When You Hear the Words "Metastatic Breast Cancer"

There’s a lot written about fighting cancer, battling cancer and surviving cancer, but not many of those words comfort the person faced with a metastatic diagnosis. The metastatic patient is living with the disease rather than surviving it. This is even more true today as rapid discoveries in anti-cancer therapies can lead to more than one try at treatment.

But while the difference in diagnoses is vast, it isn’t insurmountable. The words you say can mean a lot. There don’t need to be urgings to “beat this” — we’d all like to beat it (at any stage), but clear or stable scans are what we hope for each doctor visit. Because of that, the usual words of support can bring on an avalanche of emotions and reactions. I know these words of encouragement, and others, are said to express care, concern and love. I like to hear them (most of the time) but there are other words I like to hear more.

Instead of “You can beat this,” say “Living with this must be hard.” Because, yes, it is hard. There isn’t a cure for metastatic breast cancer. Anybody you know who died from breast cancer has died from metastatic breast cancer. There was a time when the diagnosis usually meant a short life ahead and for too many of us, that has not changed. But for others, life with metastatic disease can continue for many years. For those patients, there’s continual treatment; there may be therapy changes, constant scans and appraisals of what is happening with the disease. This is, no question, rough on the body, mind and soul. It’s comforting when a friend uses words that show he or she understands or is trying to understand what you are going through.

Instead of “You look great!” say “I know you’re still getting treatment, but you look great!”Everyone likes a compliment. Looking great, though, is deceptive. There are times when hearing that first phrase makes me feel like the person speaking isn’t really thinking about me. Looking good is nice but it doesn’t take away the anxiety and fear that a patient feels, and this is especially true in the case of patients with metastatic cancer. The strong desire to minimize pain and uncertainty with a familiar phrase can sometimes feel like an effort to minimize what the patient is actually experiencing. Rationally, I know that is unfair and ungracious but sometimes emotions are crazy that way.

Instead of “When will you be done with treatment?” say “What treatment are you having now?”If you know your friend has metastatic breast cancer, please don’t ask when treatment will be done. If she (or he) is like most of us, there will not be an end to treatment except at the end of life, and maybe not even then. Some people choose to forgo treatment or are given a break by their doctors, but those times can indicate that the cancer is not responding to what had previously worked. It’s not a “happy” end-of-treatment celebration, but something that very likely will increase the anxiety your friend is feeling.

Instead of “Oh, breast cancer is so easy to treat now,” say “What does it mean when you say ‘metastatic’?”I didn’t know what metastatic meant, in real-life terms, until I heard the words from my doctor. If you don’t know what something means, ask. Your friend will be able to explain what her life now looks like. It’s not fun to be a downer and explain this diagnosis, but it is much easier than knowing your friend doesn’t really understand.

If you know and love someone with metastatic breast cancer, prepare to be strong and patient. With luck, the two of you are looking at years of living with cancer. Being thoughtful during harder-than-normal treatments or unexpected scares that take a lot out of anyone. Your friend needs you. She really does, even if she looks great.