The Importance of Mental Health for People with Metastatic Breast Cancer

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A breast cancer diagnosis can be one of the most distressing events a woman ever experiences and can cause emotions of shock, anxiety, anger, sadness, and confusion. Along with the physical impacts of cancer, fear of recurrence, changes to identity, and perceived loss of support can exacerbate pre-existing mental health conditions. It is important, however, to understand that you are not alone. Stress and anxiety are natural reactions to a cancer diagnosis and can be overwhelming. Managing stress can greatly impact the length of survivorship. One study showed that breast cancer patients who participated in small group sessions that proposed strategies for reducing stress, improving mood, adhering to treatment, and changing health-related behaviors had a 45% lower risk of cancer recurrence and a 56% lower risk of dying from breast cancer. According to the National Cancer Institute:

  • One in three with cancer experience mental or emotional stress.
  • Nearly 25% of cancer survivors experience symptoms of depression and up to 45% experience anxiety.
  • Many cancer survivors experience symptoms meeting criteria for PTSD (Post-Traumatic Stress Disorder)

Breast cancer patient may experience some of the following psychological conditions:

  1. Severe emotional distress is the most common mental health issue among breast cancer patients. The National Comprehensive Cancer Network has endorsed a questionnaire, the “Distress Thermometer” as a resource for assessing the impact of distress on a patient’s life.
  2. Major depression is characterized by depressed mood and inability to feel pleasure, in addition to mental and physical symptoms, that interfere with daily activities. Talk to your doctor if you are experiencing symptoms of: negative or suicidal thoughts, general unhappiness, reduced concentration, guilt, low self-esteem, or physical problems.
  3. Post-Traumatic Stress Disorder occurs in cancer patients as they suffer from questions about their mortality and safety. Symptoms include: reliving the moment, increase arousal, feeling easily angered, and avoidance.
  4. Generalized Anxiety Disorder is characterized by a constant feeling of fear and worry to the point of mental exhaustion and physical symptoms of restlessness, sleep disturbances, and irritability.

Call your doctor or seek immediate medical help if you are experiencing any of the following symptoms:

  • Thoughts of suicide
  • Reckless behavior, such as excessive drinking until blackout or erratic driving
  • Inability to eat or sleep for consecutive days
  • Acute trouble breathing from anxious feelings

It is crucial for patients with MBC to prioritize their emotional wellbeing. There are many ways to get mental health help, and choosing the best option can be based on cost, availability, and personal preference. Here are ten resource options for mental health support:

  1. Join a support group to talk with other people who are experiencing some of the same symptoms. Support groups can be online, in-person, or over the phone. More resources for social support for breast cancer patients and support groups for family and loved ones can be found by visiting the Susan G. Komen page Coping with Cancer – Support Resources.
  2. Visit a mental health professional to voice your concerns and learn about adaptive strategies to control stress. You can meet with a counselor or psychologist or participate in small group sessions. If you are receiving cancer treatment at a hospital or medical center, ask if there is a Licensed Clinical Social Worker or psychologist on staff.
  3. Reduce stress to manage anxiety and improve blood pressure, heart health, and fatigue. Some ways to relieve stress include: music, painting, yoga, tai chi, mindfulness meditation, deep breathing exercises, and guided imagery.
  4. Stay active in your community by volunteering for local charities or organizations like Susan G. Komen or the American Cancer Society.
  5. Reach out to loved ones for support. Openly discuss your emotions, fears, and frustrations with your family and friends.
  6. Meet with a social worker. Social workers can help connect you with the community and available support services.
  7. Consider asking your doctor or a mental health profession about medications to treat clinical depression.
  8. Exercise releases endorphins, which can reduce stress, increase feelings of positivity, and decrease fatigue. Activities that reduce stress might include cycling, swimming, yoga, jogging, or walking. Ask your doctor about what exercise options are best for you.
  9. Eat a healthy diet that includes plenty of fruits, vegetables, and whole grains and avoid highly processed food, fried foods, sugar, and alcohol. Your diet can greatly impact how you feel.
  10. Ask your doctor to refer you to educational websites that can help you learn more about your diagnosis to reduce feelings of uncertainty.

Insurance requirements in the United States can make it more difficult to find and pay for mental health services. It may be difficult to be an insurance advocate for yourself while coping with your diagnosis and the physical symptoms of treatment, so consider having a family member or friend speak with your insurance company. Some other low-cost options include:

  • Outpatient psychotherapy clinics in hospitals and communities usually accept Medicaid, Medicare, and state insurance plans
  • Psychology doctor programs may offer clinical psychologists in training who can provide therapy while under the supervision of senior clinicians.

Other available resources for mental health providers include:

Learn more about disparities in breast cancer treatment and ways to reduce stress while coping with breast cancer in this podcast for breastcancer.org by Dr. Lola Fayanju. Dr. Fayanju is an assistant professor of surgery at the Duke University School of Medicine and researches disparities in outcomes after breast cancer diagnoses to improve the quality of breast cancer care. Her podcast focuses on some of the reasons for disparities in breast cancer care, the idea of choice and how that affects clinical trial enrollment, and resources for patients coping with stress.

Prioritizing your mental health is equally as important as caring for your physical health while living with metastatic breast cancer. If you are having thoughts of suicide or death, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

Resources

“Breast Cancer: How Your Mind Can Help Your Body,” October 2011. https://www.apa.org/topics/breast-cancer.

Cafasso, Jacquelyn. “How to Support Your Mental Health with Metastatic Breast Cancer.” Healthline. Healthline Media, January 8, 2020. https://www.healthline.com/health/metastatic-breast-cancer/mental-health-support.

“Coping with Cancer – Support Resources.” Susan G. Komen, June 2, 2017. https://ww5.komen.org/BreastCancer/SupportIntroduction.html.

Fayanju, Lola. “Breast Cancer and Race: Disparities and Mental Health Effects.” Breastcancer.org, June 24, 2020. https://www.breastcancer.org/community/podcasts/race-care-disparities-20200608.

“Mental Health Care Options for People With Metastatic Breast Cancer,” January 22, 2020. https://www.breastcancer.org/symptoms/types/recur_metast/living_metast/mental-healthcare.

Moses, Tasha, and Sarah Linden. “Mental Health Impacts of a Cancer Diagnosis.” #BHtheChange, September 14, 2018. https://www.bhthechange.org/resources/mental-health-impacts-of-a-cancer-diagnosis/.

Tremblay, Lia. “How Can a Breast Cancer Diagnosis Play Havoc with Your Emotions?” Verywell Health, January 18, 2020. https://www.verywellhealth.com/the-psychological-impact-of-a-breast-cancer-diagnosis-430338.

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