Living with Metastatic Breast Cancer

Abstract

Although prevalence estimates are imprecise, growing numbers of women in the United States are living longer with metastatic breast cancer, attributable at least in part to the availability of effective targeted therapies. Women living with metastatic disease are understudied, however, and substantial heterogeneity exists in both the clinical characteristics of metastatic tumors and the physical and psychological experience of patients living with the disease. Survivorship issues are complex for patients who are living with metastatic disease over extended periods of time, from years to decades. Newly diagnosed patients with stage IV disease are confronting cancer for the first time, while others have metastatic disease as a result of breast cancer recurrence. Many patients are able to live for years on stable medical regimens, and yet others live with a moving target of aggressive disease with arduous treatments and uneven response. The psychological common denominator is the experience of profound life threat and the accompanying uncertainty, for both the affected woman and her loved ones. Maintaining life balance in the face of metastatic disease, as well as managing pain, fatigue, and other physical and psychological symptoms are major challenges. Increasingly, the clinical approach to metastatic disease reflects the consensus that palliative and supportive care are essential from the point of diagnosis. To remedy the paucity of systematic research on women living with metastatic breast cancer for extended periods, we offer directions for research to understand the experience of metastatic breast cancer and to provide evidence-based inter-professional care.

Association between circulating tumor cells and peripheral blood monocytes in metastatic breast cancer

“…Inflammation/immune microenvironment mediates tumor progression in metastatic breast cancer (MBC), and influences the prognosis. 1–3…”

“…Inflammation/immune microenvironment mediates tumor progression in metastatic breast cancer (MBC), and influences the prognosis. [1][2][3] Circulating tumor cells (CTCs) represent a population of cancer cells involved in tumor progression and dissemination. 4 Peripheral blood represents an adversarial microenvironment for CTCs due to the presence of immune cells and other factors that interfere with the metastatic process.…”

Supportive Care Needs in Chinese, Vietnamese, and Korean Americans With Metastatic Cancer: Mixed Methods Protocol for the DAWN Study

“…These include anxiety, depression, death anxiety, demoralization, and a perceived inability to cope effectively, which can result in poor quality of life and premature mortality [ 14 , 15 ]. Patients with metastatic cancer have different needs, goals, and physical and psychosocial symptoms compared to patients with earlier-stage cancer, with individuals with metastatic cancer facing greater uncertainty about their prognosis and fear of disease progression [ 10 , 16 , 17 ]. Evidence suggests early supportive care needs (ie, after diagnosis in active treatment) should also be examined, as it can result in better quality of life and a reduction in functionally impairing symptoms [ 18 ].…”

Mindfulness Meditation as Psychosocial Support in the Breast Cancer Experience: A Case Report

“…This approach to oncology medical care also includes an interdisciplinary team to provide a more comprehensive approach which includes addressing the psychosocial needs of patients. Evidence that physical and psychological symptoms negatively affect emotional, social, and work functioning [ 1 , 2 , 3 ] is clearly established, and these decrements in functioning affect compliance, adherence to treatments, rehabilitation, and survival [ 4 ]. As one of the main objectives of multidisciplinary care is improvement of Quality of Life, psychosocial support is considered one of the fundamental elements of treatment.…”