October 13 is Metastatic Breast Cancer Awareness Day. As of 2020, approximately 168,000 women in the U.S. were living with metastatic breast cancer (mBC), which is a projected 31% increase from 2010. This type of cancer, also called stage IV or advanced breast cancer, means it has metastasized, or spread, to other areas in the body such as the liver, lungs, brain, or bones.
In a breast cancer culture focused on survivorship, those with mBC—who will be in active treatment for many years—can feel isolated and misunderstood. A report from the MBC Alliance, a coalition of 29 cancer organizations, highlights that “the dominance of the ‘breast cancer survivor’ identity masks the reality that patients treated for early-stage breast cancer can experience a metastatic recurrence.” This may occur anywhere from a few months to 20 years or more after the original diagnosis.
While there is no cure, mBC is treatable, and advances in therapies are allowing more women with advanced breast cancer to live longer, with a better quality of life. The classification of different breast cancer subtypes in 2001 led to more personalized forms of treatment, such as advances in tumour sequencing, targeted therapies, and antibody-drug conjugates. A personalized approach to medicine is leading to longer periods of disease stability for many mBC patients. Although many issues influence outcome, including age, the presence of other illnesses, past treatments, and the ability to carry out day-to-day activities, more mBC patients are living active, fulfilling lives. However, for some women, the side effects of treatments may interfere with their quality of life, and deciding to stop or pause treatment is a valid option a patient can choose to make.
In addition to personalized medicine, incorporating a healthy lifestyle can also help support living well with mBC. Exercise can have many physical benefits and can also help with side effects of cancer treatment such as fatigue, pain, depression, anxiety, and stress. But living with metastatic breast cancer can affect the types of exercise a person can do and the frequency in which they should be doing it. Bone metastases, for example, can lead to weaker bones and a higher risk for fractures or breaks. If you’re living with mBC, you may be advised to do strength exercises to help reduce these risks and at the same time, be instructed to avoid high-impact sports, like running.
Good nutrition can also be important to a patient’s well-being; a healthy diet full of nutrients may strengthen the immune system, boost energy or help maintain body weight. Changes in diet may also help to relieve certain side effects. Like exercise, however, it’s important for everyone undergoing treatment to make choices in nutrition that are right for their needs. There’s no such thing as a perfect diet, and some choices may not follow Canada’s Food Guide recommendations. That’s okay and expected.
Investing in emotional and mental health support can also contribute to living well with mBC. This could be joining a support group, practicing meditation or mindfulness, exploring hobbies or activities that you find fulfilling, crossing off items from a bucket list, or speaking to a counsellor or therapist. Sometimes, it could mean just taking time out for yourself or making more time with loved ones.
Living with mBC presents unique challenges, but with the right combination of personalized treatments, lifestyle choices, and emotional support, many people are finding ways to continuing to lead fulfilling lives. Everyone’s journey through metastatic breast cancer is different, and there’s no one-size-fits-all approach. On this Metastatic Breast Cancer Awareness Day, let’s recognize the resilience of those living with mBC and continue advocating for advancements that continue to offer better quality of life and treatments.
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