Your doctor just told you that you have breast cancer that has spread to another part of your body – maybe more than one part. You now have Metastatic Breast Cancer (MBC), also called stage 4 breast cancer or Advanced Breast Cancer. You may have been diagnosed with stages 0-3 breast cancer at some point in the past, or your initial diagnosis is stage 4. You are freaking out because your doctor has said there is no cure for MBC and that you will be in some kind of treatment for the rest of your life. I know this feeling. I have been there.
Breathe. Take a deep breath. And another. And a couple more. You are alive today and you get to decide how you want to handle this news and what to do. You have options. And you get to choose among them based on what is important to you.
For me, it was important to understand everything I could about my cancer. Even if you were initially diagnosed stage 0-3, the cancer may have changed. Ask your doctor about getting a tissue and/or liquid biopsy to understand hormone and HER2 status and any mutations the cancer may have. That information will provide your medical team with an understanding of treatment options. Some drugs are only available to people with certain mutations in their cancer, so having this information gives you the broadest possible set of treatments.
I also encourage you to think about what matters to you as you consider your treatment options. Quality of life is important – knowing how you want to spend the (hopefully many) years you have left will help you make the treatment decisions that are right for you. For example, if you work schedule isn’t flexible or you have lots of family obligations, going a long distance for treatment may be difficult. Talk with your medical team about what’s going on in your life that may influence treatment choices. For me, I travel a lot for business and pleasure, so my doctor suggested oral therapies before infused ones so that I would not have to come into the office as often.
Ask your medical team about side effects of the drugs and how they might be managed. Knowing how to handle issues like fatigue, dry skin, or hair loss may make the medications more tolerable. For many common treatments there are groups on Facebook for people on that medication where you can also get ideas for side effect management.
If you’re currently in pain from where the cancer is located, perhaps some radiation therapy can complement your medical treatment. In addition, you should ask about palliative care services available in your area. Palliative care helps with pain and quality of life management and is not hospice. It can make a huge difference in your quality of life.
An MBC diagnosis is scary, and it means things in your life will change. But by taking it one day at a time, controlling what you can and understanding your options, it will get easier. Trust me.