Not all breast cancer patients will go through late-stage cancer. However, if you have been recently diagnosed with stage IV cancer or have experienced the progression of the disease, it is important to understand that this phase is another step in your cancer roadmap. You might feel fearful regarding late-stage cancer. However, it may help to understand the phase, know how to prepare, and be able to manage your expectations and what you can control.
Managing Your Cancer
Stage 4 cancer can’t be cured, but it can be managed. With advances in breast cancer research, people with late-stage cancer are living longer. Late-stage cancer may be managed like a chronic condition, such as diabetes or heart disease. There will be moments or recurring periods of flare-ups in which treatments such as chemotherapy, surgery, and/or radiation will be necessary. On a daily basis, however, your focus will be on cancer maintenance. This will include being aware of clinical trials and research, managing flare-ups, and preparing for the progression of the disease, while also continuing to live your life.
New research and studies are constantly being conducted. This is a good time to become aware of the latest clinical trials and research. However, keep in mind that, in order to enter a study, you have to qualify for it.
Don’t wait too long to find out more about trials. You don’t want to wait until your health gets worse, which can make it harder to qualify. Many of these trials are held at academic universities or hospitals. Talk to your healthcare team about clinical trials — they may be able to provide you with information about participation.
Be sure to take advantage of support groups and counseling. You can use the resources you’ve had during the progression of your disease, as well as new ones that are focused on late-stage cancer. You evolve as your cancer does — you may find that your support needs have evolved as well.
There may be a point where your cancer progresses and you will need to start the process of planning and preparing for end of life — medically, legally, and emotionally.
Palliative care, including the decision for hospice care, is something that your healthcare team will work with you to plan. The purpose of palliative care is to keep you more comfortable and to provide relief from symptoms. Hospice care, specifically, allows you to be at home while your healthcare team provides comfort. While it may be scary to think that your healthcare team cannot cure the disease, planning palliative care will help you stay as active as your wish in your life.
Quality vs. Quantity: Stopping Treatment
There may come a time when the side effects and discomfort of treatment may outweigh the benefits of managing the disease. At that time, you may choose to stop treatment. This is an ongoing discussion to have with your oncology team. Be sure to clearly communicate and share your wishes for end-of-life care with your oncology team and loved ones.
Emotionally, this is when you may also be focused on your beliefs and values as you think about the quality versus the quantity of your life. It is an opportunity to explore your personal definition of “quality of life.”
Being prepared about what’s ahead can put your mind, and your loved one’s minds, at ease. This may mean choosing a power of attorney, or someone who you trust to make decisions on your behalf if your health deteriorates. It will also probably mean making or revising your living will. Your oncologist and an attorney can help you make this document.
Planning for end of life empowers you to make the hard decisions now, not when your health has made it hard for you to do so. It may also be a comfort to know that preparing now will also take some burden off of your loved ones. Talk with family about your wishes and be sure to communicate honestly and clearly. Knowing that you thought through these choices and made the decisions early on can help alleviate fear and anxiety.