Advanced Breast Cancer

Emotional effects

A diagnosis of metastatic disease can be overwhelming. You’ll experience a range of emotions. This is completely normal. Allow yourself to express your emotions freely, no matter what they are. You’re still the same person you were before your diagnosis. Expressing your emotions helps you stay that person.

Importance of a healthy lifestyle

Maintaining your physical health can help boost your mental health. The right amount of sleep, regular exercise and a healthy diet can all improve your mood.

Although it sounds counterintuitive, physical exercise is sometimes the best treatment for fatigue. Studies have shown that people with breast cancer who get regular aerobic exercise, such as walking or biking, feel less tired and have more energy. Think about the physical activity you enjoy most and do it daily, as often as you can tolerate it. You can modify your favorite form of exercise if you experience pain or discomfort.

Side effects such as loss of appetite or nausea can make proper nutrition challenging, but a healthy diet will help you gain strength, which is especially important during treatment cycles. Nutritionists recommend eating a variety of foods, including vegetables, fruit, low-fat milk and dairy products, whole grains and legumes, and healthy snacks, such as yogurt or nuts. Light exercise before mealtime may help increase your appetite.

Finding a way to manage stress will strengthen your coping abilities. Explore various ways to reduce stress to learn what works best for you. Some options include meditation, guided imagery, muscle relaxation and yoga. Yoga may help relieve some of the discomfort associated with metastasis. Ordinary “escapes,” such as reading, watching television and playing games, can also help you relax.

Set priorities

Now is the time to examine your life and determine your priorities. Everyone has different priorities, so listen to yourself, not others, while you set yours. Some women find comfort in maintaining their current routine and continue working. Others choose to devote more time to hobbies, traveling or spending time with family and friends. Many people with advanced breast cancer have noted the importance of simply “finding joy in life” by having fun in ordinary ways or seeking adventure in new ways. Volunteering in your community may give you perspective as a sense of purpose, and you may find comfort in spirituality. Think about what matters most to you.

Power of relationships

Maintaining strong relationships is crucial to emotional well-being. People who want to support you don't always know how to show it. If some of the people in your life seem to avoid you, it is just because they don’t know what to say or are nervous they will say the wrong thing. Reach out to family and friends, and tell them about your range of emotions. Offer to get together. You can take the initiative. Admit that you may need assistance, and let your friends and family help you. Keep talking with them about the everyday things you talked about before your diagnosis. This will help them realize you’re still the same you.

Intimate relationships are sources of strength, but they may change in challenging ways after your diagnosis. Cancer and its treatment can affect how you feel about yourself and your body and how you relate intimately to your partner. It’s normal to have doubts and concerns, such as wondering whether your partner finds you attractive. Open communication with your partner is essential to maintaining a strong intimate relationship. You and your partner should share your concerns and fears with each other.

The anxiety of coping with metastatic disease, and side effects such as fatigue and pain, affect how you feel sexually. Many people with cancer lack sexual desire. This is something you can work to change. Managing your side effects can help you feel better overall, which may help you feel more desirable and more interested in sex. Unless your doctor says otherwise, it is safe to have sex during cancer treatment.

Talk with your partner about ways to be intimate other than sexual intercourse. If you are single during your cancer treatment, you may decide to give yourself some time to adjust to your new normal before beginning a sexual relationship. Counseling (individual, couples and/or sex therapy) may also be helpful.

Monitoring for signs of depression

For some people, the emotional distress of living with advanced breast cancer can develop into depression. Remember that depression is more complex than feeling sad or hopeless. A diagnosis of depression requires that at least five of the following symptoms occur every day for at least two weeks:

  • Persistent sad, anxious or “numb” feelings
  • Loss of interest or pleasure in hobbies and activities
  • Feelings of hopelessness
  • Feelings of guilt, worthlessness or helplessness
  • Fatigue and loss of energy
  • Difficulty concentrating, remembering and making decisions
  • Sleep problems
  • Changes in appetite and/or weight
  • Thoughts of death or suicide, or suicide attempts
  • Restlessness or irritability
  • Social withdrawal
  • Repeated episodes of crying

People with mild depression may benefit from counseling without medications. Moderate or severe depression is typically managed with a combination of counseling and medication (antidepressants). Many antidepressants are available. Each one has different side effects, which can often be managed by adjusting the dose. Your doctor will work with you to find the antidepressant that works best for you with minimal side effects. Drugs known as selective serotonin reuptake inhibitors (SSRIs) are usually recommended as first-line treatment. Antidepressants often take about four to six weeks to start working.

Talk therapy, or psychotherapy, for depression most often includes cognitive behavioral therapy. In cognitive behavioral therapy, a mental health professional will help you change negative thoughts and behavior. Counseling can help you improve your communication with family members and friends, as well as ease fears about your chronic illness.

Support groups

No person should have to face advanced breast cancer alone. Talking to others with advanced breast cancer can help you learn more about the disease, treatment options, resources and how to cope. Support groups provide emotional support and help you feel less alone.

Various kinds of support groups are available. Your doctor should be able to provide you with a list of local meetings. Some are held online, offering the advantage of being available all the time. These are good options for people who prefer not talking face-to-face or who do not feel well enough to go.

Advanced breast cancer changes your life, but it doesn’t change who you are. Taking care of your emotions helps you stay yourself.

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