A metastatic breast cancer diagnosis can impact every aspect of your life. You may have plenty of days that are just like any other day of both small and large accomplishments. At the same time, there might be days when it’s tough to do the things you used to do without even thinking about it.
If you’re experiencing fatigue, it may mean that sometimes you need to take more rests than you normally would. Doctors’ visits might take up extra hours in your schedule. There may be weeks when making dinner or cleaning the house feels overwhelming.
It may feel intimidating to try to figure out how to get everything done on challenging days. It’s okay to let some things go once in a while, and it’s okay to ask for help — and that’s true for anyone!
Members of the Breastcancer.org Stage IV Community forum have offered their perspectives on finding and maintaining balance between responsibilities and self-care.
“We all have different needs and responsibilities on a day-to-day basis. So, what applies to me, a single woman, with no children, living in a major urban area where everything is easily accessible or deliverable, who continues to work and has limited drug side effects, will not apply to a woman with younger children to take care of, a husband/relationship to maintain, insurance and financial concerns, and the need to drive to appointments and to run errands, despite dealing with fatigue, nausea, and lower than normal blood counts.”
This is the time to re-evaluate priorities, figure out what keeps you motivated each day, and minimize the non-necessities in your life.
“I am living with metastatic breast cancer (MBC) and I still LIVE! I move and think a bit more slowly but I smile, laugh, love, and enjoy life more than I ever have. Living with MBC has given me a perspective and appreciation of life that I did not have before.”
“… I have taken a TON of vacations, volunteered, done lunches, concerts… and spent time with friends and family. [I’m h]aving the time of my life in between treatments, radiation, and surgery. I can rest when I need to, I don't have to worry about treatment and fatigue. AND I can concentrate on my health. I look at it as an 'early' retirement. When I went on disability I thought I only a few years left. As you can see, I am still going strong.”
“Prioritize joy. Make your life worth living. Care for yourself. Take loving care of your body and soul. Get rid of old anger, hurt, sadness, trauma. Go see a therapist, a guru, a priest, a shaman — whatever does it for you in order to get your mind and heart in order. Find peace.”
“My suggestion is try not to project yourself into the future so much. Try to live just today. Then do the same the next day. I have had some of the best moments of my life after the MBC diagnosis, not because of it but in spite of it. Many of us frame it as living with breast cancer, not dying from it.”
Be kind to yourself if the house cleaning comes to a standstill, the laundry piles up, and your family eats take-out most days. Sometimes you may need to just let things go, or tackle chores when you feel up to it.
“I don't stress out over an unclean house anymore. I do what I can and my DH (dear husband) helps out.”
“I can't stand up for long periods of time, so I went to Costco and got an inexpensive bar stool. I can sit by the countertop and cut up vegetables and meat now.”
“I continue to love my husband and five children — and still cook clean and do everything and more than I used to do (unfortunately the cancer did not make the laundry disappear!). I try to give voice to my hope and quiet the fears and enjoy each day. I am 3 years out and planning on many more.”
Ask for and accept help. This can be very difficult, especially if you’re a person who has traditionally managed your household. Designate one trusted person to be in charge of giving medical updates to family and friends and helping you organize priorities.
“Accept help when you need it. This is easier if you keep in mind how good it makes you feel when you can help others.”
Be direct and detailed about your needs, and prepare a list of tasks that people can do for you. Consider your treatment schedule or the times you don’t think you’ll feel up to managing daily responsibilities, and ask someone to help with chores such as cleaning, grocery shopping, cooking, childcare, and pet care.
“Get a big calendar to write all your appointments, blood draws, and infusion times on. Managing all this is a full-time job. Set up an easy-to-use system of filing. I use a separate file box to hold all my binders and files. Keep it updated so it's not overwhelming.”
Consider consulting with financial, legal, estate planning, and disability experts. It can be emotionally challenging and time-consuming to have these conversations. At the same time, getting things in order can allow you to focus on getting the most out of each day.
“It was very difficult to prepare my DH (dear husband) to pay bills, insurance, accounts, etc. I still handle it but those are tough conversations.”
“File for Social Security Disability Insurance as soon as you can if you're no longer able to work. Being stage IV, they will put you at the head of the line so you don't have to wait months and months to get your first payment.”
“Pay off your debt and do something with the money that will make you happy. I was able to leave my job. I made some nice donations to charities I care about and I put in a pool. All things that made me feel good. Without debt hanging over my head, I am able to live each day with less fear, worry, and tension in the financial area.”
“[With] affairs in order and debt secured, now you can concentrate on what's really important.”
Take care of yourself physically and emotionally: it’s more important than ever. Support your body with a good diet, exercise, and enough sleep. Consider seeking emotional support from a therapist or spiritual adviser. Consult with your doctor about medications to help with any pain, sleep issues, anxiety, or depression you may be experiencing.
“My husband and I met twice with a counselor; it was hugely helpful in getting through the first two months. She helped us understand and accept our feelings and suggested a few coping mechanisms that helped tremendously. My most difficult issue was dealing with the reactions of friends and family. Her advice really helped us through that difficult time.”
“Never, ever discount the power of anti-anxiety or antidepressant medications if you need them.”
“I am living with MBC (3+ years) and still go in and out of sadness, depression, anger, anxiety, and acceptance. I don't believe it is a straight line from anger to acceptance. It depends on the day, how I feel, how soon my scan is coming up etc.”
Take the time to do things you enjoy every day. Plant a garden, take on a new hobby, read a great book, and sit in the sun. Do small things that bring you pleasure and that you can look forward to.
“Practice mindfulness. Take joy from the moment. I'm not as good at this as I'd like to be, but I'm getting better at it and it does help.”
“Buy yourself some flowers once in a while. They will cheer you up. Go to Starbucks and buy a nice latte when you are off cycle, and sit outside and enjoy it. Go to your local park more. Being out in nature is mentally soothing and helps take your mind off your health.”
“Yes, it's a shock. Acknowledge that, mourn, cry, and then make a plan… Do not give away your possessions, enjoy them. As a matter of fact, buy that new winter coat or pretty earrings if you want! Travel if that's your thing, but buy insurance that covers pre-existing conditions. Quit your job if it doesn't bring you joy, but keep working if you love your work. […] Even with pain or side effects of treatment, you can find fulfillment in life.”
“Staying busy in the garden and watching things grow makes me feel good and brings me sunshine to block those dark clouds that creep into my head.”
Stay connected to supportive people. Make and keep these connections. It can sometimes feel like work, but these people can help ground you when you need it.
“I just try to […] stay invested in the things and people I loved and cared about before my diagnosis. They keep me grounded. I am a three-dimensional person. I am more than cancer and more than my disease. I refuse to let it define me or my life. Keeping myself connected to who I was is instrumental to both my mental and physical well-being.”
“I love my job and it gives me great purpose and a feeling of connectedness to colleagues and community. I feel as if I am making a positive contribution to society. Yes, I am tired at the end of the day, but it's worth it.”
“Keep reaching out to friends and loved ones even if they seem to be retreating from you. I found that the more I felt them retreating, the less I would reach out thinking they just don't want to deal with this. After some experience, I realize a lot of people just don't know how to help or communicate. You will need your friends and family even if it is just to go shopping with you or to a movie.”
“I've found the information and understanding in this community vital to surviving my diagnosis and beyond.”