A diagnosis of advanced breast cancer has a way of making you focus on what really matters. You didn't choose your condition, but you can choose to live well with it.
Dana Dinerman, 40, realized that within a year of her first breast cancer diagnosis. After chemo, a mastectomy, and radiation, she learned her disease had spread. "It was scary. I almost passed out," says the mom, entrepreneur, and breast cancer advocate from San Diego. "At some point I said to myself, 'I'm going to stop trying to outrun this thing. I'm just going to live my life and cancer is part of it.'"
Dinerman and thousands of others are living proof that committing to your mental and physical health makes a big difference in life with advanced breast cancer.
Riding the Emotional Wave
Treatment for the condition has one basic approach: Try the best option for your cancer, and if that stops working, move on to the next. That means the future is unclear, which can bring up feelings of fear, depression, hopelessness, and grief.
"That uncertainty is very real," says Susan Brown, senior director of education and patient support for Susan G. Komen. "You may also have a certain degree of anger, especially if this is a recurrence. It's normal to feel like you did everything right the first time and shouldn't have to go through it again."
Whatever your feelings are, it’s OK to feel them. Then try to handle those feelings in ways that will help you in the long run. Educate yourself on your condition. Create a go-to support list, including friends, family, faith leaders, and oncology counselors. Join an online or in-person support group for people with advanced breast cancer. It feels good to be with people who get it.
The 3 Ps
Cancer can't stop you from making the most of your life. Inspired by a friend’s attitude and actions after she was diagnosed with advanced breast cancer, Dinerman learned the power of the three Ps:
- Keep planning your life: Don't cancel that beach trip. Keep working on your daughter's birthday party. Check a few things off your bucket list. Plans make life feel possible.
- Be present: Make your life more meaningful by giving people you love your full attention. Dinerman practices being present by riding horses. "The thing about horses is you have to be in the moment," she says. "You can't be thinking, I have to get a scan tomorrow. You have to think about that animal with every move. It helps me."
- Have a (mostly) positive attitude: Some days are going to get you down. And that's OK. But whenever you can, find ways to be grateful and have a positive perspective.
Learn When to Control or Let Go
After your diagnosis, working on your treatment plan may give you a much-needed voice in the decision-making process.
"Treatment at this point is really different," Brown says. You may feel more freedom to focus on the therapies that will give you the kind of life you want, instead of others that cause a lot of tough side effects.
Before you meet with your health care provider, take the time to think through your values, lifestyle, and how you want treatment to fit in. Consider all options, including clinical trials. Brown says these research studies may be a better option before you’ve had a lot of treatment for metastatic disease.
When she was first diagnosed, creating a treatment plan helped Dinerman feel in control and mark progress. "But you have to roll with the punches at certain points," she says. "Do your research, but don't let it control your life."
Be Good to Yourself
When you give yourself permission to focus on your own happiness for a few hours, you're stronger mentally and physically. Every little bit gives you an edge before your next treatment.
"I'm busy taking care of my son and husband, but I have to take care of myself first so I can take care of them," Dinerman says. "The days you have to get a scan or treatment can make you feel crummy and frustrated. Take a bath, get a massage or watch a bunch of movies. Do whatever brings you joy. I do it all the time."
All the usual health advice applies for people with this condition -- don't smoke, don't drink a lot, and eat healthy food -- but exercise is key.
"You don't have to go out and run or be aggressive at the gym. Just move," Brown says. "Take a walk. Do yoga. Safe activities offset fatigue and may even increase appetite."
Bonus: Exercise releases endorphins, feel-good chemicals that give your mental health a boost.
Keep Control of Symptoms
Advanced breast cancer treatments often have side effects, which can be tough to power through. "When I have radiation, I get tired towards the end of the week. Chemo does the same thing," Dinerman says. "This is a different kind of fatigue from what other people experience."
Other side effects include dry skin, weight gain or loss, rashes, nerve damage, pain, and nausea.
This is where a comfortable relationship with your cancer care team comes in handy. There’s often help for many treatment side effects, but your team can only treat them if they know what’s bothering you.
Jot down details about how you feel -- When do you feel symptoms? Where do you feel them the most? -- and talk about what's happening at your next appointment.
"People don't like to whine or complain and feel reluctant to talk about what's bothering them," Brown says. "Getting ahead of it makes the interventions more effective."