Coping with Metastatic Cancer

Approved by the Cancer.Net Editorial Board, 01/2016

When cancer spreads to a different part of the body from where it started, doctors call it metastasis. They also call it “metastatic cancer” or “stage 4 cancer.” Sometimes the term “advanced cancer” also describes metastatic cancer. But it shouldn’t be confused with “locally advanced cancer,” which is cancer that has spread to nearby tissues or lymph nodes and not throughout the body. Learn more about the basics of metastasis.

The naming of metastatic cancer can be confusing. Doctors name a metastasis for the original cancer. One way to remember this is consider a garden:  If dandelions from the lawn go to seed and grow in the rose garden, nobody calls them roses. Rather, they are dandelions spread to the rose garden. In a similar manner, breast cancer that spreads to the bone is not bone cancer, it is metastatic breast cancer.

What does it mean to have metastatic cancer?

In the past, many people did not live long with metastatic cancer. Even with today’s better treatments, recovery is not always possible. But doctors can often treat cancer even if they cannot cure it. A good quality of life is possible for months or even years.

How is metastatic cancer treated?

Treatment depends on the type of cancer, the available treatment options, and your wishes. It also depends on your age, general health, treatment you had before and other factors. Treatments for metastatic cancer include surgery, chemotherapy, hormone therapy, biologic therapy, and radiation therapy.

Goals of treatment

For many patients diagnosed with cancer, the goal of treatment is to try to cure the cancer. This means getting rid of the cancer and never having it come back. With metastatic cancer, cure may not be a realistic goal. It is reasonable to ask your doctor whether cure is the goal.

If cure is not the goal (understanding that it might be a hope, dream, or miracle and that it is reasonable to “never say never” and “never say always”), what is? The goal of treatment is to help a patient live as well as possible for as long as possible. Getting more specific, the goal can be broken down into four parts:

  • To have the fewest possible side effects from the cancer

  • To have the fewest possible side effects from the cancer treatment

  • For the patient to have the best quality of life

  • For the patient to have the longest quantity of life

Each patient emphasizes these items differently. It is important to tell your doctor and care team what is important to you.

Getting treatment for metastatic cancer can help you live longer and feel better. But getting treatment is always your decision. You can also read Making Decisions about Cancer Treatment and the ASCO Care and Treatment Recommendations for Patients. These recommendations include information on treating many types of metastatic cancer.

Living with long-term cancer

When doctors can treat metastatic cancer, your situation may be like someone with a chronic (long-term disease). Examples of chronic diseases are type 1 diabetes, congestive heart failure, and multiple sclerosis. Doctors can treat these conditions, but not cure them.

The challenges of living with cancer

Living with metastatic cancer is challenging. The challenges are different for everyone, but they can include:

  • Feeling upset that the cancer came back – You might feel hopeless, angry, sad, or like no one understands what you are going through, even family.

  • Worrying that treatment will not help and the cancer will get worse.

  • Dealing with tests, doctor’s appointments, and decisions.

  • Talking with family and friends about the cancer.

  • Needing help with daily activities, if you feel exhausted or have side effects from treatment.

  • Finding emotional and spiritual support.

  • Coping with the cost of more treatment – Even if you have insurance, it might not cover everything.

Meeting the challenges of metastatic cancer

To understand your situation, you may want to get a second opinion. Many people find that it helps to get an opinion from another oncologist, and many doctors encourage it.

Your doctor can help you cope with cancer symptoms and treatment side effects. For example, if you have pain, your treatment might include surgery to remove a tumor in a painful area. Your doctor might also prescribe pain medication or anti-nausea medication.

Deal with emotions and lifestyle changes

Coping with emotions and lifestyle challenges is an important part of living with metastatic cancer. Ways of coping include:

  • Learning about the metastasis—You might want to know everything possible, or just basic information.

  • Talking with a counselor about your situation – For example, a psychologist, psychiatrist, or oncology social worker.

  • Managing stress—From planning ahead to trying meditation and yoga, there are many options to help lower your stress level.

  • Finding meaning—Talking with a hospital chaplain, a counselor, or your religious leader can help.

Recognize your feelings and concerns

Talking about fears and concerns is important, even when treatment is working well. Tell your doctor and health care team about emotional symptoms. People may live for years with metastatic cancer. Your doctor can help you have the best quality of life possible during this time. Hospitals and medical centers have many resources for you and your family.

Family members need help, too

Your loved ones might also need help coping. Having a family member or friend with metastatic cancer is challenging, especially for people who help care for you. They can try the ways of coping above. Your doctor and health care team can suggest more help for family members. For example, support groups for family members meet in person and online.

More Information

Advanced Cancer

Coping with Uncertainty

Dealing with Cancer Recurrence

Finding Support and Information

Additional Resources

American Cancer Society: Treating Cancer as a Chronic Illness

National Cancer Institute: Managing Cancer as a Chronic Condition