Metastatic Breast Cancer Comes with Difficult Decisions

Receiving a diagnosis of metastatic breast cancer may bring with it range of different emotions from anger to acceptance.1 How you deal with these emotions is important, even critical for your survival. It may be time to think about the things that you have not allowed yourself to think about, or even begin to look at life differently than you ever have before.

Keep Your Doctor Informed

Every patient’s experience with metastatic breast cancer is different. Some experience few or no symptoms and some experience a variety of symptoms. Some of these may be non-specific, such as fatigue, nausea, pain, and shortness of breath. It may be helpful to keep a diary or journal to record how you feel each day. Occasionally, breast cancer patients choose not to tell their doctor about symptoms they may be having or if they do, they underestimate the severity of them. This will not help the patient or the doctor treating the patient.

If your doctor tells you that your breast cancer has reached a stage where no treatment can be given, this will likely bring fear, anxiety, sadness, and grief as you consider the end of your life. Try not to keep your feelings inside, but share them with your loved ones. It will help to hear what their thoughts are too, and that you are not alone.

If this is the case, your doctor should help you find a palliative care program. Most cancer treatment facilities have a palliative care program in place. The health care providers in palliative care programs are there to help you manage your pain and discomfort and to improve your quality of life. Be honest about your symptoms so that they can help manage your pain appropriately.

Maintaining Control of Your Life

It is easy to feel like you are losing control of your life when you are juggling several doctor appointments, taking medications and trying to manage your personal life, all while fighting for your life.

But this is your chance to make your wishes known, to ensure that the time you have ahead of you is spent the way you want to spend it, and that your wishes will be honored after you are gone. Your loved ones and caregivers will be grateful to know that your wishes will be carried out as you wanted them to.

If you and your loved ones have already discussed plans for your care but received this information afterwards, you may want to review them and ensure that they are still accurate. The kinds of things that you should determine while you are still able include the following.2

  • Advance directives or living will– These are instructions for your health care providers so that they know what you do and do not want done concerning your health and your body. These instructions take the pressure off of any one person, including the doctors who are taking care of you, and ensure that your wishes are honored. More than likely, your doctor has a standardized form that you can complete and have placed into your medical chart.
  • Choose your medical power of attorney (MPA) – This is the person that will make medical decisions for you, if you should become unable to do so for yourself. If an MPA is not chosen and you are unable to make your own decisions, the standard procedures will be followed concerning next of kin.
  • Last will and testament – This is a legal document that allocates the distribution of your property and possessions after your death. If you have young children, the guardianship of those children will also be addressed in this document. Without a will in place, state laws take over, which can create a long, expensive process that in the end, may not correspond with your wishes.

These topics are not the most pleasant ones to approach and you may find yourself trying to avoid them. However, every living thing has an inevitable appointment with death. The sooner you understand this the better, and you may even find relief in the fact that you have taken care of a situation that may cause strife within your family after you are gone.


1 Clinical practice guidelines for the management of advanced breast cancer. (January 2001) National Health and Medical Research Council as prepared by the iSource National Breast Cancer Centre, Australia.

2 Planning for End-of-Life Care Decisions. (June 14 2010) Retrieved from the National Institute on Aging at

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.