Metastatic breast cancer (MBC) is cancer that starts in the breast but has spread to other parts of the body, such as the bones, lungs, or brain. It is also called stage 4 breast cancer. According to Breastcancer.org, about 30 percent of women who receive a diagnosis of breast cancer at an earlier stage will later be diagnosed with metastatic disease. About 6 percent of breast cancers are metastatic when they’re first diagnosed.

With recent advances in treatment, many people are living longer with MBC than was possible a couple of decades ago. Some will manage MBC as a chronic illness that is treated over several years.

If you’re living with MBC, it’s important to take care of yourself to the best of your ability. You can take steps to proactively manage the condition and maintain a better quality of life. Read on to learn five tips, backed by science and MyBCTeam member experience, to manage MBC and improve your well-being.

1. Eat Well With Metastatic Breast Cancer

While living with cancer, it’s important to try to get a good balance of nutrients. Eating enough calories from healthy sources can help your body get the energy it needs. Adopting a more nutritious diet may help you feel better overall.

People who are losing weight may need to focus more on total calories than the specifics of healthy eating. A registered dietitian in a cancer center, or one who is familiar with nutrition and cancer, can help you design the best diet for retaining or gaining weight.

Getting the Right Nutrients

Eating a healthy diet doesn’t mean you have to follow a complicated eating plan or stop eating your favorite foods. You can stay as healthy as possible while sticking to a few simple guidelines. Talk to a registered dietitian if you need help determining what to eat.

In general, try the following:

• Make sure to get enough calories.
• Try to eat more frequent meals if your cancer treatments are making you lose too much weight. You may also need to do this if you experience nausea from chemotherapy or bloating after regular-sized meals.
• Eat foods with lots of nutrients, including fruits, vegetables, and whole grains, as often as you can.
• Include healthy sources of protein in your diet, such as beans, nuts, seafood, poultry, and occasionally, red meat.
• Drink plenty of water.

Some MyBCTeam members don’t restrict their diets. “I think the best thing is to do what you already know: a little of everything in moderation,” wrote one member. “As long as your overall diet is wholesome — fresh fruits, vegetables, etc. — then there’s nothing wrong with the occasional indulgence. Life is meant to be lived and enjoyed.”

Several members reported eating more vegetarian or plant-based meals. One member who’d just undergone a second surgery for breast cancer wrote, “I bounced back from this surgery much faster than the last. I totally changed my diet since last time and am on a completely whole-food, plant-based diet. I attribute that to the way I am feeling. I am hoping this eating plan will help when I start treatments.”

Managing Eating With Breast Cancer Treatment Side Effects

Breast cancer treatments can sometimes make eating more difficult. People living with MBC often have a variety of treatments, such as chemotherapy, immunotherapy, and radiation, during the treatment period.

Other treatments may also be added depending on the type of breast cancer. For example, individuals with HER2-positive breast cancer may use certain targeted therapy drugs.

These treatments can lead to several side effects that can make eating difficult. People may experience loss of appetite, mouth sores, nausea, and vomiting.

Work with your cancer care team to develop new habits if you can’t eat your usual foods while undergoing treatment. Certain strategies may help:

• Experiment with your meal times and temperatures if you feel nauseated. Eating frequent, small meals that include room-temperature or cold foods may help.
• Try avoiding foods that are spicy, high-fat, greasy, or very sweet. They may be more likely to trigger nausea.
• Add more fiber to your diet, and drink more water if you experience constipation.
• Choose higher-protein foods to help combat fatigue.
• Eat softer foods if you have mouth sores. This includes items that you don’t need to chew and that don’t have a strong flavor.
• You may need calorie-rich supplements if you’re unintentionally losing weight.

Many MyBCTeam members have suggested eating mild foods when dealing with digestive troubles. Said one member, “Try the old BRAT diet: bananas, rice, applesauce, toast — just bland stuff.”

If you’re plagued by a lack of appetite, it may help to remove any restrictions on what you eat. “During chemo, when my taste buds were off and I was nauseous, I ate whatever tasted appealing. Now post-treatment, I just try to eat healthy,” wrote one member. Another commented, “I asked my oncologist about my diet, and since I am stage 4, he told me to eat whatever I wanted. In reality, I actually feel a little better when I am watching what I eat, so I do a little of both.”

2. Get Physical Activity

Exercising is an important part of living well. Getting regular physical activity can help:

• Improve treatment side effects, including reducing nausea, lessening fatigue, improving digestion, and increasing sex drive
• Raise energy levels
• Lengthen and deepen sleep
• Enhance bone health
• Improve movement and flexibility
• Build muscle and maintain the strength needed to complete daily tasks
• Boost mental health and reduce stress

Studies have found that those with high-risk breast cancer who are more active tend to have a better outlook and live longer compared with individuals with breast cancer who don’t exercise.

In general, physical activity can be safe for people undergoing breast cancer treatments. However, certain exercises may be too hard on the body, including those that put stress on the arms or shoulders following breast cancer surgery. Light exercise can be satisfying and raise your energy levels.

Talk to your doctor before starting a new exercise habit. Your doctor can help you understand what types of physical activity may be a good fit. It is usually a good idea to start slow — don’t push yourself too hard, and stop exercising if something doesn’t feel right.

Some MyBCTeam members have tried physical therapy or occupational therapy (OT) to help get them moving after treatments. “Postoperatively, OT helped me a ton,” one member wrote. “Also, my plastic surgeon’s nurse gave me arm exercises to do.”

Other members tried a variety of different types of exercise. “I’ve been lifting weights for nearly a year, and have amazing results with weight loss, increased muscle mass, and just feeling overall healthier. I take classes to ensure I’m using the correct form so I don’t get injured,” one member commented.

“I had never done yoga until my diagnosis,” reported a MyBCTeam member. “I started with a group of cancer patients/survivors. I did it all through treatment and now take yoga classes regularly at the YMCA. Dropped a bit of weight, and I feel better.”

3. Manage Stress and Emotions While Living With Breast Cancer

A diagnosis of MBC can be stressful. You may have to make a lot of big decisions, rethink plans, and change your daily routines. However, you don’t have to figure it out alone. There are many resources that can help.

Many people with breast cancer find counseling useful. You may want to talk to a therapist, psychiatrist, psychologist, social worker, or religious leader. This type of mental health support can help you learn coping skills, manage anxiety and depression, make decisions, and have important conversations with loved ones.

Talking to others who are in your shoes can also help. Your health care team may be able to direct you toward an in-person support group where you can meet others in your area with breast cancer. Additionally, online support groups like MyBCTeam can help you connect with others. You may also be able to find groups through social media.

4. Talk to Others About Your Diagnosis and Adjust Expectations

Most people with MBC will feel the need to talk to others about it. Talking things through may help you better understand and accept your diagnosis. However, it’s up to you who you want to tell and how you want to explain the information.

You may want to tell loved ones about your diagnosis in person. You can also ask a friend or family member to tell other people for you. Some people, like acquaintances or co-workers, may not need to know as much information. You may want to take some time considering how many details you aim to share with different groups of people.

“When I was first diagnosed, I knew I needed time to process before talking about it,” one MyBCTeam member said. “I called one of my sisters and asked her to be my communicator with family and close friends. About a week or two later, I was OK talking about things.”

“I was apprehensive when talking about my diagnosis to my family at first,” commented another member. “But I will tell you, I was very grateful for the support network I had, and needed their love to help me through the journey.”

Navigating Family Life With Metastatic Breast Cancer

The roles and responsibilities you have at home may need to change depending on your current stage of treatment. Breast cancer symptoms and treatment side effects, like fatigue and brain fog, may make it more difficult to continue your usual role within your household.

You may need to ask friends and relatives for help with tasks around the home, including cleaning, meal prep, or lawn care. Your partner or another loved one may need to help care for and transport children. You may not be interested in sexual activity, or it may become uncomfortable. A family or relationship counselor may be able to help you, your partner, and your children work through changing routines and emotions.

Working While Living With Breast Cancer

A MBC diagnosis is a significant life change that will likely affect your occupation and career path. You may be able to work with your current employer to adjust your workload or take advantage of accommodations. The Americans With Disabilities Act National Network has resources that can explain your rights.

At some point, you may need to quit your job or find a new one that better suits your needs. For example, it may help to find a part-time or remote job that has a more flexible schedule. This can be a good fit if you need to take time off to go to doctor’s appointments or if you aren’t feeling well enough to work.

5. Keep Talking With Your Health Care Team About Your Metastatic Breast Cancer Treatment Plan

Your treatment plan may change over time. A medication that was once effective may stop working to control your cancer. Your doctor may recommend switching to a new treatment.

Your goals and priorities might also evolve, and you might want to make different treatment decisions. Treating MBC requires an ongoing conversation between you and your health care team.

Palliative Care

Advanced breast cancer often comes with many symptoms and side effects. Palliative care aims to reduce symptoms, ease pain, and help you feel more comfortable. You can use palliative care while also receiving other treatments that directly treat your cancer.

A palliative care team can help you better understand your treatment options and provide emotional support. Talk to your doctor if you’re interested in learning more about palliative care.

Deciding Not To Treat

Sometimes, the right treatment option is none at all. You may decide to stop all cancer treatments because you feel the risks outweigh the benefits. In some cases, doctors may not expect treatments to be very helpful.

It’s important to regularly talk to your health care provider about what is realistic to expect from each treatment option. Don’t stop taking your cancer treatment without first talking it over with your doctor.

Hospice Care

If you decide that you no longer want to continue going through cancer treatments, you can choose to receive hospice care. Hospice is an option for end-of-life care. It connects you with a care team that helps manage your physical, mental, emotional, and spiritual needs.

If you choose to use hospice care, you can still receive medical care to reduce pain and improve your quality of life, but you will no longer use treatments like chemotherapy. You can receive hospice care in a hospital, nursing home, or in your own home.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 67,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Are you living with metastatic breast cancer? Do you have any advice for others about easing symptoms and feeling better day to day? Share your experiences in the comments below, or start a conversation by posting on your Activities page.