It can be really hard for patients to “take in” the fact that their breast cancer has spread to a different part of their body, like the bones, liver, or lungs. It means they have metastatic disease. Fortunately, there are more metastatic breast cancer treatment options than ever before, and many patients can live long and full lives. After about a decade of working as a cancer doctor (medical oncologist) who specializes in breast cancer, I’ve learned about this treatment process and the effects it has on my patients’ lives. Here’s what I want them to know. 1. It’s a marathon, not a sprint. When cancer spreads, I view it as a marathon, not a sprint. Patients will most likely remain on some form of cancer-fighting therapy for the rest of their lives. Today, metastatic breast cancer is highly treatable, but it’s not necessarily curable. Treating metastatic breast cancer is different than treating early-stage breast cancer. Once treatment for early-stage breast cancer is done, we presume patients are cured of their breast cancer. But, with metastatic disease, patients will be treated for their cancer often for the rest of their lives. In general, we will continue a therapy for as long as a patient tolerates it or as long as it keeps their cancer under control. Fortunately, many treatments work for a long time in patients with metastatic breast cancer. 2. Find the right oncologist. It is incredibly important to have a trusting and open relationship with your oncologist. You want to feel like you’re getting clear, reliable information from your doctor, of course, but you also want the relationship to go both ways; to have your doctor be open to receiving information you provide as well. We are making tremendous strides in developing new breast cancer treatments, particularly for patients with metastatic breast cancer. So, if you learn about a new therapy option, don’t be afraid to talk about it with your doctor. I also think it is really valuable for patients to get a second opinion—even if you trust your initial doctor, sometimes it can be helpful to hear another doctor’s perspective. A different physician can say something in a different way that really registers with you and changes your outlook or understanding. Additionally, another medical institution may have access to investigational clinical trials that aren’t offered at your original facility. That is why I encourage patients to know their options and seek another provider’s opinion early on, even if it is only to feel comfortable with the treatment plan. 3. Lean on your support system. Treating metastatic breast cancer can be very stressful, especially at first when you are trying to “take in” everything you are hearing. I encourage my patients to have a friend or family member accompany them to appointments to offer emotional support, take notes, and ask questions. It is so helpful to have someone with you as another pair of eyes and ears during such a challenging time. I also urge my patients to find support groups in any form that will benefit them. Some patients like to stick to online message boards, and others find comfort in religious groups or other organized in-person support meetings. There’s no one-size-fits-all support system, so think hard about what forum would offer you the greatest value. I often recommend my patients see a therapist, especially at the beginning of treatment. having an objective, trained professional listen to you can be extremely helpful. 4. Be upfront about symptoms and side effects. Do not be afraid to ask your doctor for ways to manage side effects you may be having from the treatment or from the cancer itself. Often, patients can be concerned about sharing any issues, because they do not want to have more testing or make any treatment changes. However, it is important for your physician to know what is going on because you do not want to be receiving treatment that is not helping or significantly impacting your quality of life. Plus, there are many things we can suggest to improve potential symptoms. For example, there are data showing certain breast cancer patients can really benefit from acupuncture and other non-Western medical approaches. Keep in mind, though, it’s important to share any alternative treatments with your oncologist, especially if you are taking vitamins or supplements. You do not want to take something that may interfere with your medications, so make sure to talk to your doctor before trying anything new. Bottom Line It can take some time for your metastatic breast cancer diagnosis to sink in, and it is hard to process being on therapy for the forseeable future. But, I want patients to know they’re surrounded by support—from their doctors, nurses, therapists, family members, friends, support groups, and more. New treatments can give patients options they never had before. As a breast cancer oncologist, I love my job because of the long-term relationships I develop with my patients. I have watched them live their lives through the years. Working together, the goal is to help you treat your cancer and live your life without cancer defining it.