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Dealing With Metastatic Breast Cancer

Meeting The Challenges Of Metastatic Cancer

Metastatic Breast Cancer: Dealing with the Emotional Fallout

To understand your situation, you may want to get a second opinion. Many people find that it helps to get an opinion from another oncologist, and many doctors encourage it.

Your doctor can help you cope with cancer symptoms and treatment side effects. For example, if you have pain, your treatment might include surgery to remove a tumor in a painful area. Your doctor might also prescribe pain medication or anti-nausea medication.

When To Seek Help

Being preoccupied with negative thoughts can be a sign of depression. Other signs include feeling low for most of the day, every day feeling guilty or worthless or a burden on your family and not being able to enjoy things that normally give you pleasure. Depression can also cause physical symptoms such as poor appetite, tiredness and not sleeping well. Like all health issues, depression needs professional help. Your GP will be able to refer you to someone and treatment is usually very effective.

Many women with metastatic breast cancer seek professional help with managing depression, anxiety or stress. You should not feel embarrassed about telling your doctor if you are struggling to cope emotionally or if you think you need help. You are experiencing a life-changing situation and it is normal to need support while you are coming to terms with your diagnosis and getting your thoughts in order.

A number of health professionals may be able to help you work through these issues including your GP, clinical psychologists, social workers and psychiatrists. If you feel some ongoing counselling would be of benefit, your GP can refer you to an appropriate person and arrange for you to have up to 10 Medicare-subsidised appointments through the GP mental health treatment plan.

BCNAs Anxiety, depression and breast cancer fact sheet has more information about the symptoms of anxiety and depression and how to seek help.

It Was So Much Harder The First Year Than It Is Now

Its been almost three years since my diagnosis of MBC and I can tell you, it was so much harder the first year than it is now. Like many, my first thoughts were focused on dying, planning my funeral, and getting my affairs in order. I spent most of the first year feeling very sad and crying a good part of the time. Every new ache and pain scared me silly.

Nearing my one-year anniversary, I totally fell apart, so I took myself to a doctor and got on an antidepressant. Seeing that doctor was one of the best things that could have happened! After listening to my story, his words were: Girl, go home and get your s*** together! Stop dying and start living! It may sound harsh but it was exactly what I needed to hear.

Ive tried to live that way ever since and my life has been so much better. Yes, I still worry over every new ache and pain, but take a pain pill and get on with my life. I go on vacations, shop, make all kinds of things, and live as normally as possible.

Heres my advice: Give yourself time. Its a shock and you wont be thinking clearly at first. Dont be afraid to ask for, and demand, any meds you need for pain, sleep, depression. A few sessions with a cancer counselor can be beneficial.

After the shock is over, look into your financial needs. I didnt realize I qualified for disability until six months later. Once I applied, I received my acceptance letter three weeks to the day

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Cherishing The Current Moment

Living in every moment reflects the participants view of MBC as causing them to live with finite time after the inherent deep thinking that they have an incurable illness. Therefore, they cherished every present moment and spent the valuable time they had left with no regrets. The following statements reflect two participants views:

Nowadays, I take health regimen such as exercise and eat healthy food every day. I do good to others and enjoy every beautiful moment. .

I do not want to think about the future in my heart. In fact, I dare not think about it. I continue to cherish my day as a routine. .

Find A Support Network

Linda Carey to join the Stage IV Stampede on Metastatic Breast Cancer ...

For her, one of the best ways to cope has been through peer support groups, both online and offline.

“There’s an amazing Facebook group called the Young Breast Cancer Network, which I was directed to when I got my primary cancer diagnosis – and they also have a subgroup for people who have secondary cancer,” Emma says.

“It’s a really sad group to be part of sometimes – quite a number of ladies from the group have died recently – but it’s also a really, really supportive group,” she adds. “Sometimes it’s easier to talk to people who are in exactly the same boat, who you can voice your fears to without upsetting anyone around you. As much as the people around you love and support you, there are so many little things that they don’t quite understand because they’re not right where you are.”

Emma also attends a local Breast Cancer Care support group for people living with secondary breast cancer, and says it’s fantastic to meet up in 3D.

“Some months we have information sessions – most recently on haircare during chemo – and other months we just get together to chat about what’s gone on,” she explains.

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Detecting Cancer Types With Better Screening

New screening scans and biopsies are contributing to more favorable outcomes, says Erica Mayer, MD, director of breast cancer clinical research at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston.

Since newer medications are only effective when targeting certain cancers, getting tumors checked by a biopsy to look for unique aspects of the tumor is critical.

A good proportion of patients are found to have a tumor type for which appropriate medications can be available for them, Dr. Mayer explains. In addition, she says that without this kind of testing, doctors may wind up treating a cancer with the wrong medication.

Symptoms And Diagnosis Of Metastatic Breast Cancer

The most common parts of the body where breast cancer tends to spread are the bones, lungs, brain, and liver. But metastatic breast cancer can affect other parts of the body, as well.

Metastatic breast cancer symptoms can be very different depending on the cancers location, but may include:

  • biopsy of any suspicious area

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    a tap, removal of fluid from the area with symptoms to check for cancer cells a pleural tap removes fluid between the lung and chest wall a spinal tap removes fluid from around the spinal cord and a tap of fluid in the abdomen removes fluid in the abdominal cavity

These tests may also be used if you have no history of breast cancer and your doctor is having trouble determining the cause of your symptoms.

When breast cancer spreads to other parts of the body, its important to confirm whether the cancer has certain characteristics that may influence your treatment options, such as HER2 status and hormone receptor status. If you have been diagnosed with metastatic breast cancer years after an early-stage breast cancer diagnosis, it may seem logical to assume that the hormone receptor status and HER2 status are the same. But research has shown that the hormone receptor status and HER2 status of early-stage breast cancer can be different than that of a metastatic recurrence.

A biopsy may be done to determine these factors that can influence your treatment, which will be listed in your pathology report.

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Expand Your Social Circle

People with cancer who have more social support tend to feel less anxious and depressed and report a higher quality of life, according to the American Cancer Society . That can include informal social interaction, such as spending time with family, friends, and acquaintances, as well as more formal sources of support, such as working with a counselor or joining a support group. Research has shown that participating in metastatic breast cancer support groups can improve mental well-being and quality of life.

Get Help From A Professional

Young with Metastatic Breast Cancer: Dealing With Chronic Illness & Scanxiety

If youre feeling anxious all the time, talk to your doctor. He or she may be able to refer you to a social worker, psychologist, or psychiatrist experienced in working with people who have metastatic breast cancer. Psychotherapy, which is sometimes combined with medication, can help you change negative patterns of thinking and behavior and enable you to feel less anxious and live each day more fully.

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From Cured To Stage 4

Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.

Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.

âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â

In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.

âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â

Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.

âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â

And along with mets, she also had to deal with many misconceptions regarding her disease.

The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.

Caring For A Loved One With Cancer

Family members and friends often play an important role in taking care of a person with metastatic breast cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves. Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

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Nutrition And Unwanted Weight Loss

Although a loss of appetite can make it hard to eat, its important to get enough calories, protein and nutrients. Eating helps strengthen your body.

Your health care provider can help you decide how many calories you need each day.

For most people with metastatic breast cancer, major weight loss isnt a problem until the cancer is very advanced.

Tips to prevent unwanted weight loss

  • Eat small meals and snacks every few hours throughout the day.
  • Try not to snack too close to mealtimes to avoid feeling too full before meals.
  • Limit fluids at meals to avoid feeling too full, but drink plenty of fluids at other times during the day.
  • Take high-calorie snacks with you when youre on the go.
  • Eat your favorite foods more often.
  • Increase the calorie content of meals and snacks with healthy choices by adding oils, avocado, nuts, pesto and natural peanut or almond butter.
  • Sip on homemade smoothies, milk shakes or prepared liquid supplement drinks .

Watch our video on diet and nutrition tips to manage side effects during treatment for metastatic breast cancer.

For more tips on improving nutrition and loss of appetite , visit the National Cancer Institute website.

Fred Hutchinson Cancer Centers Cook for Your Life website offers recipes, cooking videos and nutrition and health information in English and Spanish.

Side Effects And Complications

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Anti-estrogens can increase the risk of thrombosis and cause changes in the lining of the womb. Aromatase inhibitors can cause muscle and joint problems, among other things. They can also lower bone density, which increases the risk of bone fractures.

Younger women who are having hormone therapy stop getting their periods. They cannot get pregnant during treatment. The treatment often leads to problems that can also arise during menopause, such as hot flashes, sleep problems, dry skin and dry mucous membranes.

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Limitations And Future Research

This research has been conducted on Chinese MBC women and in one cancer hospital in China and cannot be generalized for the MBC women of other countries. Nevertheless, it is worth noting that the experiences of Chinese MBC women have been generally explored. However, this study did not explore MBC womens perceptions of the treatment decision-making processes. Therefore, it is recommended to perform similar studies on the MBC women from other religions and countries and cancer treatment decision-making processes.

Meditate For 10 Minutes A Day

The goal of mindfulness meditation is to learn how to distance yourself from the thoughts, emotions, and reactions that cause you to feel out of control and instead focus on simple moments in the present. A report published in the July 2016 issue of the journal Breast Cancer found that practicing mindfulness meditation can help reduce stress, anxiety, and depression in people diagnosed with breast cancer. Many cancer centers offer classes in mindfulness meditation, but you can also easily do it on your own. Numerous free and low-cost apps are available, and many cancer centers offer free guided meditations on their websites. Shumay recommends finding a comfortable spot in your home where you can sit, lean back, or lie down. Meditate for 10 to 20 minutes at the same time each day.

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Support For Your Caregivers

Your loved ones might also need help coping. Having a family member or friend with metastatic cancer is challenging, especially for people who help care for you. They can try the ways of coping above. Or your health care team can suggest other tips. For example, there are in-person and online support groups for family members of people with cancer.

Side Effects And Mental Health

Metastatic Breast Cancer: Dealing with the Emotional Fallout

Cancer treatment can be difficult to go through. It often has severe side effects and sometimes leads to complications. The side effects vary depending on the kind of treatment, but they can often be effectively treated themselves. The treatment of side effects is part of what is known as supportive care. If the treatment is too distressing, though, there may be good reasons for deciding not to have treatment.

One common side effect is . The word ‘fatigue’ describes paralyzing physical and mental exhaustion and tiredness that can be accompanied by increased irritability. People may be affected by fatigue the whole time they are having treatment, and sometimes even longer. It is most likely caused by physical and psychological reactions to the disease and the treatment. Fatigue can be very distressing and make people feel down. Even small tasks may become impossible or very difficult to perform. It is important to talk to your doctor and find your own personal way of dealing with fatigue.

Any life-threatening disease that requires repeated courses of physically draining treatment will inevitably end up affecting your mental health too. Almost everyone in this situation will feel down from time to time. If these feelings last for a longer period of time, may develop. It is then important to get treatment because depression is in itself a serious disease.

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Survival Rates Of Stage 4 Breast Cancer

Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.

Factors affecting survival rate of metastatic breast cancer

Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:

  • Response to treatment
  • The extent and location of metastases
  • The presence of other health issues not related to cancer
  • The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.


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