Do not breastfeed during treatment and for 1 month after your last dose of TRODELVY.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Certain medicines may affect the way TRODELVY works.
The most common side effects of TRODELVY include decreased white blood cell (leukocyte and lymphocyte) and red blood cell counts, feeling tired or weak, hair loss, constipation, increased sugar levels in the blood, decreased protein levels (albumin) in the blood, decreased appetite, changes in kidney function test, increased levels of enzyme called alkaline phosphatase in the blood (test for liver or bone problems), and decreased levels of magnesium, potassium, and sodium in the blood.
These are not all of the possible side effects of TRODELVY. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Important Facts about TRODELVY, including Important Warning.
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