How Well Are You Managing Life With Metastatic Breast Cancer?
Lara DeSanto | June 5, 2018
- 0 My diet is mostly plant-based.
- 1 Most of my meals include a red meat or processed meat component.
- 2 I regularly eat take-out or fast food.
What is your diet like?
It’s important to eat a healthy diet when you’re living with metastatic breast cancer. But what exactly does that mean? While there’s no diet plan that can cure cancer, there are certain recommendations you can follow to help you keep your strength up and stay as healthy as possible. One way to make sure you’re staying healthy is to follow a plant-based diet, which is recommended by the American Institute for Cancer Research. This doesn’t necessarily mean you have to go completely vegan or vegetarian, but it does mean your diet should center mainly around plant foods, including vegetables, fruits, whole grains, and beans. To help you stay on track, follow this general rule at mealtime: two-thirds or more of your plate should be plant-based foods, and one-third of your plate or less should be animal protein. If you regularly eat red meat or processed meat, make an effort to cut back. “It’s also important to maintain bone health,” says Roberto Leon-Ferre, M.D., an oncologist at the Mayo Clinic who specializes in breast cancer. “Increasing their vitamin D intake, making sure they are having enough calcium in their diet … I think that’s hugely important, particularly in breast cancer patients.” Tell your doctor about your regular eating habits and ask if you need to make any other adjustments.
Do you drink alcohol, and if so, how often?
It’s well established that drinking alcohol can increase the risk of certain cancers, but what about drinking when you already have cancer? Heavy drinking can cause a variety of other health problems, as well, and when you’ve been diagnosed with metastatic breast cancer, your health is a top priority. Additionally, drinking during or after cancer treatment could raise your risk of a new cancer or cancer recurrence, according to the National Cancer Institute. If you drink more than one drink per day, more than five to seven drinks per week, or binge-drink, it’s important to cut back, says Dr. Leon-Ferre: “I think that moderation is the key.” As always, everyone’s cancer situation is different, so it’s best to ask your doctor whether you should avoid drinking, especially if you’re actively undergoing treatment.
Do you smoke?
“Patients that smoke and have a diagnosis of cancer don’t do as well as those that don’t smoke,” Dr. Leon-Ferre says. Why? Because smoking affects not just your lungs, but your immune system as well. One 2017 analysis found that people who continue smoking after they are diagnosed with breast cancer have “poorer overall survival.” Smoking is unhealthy, period, and when you smoke with metastatic breast cancer, you are increasing your risk of infections and other major health problems. If you do smoke, talk to your doctor about how to take steps to quit — and the sooner you do, the better.
How often do you get aerobic exercise?
Although you may not feel up to it at times, it’s important to stay physically active when you’re dealing with metastatic breast cancer. According to the University of California San Francisco Health, people with breast cancer should try to get 20 minutes of aerobic exercise at least three times a week. Aerobic exercise — which goes beyond stop-and-go activities like walking the dog or gardening — can help you combat cancer treatment side effects, feel more energetic, sleep better, and even improve your mood, among other health benefits. According to Dr. Leon-Ferre, aerobic exercise not only can help improve breast cancer outcomes overall, but it also boosts your heart health, which can help you better tolerate certain cancer treatments. Not sure where to start? Get a referral from your doctor to a physical therapist, or see if you can find a personal trainer who has experience working with people with cancer. They can help you come up with an exercise plan that works for you.
Has your weight changed since your breast cancer diagnosis?
If you’ve experienced weight changes during metastatic breast cancer treatment, you’re not alone; in fact, it’s quite common. Chemotherapy, steroid medications, and hormone therapy can all lead to weight gain, according to the American Society of Clinical Oncology. But if you’ve gained a significant amount of weight, it’s important to work toward weight loss. “Maintaining a healthy weight in general leads to better outcomes in the long term,” says Dr. Leon-Ferre. Research shows that being overweight or obese can increase cancer risk and growth, including breast cancer. If you have concerns about your weight, your doctor can offer suggestions to help you manage it.
How well would you say you are dealing with stress?
It’s a fact: Excess stress is bad for your health. And while your physical health is likely your main focus when you’re dealing with metastatic breast cancer, that doesn’t mean your mental health should go ignored — especially because they are so closely tied together. “Stress can blunt the ability of the immune system to protect against cancer,” says Dr. Leon-Ferre. In fact, some research shows that stress can help cancer tumors grow and spread; one 2013 study even found that stress activates a gene that can allow cancer to escape from its original tumor and metastasize. Because cancer diagnosis and treatment can be an incredibly stressful experience, it’s important to take steps to reduce your stress wherever possible. Cancer patients who find ways to cope with stress have lower levels of depression, anxiety, and symptoms related to their cancer, according to the National Cancer Institute. Try to integrate a few minutes of meditation into your day, learn relaxation exercises, or seek help from a professional counselor or therapist. Your doctor may also have recommendations for medications that can help with your mental health symptoms, or they may be able to connect you with a support group of others who are going through similar experiences.
How often do you get a quality night’s sleep?
Sleep issues are common in women who have metastatic breast cancer, whether they are linked to treatment side effects, physical pain, or the emotional toll cancer can take on you. The first step toward better sleep is to make sure you are practicing proper sleep hygiene. That means maintaining a good “bedtime routine” and going to bed at the same time each night, without your phone or other devices nearby, in a dark, quiet room. But often, sleep hygiene practices aren’t enough. If your sleep troubles persist, talk to your doctor; they can offer strategies to help you get the rest you need for your health. And if you’re struggling with sleep issues as a side effect of treatment, your doctor may be able to offer an alternative treatment that will be better suited to you, Dr. Leon-Ferre says.
How well do you feel like you are coping with treatment side effects and/or complications?
Living with metastatic breast cancer and undergoing treatment can be hard on you, physically and mentally. For example, if your cancer has spread to your bones, the pain can be severe. Talk to your doctor about ways to effectively manage that pain; there are medications and therapies available. Additionally, systemic treatments for metastatic breast cancer can come with many side effects, according to the American Cancer Society. “A lot of patients have this sort of ‘fighter’ attitude, saying ‘Well, I’m going to put up with these symptoms because it’s part of the treatment,’” says Dr. Leon-Ferre. “What I like to tell my patients is that for all these things, there’s usually something that we can do as long as we’re aware of that particular symptom. There’s a lot of ways we can help them cope with pain, and hot flashes, and menopausal symptoms.” Make sure you let your doctor know about any side effects you’ve been experiencing. They can offer suggestions or provide further treatment to help you cope.
What does your support network look like?
Having a strong support network can make a world of difference when you have metastatic breast cancer. In fact, research shows that larger social networks can help improve overall survival in people with breast cancer. “The more of a support network [patients] have, and the more they have the ability to preserve relationships through their disease, the better they are going to be doing overall,” says Dr. Leon-Ferre. Everyone’s support network is different — it can include your health care team, your friends, your family, and others going through similar experiences. Breast cancer can be an isolating experience. So if you haven’t already, talk to your doctor to see if they can connect you with a support group, or try reaching out to an online community. There are Facebook groups and online forums for people living with metastatic breast cancer where you can share your experiences and get advice from people who have been there.
How well do you feel you are communicating with your health care team?
Having a healthy relationship with your health care team helps ensure you are getting the best care possible, personalized to your needs. It’s a two-way street: “There has to be a mutual trust in which the patient has to feel comfortable sharing concerns, big and small, with their provider, and we as providers need to be open to having those discussions and to never make assumptions,” says Dr. Leon-Ferre. Take this opportunity to bring up your concerns with your doctor. Sometimes, making a list of questions before each appointment can help you remember to bring up issues. You can also ask your doctor if the hospital has social workers or patient advocates (sometimes called “patient navigators”) they can connect you with. Keeping track of your care can be overwhelming, but there are people ready and waiting to get you the help you need.