Coping with stress in relationships with metastatic breast cancer

You may be afraid to talk about your feelings or fears with friends and family because you think they will become upset or withdraw from you. Yet you might want and even need those conversations. Rather than assume how others will react, ask if they would be OK talking about a tough subject.

Some people might be so uncomfortable talking about your diagnosis of metastatic disease that they can’t provide you with support, even if they want to help you. Others might be grateful if you explain in specific terms exactly what you need.

You might find that some relationships improve as old conflicts are set aside and bonds strengthen. It’s also possible that some relationships might feel more draining than supportive. You may decide to let those relationships go.

Dealing with stress with your spouse or partner

You and your spouse or partner have shared many things. Your personalities and the nature of your relationship before your diagnosis will play a role in the stresses you might feel going forward.

Because your treatment for metastatic breast cancer is ongoing, talking about it with your partner is important. You both may worry about the future you had envisioned together. Side effects, financial and insurance concerns and time off from work can increase stress. Your spouse or partner might try to “fix” things by taking charge of your care, or withdraw because of feeling helpless. Just talking about worries can build closeness.

To lessen stress with your spouse or partner, you could:

• Ask friends for help so your loved one does not always need to drive, clean and shop for groceries.
• Take advantage of periods when you feel good to have time for physical closeness or intimacy.
• Talk to an oncology social worker for help if you feel stress about sex or intimacy, which many people do.

If your relationship has been rocky, a diagnosis of metastatic breast cancer may add to tensions. Couples counseling may help. Even if your relationship is good, counseling may help the two of you work through the tensions you feel as a couple facing metastatic breast cancer, together.

Dealing with stress with children

You may feel a lot of anxiety about your children. Worrying about how to tell them about your diagnosis and what their reactions will be can cause stress. The stress can increase as you think about possibly not reaching milestones or not being there for them.

Consider what your children need and what you need, based on their age and stage of development:

• Younger children should be given information appropriate to their age, understanding and emotional makeup. An oncology social worker may help with this. If you worry about missing milestones like birthdays and graduations, consider creating a keepsake letter, video or gift for a child’s life event.
• Older children may go online to learn more about metastatic breast cancer, so help them find trustworthy sites.

With adult children, you may feel stress from trying to keep your independence when they want to step in and take over. They may expect frequent updates about your health. Talk with them about what you need and how you can keep them informed. Plan visits that don’t include treatments or chores to help you enjoy each other’s company.

Dealing with stress with parents

You may be all grown up, but when one or both your parents learn about your diagnosis, they may try to do more for you than you want. This can cause conflict and stress. Establish boundaries by telling them specifically how they can help

If your parents are elderly, you might worry about who will help them if you become ill. A geriatric care manager can help you and your parents make plans that will reduce everyone’s anxiety.

Dealing with stress with friends and other family

Some people may rush to help. Others may stay away because they don’t know what to say or do. Keep in mind that retreat is about them, not you. As many in your shoes before have found, new and unexpected friends may appear.

Let others know that you value their presence without needing them to talk or entertain you. Tell them that just sitting by your side can help you feel better.

If you are single or used to living on your own, you might not have a companion for doctor’s visits, practical help or just talking. You may be able to keep stress away by reaching out to friends, family or a support group.

Your circle of friends may include people with metastatic breast cancer. It can be sad and scary if a friend becomes ill or dies. It also can be affirming to see how she made choices about her care and how her community of friends supported her.

Dealing with stress with healthcare providers

Your healthcare team may add to your stress by not acknowledging your feelings and experiences. They may be too focused on medical issues or be uncomfortable talking about your stresses. Providers are human, too. But you deserve a team that has a positive attitude and supports your emotional well-being.

Try these tips for managing stress with your care team:

• Choose providers you trust and can feel comfortable with in an ongoing relationship.
• If your provider is avoiding sensitive topics, try saying, “I know this is difficult for both of us, but I’d really like to talk about my concerns.”

To gain access to a certain treatment you may decide to go with a doctor whose expertise is first-rate but who doesn’t have a warm personality. Remember that your healthcare team includes nurses, social workers and others who can provide emotional support.

Dealing with stress with employers and co-workers

To reduce work-related stress, you may want to talk with your employer and co-workers about the challenges you face. But remember, you decide how much you want to tell people. You don’t have to share details of your diagnosis or treatment if you choose not to.

Your supervisor or employer will need to know if you need any work accommodations. Speak with your human resources manager about what health information you may need to disclose.

It helps for your employer to understand that you may be well for a long time, but that you’ll also be in ongoing treatment. If you want to, discuss reducing work hours or working partially from home. Be sure your health insurance will remain the same if you cut back on hours.