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Dealing with a Diagnosis of Advanced Breast Cancer

A diagnosis of advanced breast cancer can evoke many difficult emotions. You may feel angry, shocked, fearful, guilty, paralyzed, depressed, anxious, or all of the above, and more. These are normal reactions. It’s important to allow yourself to experience all of your feelings so you can move forward and take an active role in your treatment. Here are just some of the difficult feelings many women experience when faced with an advanced breast cancer diagnosis, and some important thoughts to keep in mind to help you deal with some of these feelings.

I don’t want to die!
A diagnosis of advanced breast cancer is not an immediate death sentence. Many women live with the disease for many years with a reasonably good quality of life, thanks to advances in breast cancer treatments.

How will I tell my family?
Telling loved ones, especially young children, about a cancer diagnosis can be stressful. It’s important not to turn the diagnosis into a scary, mysterious secret. Trying to keep it a secret will only cause more stress for all involved. Children need to be told in a way they can understand, depending on their age and maturity. Once everyone knows what you’re facing, you can work together to figure out the ways of coping that are best for you and your family.

My doctor was insensitive when he (or she) gave me the news of my diagnosis.
It’s normal to feel angry at the bearer of the bad news that you have advanced disease. It’s also normal for healthcare professionals to feel uneasy about giving that news to anyone. There’s anxiety and discomfort on both sides. It’s important to remember that neither you nor your doctor caused your cancer to recur. Researchers are still trying to understand why some cancers recur and others do not.

Many women blame themselves, but most likely, there is nothing you could have done to prevent the recurrence.

If you feel anger toward your doctor and feel you cannot build a trusting relationship with him or her, find another doctor. If you generally get along well, but you’re upset or uncomfortable with how he or she told you about the diagnosis, it’s important to acknowledge your feelings and then move on. Sharing this feedback with your doctor can actually help your doctor understand the communication style that works best for you.

If my doctor had taken me seriously when I complained about back pain months ago, we would have caught this earlier.
Again, it’s normal to think that somehow, someone – especially your doctor – should have been able to prevent this from happening, or at least find it at an earlier stage. Doctors would like nothing better than to be able to prevent every breast cancer from metastasizing.

Unfortunately, some breast cancers do spread, no matter what treatments you get to try to prevent recurrence, and no matter how diligent you and your doctors are about follow-up care. In addition, once the cancer has spread, it will most likely respond (or not respond) to treatment in the same way, whether you find the metastasis right away or a few months after it develops. So “catching it early” does not mean a metastasis is more treatable or that you have a better chance of shrinking it or slowing down its growth. In other words, “early detection” doesn’t work for advanced breast cancer the way it works for early-stage disease in terms of possibly improving your prognosis or treatment outcomes.

It must have been all the stress I’ve been under that made the cancer come back.
Aside from blaming someone else, many women blame themselves when they find out they have advanced breast cancer. It is common to ask yourself what you could have done differently to prevent this from happening. But most likely, there is nothing you could have done to prevent the recurrence. And there is no body of evidence connecting stress to cancer, so go easy on yourself. It’s okay to take a look at what is most stressful in your life and try to reduce that stress, especially now that you’re dealing with advanced disease. But it is not helpful to try to second-guess what you could or could not have done in the past. Most likely, there is nothing you could have done that would have changed things. Some cancers have a tendency to spread, and there’s nothing anyone has found so far that can stop them.

Try to stop blaming yourself if this has been an issue for you, and start eliminating the things that make you anxious, while adding activities and experiences that give the most meaning to every day of your life.

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