Get Support During Advanced Breast Cancer

With stage III or IV breast cancer, you’ll probably put a lot of focus on your treatment. That’s good. But remember that it’s also important to do things to help yourself feel as good as you can every step of the way.

“Breast cancer is unlike some other cancers because even if your cancer has metastasized [spread to other areas of your body], you may have many, many years ahead of you. You want to make them good years,” says Erin Macrae, MD, a medical oncologist with Columbus Oncology and Hematology Associates in Columbus, OH.

Steven Z. Pantilat, MD, a palliative care doctor and author of Life After the Diagnosis, agrees. “You don’t have to choose between surviving and your well-being,” he says. “In fact, making your care and comfort a priority can improve your treatment experience.” Try these seven ways to do just that.

Don’t Grin and Bear It

“You should not feel badly if you’re in pain and need more medication,” says Stephanie Bernik, MD, chief of surgical oncology at Lenox Hill Hospital in New York City.

If you take a medication that causes side effects that bother you, such as constipation or brain fog, “Tell your doctor,” Bernik says. “There are new techniques and medications to try, like slow-release pain medication, patches, and even Botox in muscles if you’re using a tissue expander after mastectomy.”

Choose Your Cancer Team Carefully

Your experience will be better if you can talk to your doctors about what’s on your mind, and feel that they support you. And yes, it’s OK to switch doctors mid-treatment.

Marty Oxford, 55, wasn’t happy with the way her treatment for stage III breast cancer was going. “After surgery in 2015, I started chemo [at a local hospital] right away. A few months in, I was so weak I couldn’t take care of myself, and the doctors I was seeing didn’t seem to know what to do,” says Oxford, who lives in Pine Mountain, GA.

So Oxford made a bold move: She switched to a different facility, which specialized in cancer care, in the middle of chemo and radiation. “There, I was offered nutrition support, physical therapy, occupational therapy, and even acupuncture,” Oxford says. “I felt almost embarrassed to leave my other doctors -- like I should apologize for choosing what was best for me! But having a team that addressed my whole health helped me go from fighting for my life to living it.”

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Ease Side Effects With Exercise

It may sound counterintuitive to get moving when you’re tired and nauseated. “But research consistently shows that exercise decreases side effects like fatigue, depression, and pain,” says Katie Deming, MD, a radiation oncologist with Kaiser Permanente in Portland, OR.

“Even walking 10 minutes at a time a few times a day can make a difference,” Deming says. “Strength training, like yoga or light weights, is also very helpful.” If you’re new to exercise or you have trouble moving because of treatments like surgery, work with a physical therapist. Ask your cancer doctor to recommend someone.

Realize That 'Pampering' Is Crucial Self-Care

“When you’re going through cancer treatment, you should absolutely do things that make you feel better about yourself. It can boost your self-confidence and even motivate you to keep taking healthy steps, like exercising,” Deming says.

That may be getting a wig if you’ve lost your hair (or wearing your temporary baldness proudly), having massage therapy (seek out a therapist who has treated people who have breast cancer), or finding the right lotion or oil to soothe dry skin. Not sure what products to use or who to see? Ask an oncology nurse -- they often know what works during breast cancer treatment.

Seek Support

When you’re used to helping everyone else, it can feel strange and even uncomfortable to be the one asking for a hand or a listening ear. But consider it part of your treatment, Deming says. Research shows that women with breast cancer who have social support tend to outlive those who don’t.

If you’re worried about burning out your closest friends and family, cast a wide net. “I asked the Prayer Line at my church not just to pray for me, but also to help with shopping and appointments,” says Anna Renault, 67, of Baltimore, who has stage IV metastatic breast cancer.

And when people ask if they can help, don’t just say yes. Tell them specific things that you need, like meals or child care. “I encourage patients to ask someone they enjoy spending time with to drive them to and from treatment,” Deming says. “It gives them a way to support you and can help you keep your spirits up.”

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Ask Your Doctor About Palliative Care -- Now

Many people think palliative care is the same as hospice care, or that it’s only for end-stage diseases. It’s not.

“Palliative care physicians address all the symptoms of cancer and its treatment, and focus on improving your quality of life and your family’s, too,” says palliative care doctor Sandra Pedraza, MD, of Ohio State University’s Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. “We can help with pain, anxiety, stress, depression, dry mouth, muscle and joint pain, hot flashes, sleep trouble, swelling, the feelings that your quality of life isn’t good because of cancer or treatment, and more.”

Research shows that people who use palliative care have better treatment experiences. So if you don’t feel as good as you want to, “ask your physician to refer you to palliative care,” Pedraza says. In addition to prescription medication, palliative care specialists also help you use complementary treatments like acupuncture, hypnosis, biofeedback, and music therapy, which studies show can improve quality of life.

Not all doctors understand the role of palliative care in cancer treatment. If yours tells you that you’re not “ready” for palliative care, “Say, 'I know I’m not dying, but palliative care can also be for living well. I’d like to see a palliative care expert while I continue to see you for cancer treatment, too,' ” Pantilat says.

Talk to People Who Can Relate

Anxiety and fear can increase feelings of pain and lead to other issues, like sleep troubles. “Arming yourself with information can help ease your mind and empower you to be your own advocate,” Bernik says.

That doesn’t mean Googling everything you can find: “You may end up more anxious, because you can’t filter out worst-case scenarios or bad information,” Pantilat says.

Instead, talk to other people who’ve been through cancer treatment. “What helped me was talking to an old friend who had survived cancer,” Oxford says. “There’s no training for how to be a cancer patient, but my friend was able to say, ‘This is what is about to happen, here’s when you need to ask for help,’ ” she explains.

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If you don’t have someone to talk to, consider joining a local or online support group. And you may also want to talk with a counselor or social worker who has worked with people who have cancer.  Your doctor or hospital should be able to help you find one.

Above all, remember that you’re much more than a breast cancer patient. You’re still you, and all of your resources can help you get through this difficult time.

WebMD Feature Reviewed by Laura J. Martin, MD on March 19, 2017

Sources

SOURCES:

Erin Macrae, MD, medical oncologist, Columbus Oncology and Hematology Associates, Columbus, OH.

Steven Z. Pantilat, MD, palliative care doctor; author of Life After the Diagnosis (Da Capo/Lifelong Books, February 2016); professor of medicine, Kates-Burnard and Hellman Distinguished Professor in Palliative Care, UCSF, San Francisco.

Stephanie Bernik, MD, chief of surgical oncology, Lenox Hill Hospital, New York City.

Katie Deming, MD, radiation oncologist, Kaiser Permanente, Portland, OR.

Sandra Pedraza, MD, palliative care doctor at the Ohio State University’s Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.

Cancer: "Postdiagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project."

New England Journal of Medicine: "Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer."

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