Hear My Voice: Facing the Emotional Roller Coaster of Metastatic Breast Cancer

A diagnosis of stage IV breast cancer can lead to a roller coaster of emotions, which is normal. Julie Larson, LCSW, developed this list of tips and ideas to help smooth the ride. 

The weight in the room is palpable, thick with uncertainty and fear. Later I hear undeniable hope and the unmistakable clear tone of renewed perspective. Tears swell close to the surface during intimate conversations and the roar of laughter is a quick partner to humility and grace. This is the roller coaster of emotions that inevitably accompanies a cancer diagnosis, including metastatic breast cancer. Fear, worry and uncertainty woven together with hope, renewed perspective and gratitude. Experiencing the extreme shifts is often startling and unfamiliar to many affected by metastatic disease. Yet, most of those living with metastatic breast cancer (and their loved ones) have been affected by the ride.

Often it is helpful to know these emotional ups and downs are normal. You are not alone. After all, a metastatic breast cancer diagnosis is a life-changing experience. Treatment alone often demands changes in your daily routine, shifts in professional goals and physical losses which can be challenging to reconcile. "Why me" questions and the uncertainty about the future can be overwhelming.

Finding your way through the day to day is an exercise in self-awareness, acceptance, and frustration tolerance. And yet, those with metastatic disease all over the world are not only surviving but thriving as they live with cancer. The tips and ideas below may help smooth the ride a bit for you.

Connect with others. Learning that others with this diagnosis wrestle with similar thoughts and feelings can be reassuring. Talking together and supporting each other along the way can help you feel less isolated. Likewise, staying connected to longtime friends and groups can help you hold onto a sense of normalcy and provide valuable escapes from time to time.

Find answers to your questions. Write down anxiety-provoking thoughts and you will likely discover a list of questions. Seek answers to these concerns from trusted resources. Find the facts and differentiate "what if" from "what is" to help ground you and reestablish a sense of control.

Know your people. Even if you have a large network of support, it is likely the case that different people in your circles have varying strengths. Identifying who is best to turn to for different needs (practical, emotional, logistical) helps protect you from feeling disappointed by the availability or reactions of others during this time.

Identify your triggers. Maybe it's a particular date on the calendar. Perhaps it’s an area of town close to where you received treatment or heard difficult news. Maybe it's the topic of how to talk with your kids, or the role of faith in cancer survivorship. Perhaps a certain song does it for you or a particular smell. Most people affected by early-stage and metastatic breast cancer have emotional triggers that stir up intense emotions. Understandably, triggers can happen unexpectedly. But the more astute you become at knowing what has the potential to upset you, the better you will be at protecting yourself or preparing for challenging moments.

Break time down into manageable parts. You may have heard the adage about breaking down a daunting task to get it done. This tip has the same wisdom at its heart. There can be times during your survivorship that are more challenging than others. Break that time down into smaller, more manageable parts. The morning. Lunch time. The time until your spouse is planning to call. The hours before the kids come home from school. This can help keep your focus on the present and give you a sense of momentary purpose and control.

Tune into your body. Worry, dread, fear, uncertainty are all feelings that tend to be "top heavy." In other words, all too often we get caught in the spin of our thoughts. A deep breath, changing the position of your body, rubbing your hands together or hugging yourself helps you to reconnect with your body and with the present moment. If you are able to catch yourself in the mental hamster wheel, take a moment and tune into your body and see if that helps slow the pace for you.

Express your feelings. Research suggests that emotional well-being isn't attained by the absence of negative feelings but rather the ability to tolerate and respond to the range of emotions in effective ways. Using anger to advocate for oneself; guilt as motivation to make personal changes; sadness to empathize with others are examples of how all emotions can serve you in unique ways. And expression does not have to be verbal. Writing, painting, dancing or playing a musical instrument all provide ways of responding to the range of emotions that are normal to cancer survivorship.

Make time for fun and relaxation. Nurturing yourself is a necessity, not a luxury. When you make time to care for yourself and do things that help you recharge, you will be in a better place to handle stressors that come your way. Go for a walk. Cozy up with a cup of tea. Have coffee with a dear friend. Stargaze. Laugh. The value of understanding what activities help you feel good is immeasurable and may be one of the best tools you have for caring for yourself along the way.

Julie Larson, LCSW, is a psychotherapist in New York City, where she works primarily with people under age 40 around issues of wellness, loss and life transitions. Ms. Larson previously served as the young adult program director at CancerCare, where she developed a national program of age-specific support services and educational materials for young adults impacted by breast cancer. Ms. Larson is also a member of the multidisciplinary steering committee of the LIVESTRONG Young Adult Alliance, a coalition of organizations working on national initiatives to improve the survival rates and quality of life for young adults with cancer.

Visit lbbc.org/hearmyvoice to read the other posts in our series.