Living with Metastasis: The Emotional Toll of Breast Cancer (Stage 4) as a Chronic Illness
I have Stage 4 breast cancer. However, I am also in clinical remission, with no sign of cancer in my liver (which was once riddled with tumours).
What does this mean?
We can assume that there are still cancer cells in my body and that, eventually, we will find new tumors. Until that time, I undergo chemotherapy and herceptin treatments once a month (if my cancer were hormone positive, I might be a candidate for some other kind of treatment but this is what works for me).
I stay in bed for a few days.
And the rest of the month I feel fairly good.
My oncologist likes to say that, for women in my situation, treating Stage 4 breast cancer is like treating diabetes (or any other chronic illness). It must be taken seriously and treated but it can be managed and, when one responds well, the progression can be slowed or even stopped for long periods.
This is good to hear, given the alternative. And it’s infinitely more hopeful than the initial prognosis when my cancer first returned.
But chronic illness brings its own set of challenges. While I am happy to be going for treatment only once a month, in some ways this makes it harder to face treatment. I certainly resent it more. And long term chemotherapy does take its physical toll. But it is the emotional grind that is perhaps the most debilitating.
Some days it’s hard to accept that I will always be a cancer patient and that, unlike many other women who live through breast cancer, I will never put it behind me. Sometimes, I mourn for my former ambition and the faster paced life I have left behind. And sometimes, depression seeks to envelop me like a heavy blanket. On those days, it’s all I can do to get up in the morning.
I wrote a short post on my personal blog, Not Just About Cancer, last week about fighting the blues and several wise women offered advice and support. For, the last few days, I have been making a concerted effort to do what I need to feel well and, today, it feels like it’s working.
I thought I would share some of the advice I have received and other things that help me to cope and stay well:
1. I try to remind myself that my emotions do tend to be tied to my chemo cycles. Chemo weeks (especially a few days after treatment) can be a bit of an emotional trough.
2. Eat well. I am forty years old, and I continue to be shocked when an improvement in my diet has an almost immediate effect on my emotional well-being.
3. Get fresh air and exercise. Close to chemo days, this could mean sitting outside for a few minutes. As I get stronger, getting sweaty really, really helps. I went for a run/walk yesterday (my ten year old can walk faster than my ‘running’ so it can be hard to tell the difference) and came back a different woman.
4. Take time to do things that nurture my spirit. The tension between things I ought to do and the things I enjoy doing is one that is familiar to almost everyone I know (and, I for one, spend far too much time engaged in activities that fall into neither of these categories). I am trying to remind myself that I am more productive when my creative side has been nurtured.
5. Take some time to myself. Last week, I decided not to feel guilty about just lying around reading when my kids were out and I was stuck in bed anyway.
6. Realize when it’s time to get outside of myself. This is a very difficult balance for me. It is sometimes tempting to keep social activities down to the bare minimum (to those required by parenting) but I need my friends and family and I need to stay engaged in the world.
Balancing the last two points is enormously tricky. On the one hand, I know I can burn myself out with social events when I recover from chemo and get the itch to be active. Lately, though, my tendency has been to turn inward. It can be especially hard to see folks I once worked with, as they continue with the work and the rhythms that I did not give up by choice.
But my friends like and care for me because of who I am. And just as I want to be known as more than a person living with cancer, I need to remember that my friends are also well-rounded people who are defined by much more than the absence of cancer in their lives.
And besides, laughing and playing with my friends is good for me.
This brings me to my final point.
7. Take the time to remind myself of everything that is good in my life.
There are many things. And I am enormously grateful.
I would be very interested in hearing from other women living with metastatic (Stage 4) breast cancer. What do you do to stay emotionally healthy? You can post your response as a comment below.