How to Take Care of Your Emotional Health When You’re Living With HR+/HER2- Metastatic Breast Cancer

“A diagnosis of metastatic breast cancer means that you will most likely be living with breast cancer for the rest of your life,” says Hanna Y. Irie, MD, PhD, a medical oncologist who specializes in breast cancer care at Mount Sinai Hospital in New York City. “Initially, this can be a hard concept to wrap your head around.”

Your emotional and physical health are more closely linked than you might think, though. “When you take the time to address your emotional needs, you’re more likely to make more informed treatment decisions and communicate more effectively with your treatment team,” says Cassie Spector, LCSW, an oncology social worker and the program coordinator for breast and gynecological cancers at CancerCare in New York City.

Here’s how to feel more in control of your emotions:

• Find ways to express how you feel. Whether it’s joining a support group, keeping a journal, or talking with a counselor, letting your feelings out can help you better understand them.

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• Lean on your loved ones. Chances are, your loved ones want to be there for you but might not know how. Be open and honest with those close to you about how you feel and how they can support you.

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• Engage in healthy lifestyle habits. Eat a nutritious diet, prioritize your sleep, and stay active, all of which can help boost your overall well-being.

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• Take steps to manage stress. A breast cancer diagnosis can be understandably stressful.

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  But finding ways to relax — whether it’s with meditation, guided imagery, relaxation techniques, or even making time for your favorite hobby — can help you unwind and take your mind off the disease.

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• Focus on what you can control. Educate yourself about the condition, stay on top of your checkups, lean into healthy lifestyle changes, and become an active participant on your care team.

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• Pursue your dreams. “I’ve found that many people with metastatic breast cancer use it as an opportunity to take charge, be bold, and take on the dreams and passions that they’ve harbored for much of their life but were either held back or afraid to step forward on that path,” says Dr. Irie. Once they decide to follow their dreams, “They’ve gotten a significant amount of fulfillment from it,” she says. Think about what’s really important, and don’t be afraid to do the things that will make you happy.

Keep in mind, the strategies that work best for one person may not work well for another, and finding the right approach may take some trial and error. “You have to try different things before you find a few strategies that help you feel even a little bit better on a day-to-day basis,” says Irie.

“It’s very important for anyone struggling with thoughts surrounding metastatic breast cancer to be open and communicate with a provider,” says Irie.

If you’re feeling overwhelmed or anxious, and it’s affecting how you’re sleeping or eating, your medical team would want to know, so they can help address these concerns and support you,” says Spector. If you don’t speak up, your team won’t know what type of support you need, she adds.

Hesitant to speak up? Don’t be. “It can be intimidating at first, especially when appointments are focused more so on your physical well-being or scan results or medication,” says Spector. “However, these conversations can make a significant difference in how you’re feeling supported or understood.”

To start the conversation:

• Choose a good provider. Think about who on your cancer care team you feel most comfortable opening up to — anyone from an oncologist or nurse practitioner to a psychologist or social worker — and broach the subject with them first, says Irie.
• Prep for your appointment. Keep notes about how you’ve been feeling. Have you noticed changes in your appetite, motivation, or sleep? “It’s easy to forget in the moment, so bringing notes can be helpful to refer back to,” says Spector.
• Bring a loved one with you. They can help you articulate your feelings and act as an advocate on your behalf, says Spector.

“Talking with your medical team about how you’ve been feeling is not a weakness. It’s a strength,” adds Spector. “It’s important not to minimize what you’ve been feeling, as your emotional health is a critical part of your care.”

“Communicating your fears, worries, and anxieties, and having that type of release, is very therapeutic,” says Irie.

Think about what type of support might work best for you. “Everyone is a bit different,” says Spector. For example, she says, some people prefer to be in a group specifically for metastatic breast cancer. Others might prefer to be in targeted groups, such as those for young adults, regardless of their diagnoses. Still others may prefer individual counseling, mentorship, or peer support.

Not sure what might work best for you? “Really lean into why you’re seeking support,” Spector advises. “Do you want to find connections with others who have a metastatic diagnosis? Are you comfortable sharing in a group setting? Would it be helpful to hear other people’s experiences?”

You can also reach out to different support group moderators to get a sense of what topics tend to come up. This can further help you decide if a given group might be beneficial for you, she adds.

• After a metastatic breast cancer diagnosis, it’s just as important to take care of your emotional health as it is your physical health.
• You may feel more in control of your emotions by focusing on the future, including what types of treatments you may choose or what goals and dreams you want to pursue.
• Consider joining a support group or mentorship program for additional support.