Recurrent/Metastatic Breast Cancer Diagnosis

    Recurrent and Metastatic
    Breast Cancer Treatment Handbook

Recurrent and Metastatic Breast Cancer Treatment Handbook 1st Edition


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    Breast Cancer Support Partner Handbook

Breast Cancer Support Partner Handbook 9th Edition
Over 24 Years of Publication


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You may have recently found out your breast cancer has recurred or you may have been diagnosed with metastatic (Stage IV) breast cancer. You may be struggling to understand "why" and figure out what can be done.

Mastering recurrent/metastatic breast cancer treatment begins by getting your questions answered about your diagnosis. Just as important is understanding what you can do to impact your treatment decisions and enhance your quality of life by learning how to live beyond the limits of fear. The Recurrent and Metastatic Breast Cancer Treatment Handbook is written as comprehensive guide to help you navigate the treatment decisions you will be asked to make, while helping you maintain an acceptable quality of life.

You may be feeling overwhelmed, desperate, shattered, angry, depressed and confused. Or, you may feel fiercely determined to fight this disease more than ever; but you don't know what to do, where to get the needed support, energy and information to fight again. If you are struggling with these feelings, you are experiencing a normal reaction to the news of recurrence. This is, obviously, a very difficult time, both physically and emotionally. You have been there before with breast cancer treatment, but now it seems you need some extraordinary coping skills to face it again-coping skills that we call Survivalist skills.

What is a Survivalist? The American Heritage Dictionary defines a Survivalist as:
"One who has personal survival as a primary goal in the face of difficulty, opposition and especially the threat of a natural catastrophe (death)."

A survivor continues to endure and live on, but a Survivalist uses incredible strength, courage and resolves to confront a desperate situation as a challenge, instead of as a defeat.

Survivalists tend to have the following common characteristics:

Survivalists have all realized, like you, that life is fragile and unpredictable. They have learned to manage their daily burdens with grace, hope and joy.

Admittedly, becoming a Survivalist doesn't happen quickly or easily. It is a process. Having cancer, again, is tough. You don't need to abandon yourself to hopelessness, thinking there is nothing you can do, or that can be done, to control your cancer. There is much that can be done. There is much you can do. Recurrence challenges you to learn how to face the difficulties of additional treatment and to live with the disease. You may not feel it, but you do have the resiliency to face treatment again.

While your treatment team can provide the best care medicine can offer, you must partner with them in your recovery to control the mental, physical and social aspects of your disease. With recurrence, one of the greatest battles you will face is the battle in your mind-the mental battle. You hoped before, and now you are disappointed, frightened and overpowered. You may be afraid to hope again. Survivalists agree that the mental battles are often the most difficult to fight and that mental recovery often takes longer than physical recovery.

The mental battle is often the toughest because this is something that only you can do-there is no pill or treatment. It must be met by identifying and confronting your fears; fears that can rob you of every precious second. Avoiding your fears will only make you a victim of your fears. Eleanor Roosevelt said, "We must do what we fear." It's hard, but it is immensely freeing. When you address your fears, seek and find answers, and then take action; you will be in control.

The physical realm involves not only your active participation in treatment decisions but also your active contribution towards those decisions. Your healthcare team cannot practice good medicine without your help. If you expect too much from your doctor and nurses, and too little from yourself, you may be limiting the quality of care you receive. The physical area also includes how you manage your body-what you eat and how you move. Diet should be a primary focus, not a fad or a diet that is restrictive of food groups, but one that makes every spoonful you eat nutritious. Exercise, how you move your body, can increase your energy level, reduce depression, decrease pain and improve your mood. Participating in an activity of your choosing, such as a simple daily walking program, has many benefits to improve your physical quality of life while you are undergoing treatment.

Our social lives, how we relate to people around us, affect how we feel physically and emotionally as well. Knowing how to communicate with others in order to get what you need will help you master this crisis. It may mean that you need to evaluate your relationships, drawing closer to those that are nourishing and distancing yourself from those that are toxic. Effective communication means saying "no" when necessary and asking for help when needed. It means talking openly to your healthcare team, family and other support systems about your needs, wants and desires. Addressing these social issues can help bring back a sense of control and harmony in your life.

Recurrent breast cancer treatment means receiving appropriate, proven medical treatment and complementing that care with the things that you can do mentally, physically and socially to create an optimal recovery environment. National guidelines on breast cancer recurrence can be found on the National Comprehensive Cancer Network (NCCN) at

Through my experiences with numerous breast cancer patients and my knowledge of breast cancer, I know that what we "think" will not cure the disease. However, there is new evidence that our ability to deal with disease is influenced by psychological and social issues as well as by medical treatment. Your approach should be a blending of both-mind and medicine. Mind may not triumph over illness but your mind definitely influences your health and contributes to your sense of well-being. I am not saying "thinking positive" will improve, or even cure, your cancer. However, I am saying that how you think will influence what you do and impact your ability to get the things you need for your recovery. Reducing the "poor me" thinking will improve your quality of life by decreasing depression, increasing your energy and maintaining healthier relationships.

You bring to this experience of recurrence your own unique personality, life experiences, coping skills and support environment. My goal is that you will recognize your ability to once again find the ability and courage to face this new challenge. However, there is no right or wrong way-nothing you must or must not do. Whatever choices you make to fight for recovery are the right decisions for you, there are no mistakes because you are the expert on your needs. I encourage you to live your life fully while you live with recurrent breast cancer. Remember, breast cancer the second time requires incredible strength, courage and resolve to confront a difficult situation as a challenge instead of a defeat. But, you can do it because you because you have Survivalist skills.

May God Bless In Your Survivalist Journey,