Diagnosis: Metastatic


A patient with metastatic breast cancer offers nine steps to getting away from fear.

Is there a “right way” to handle a cancer diagnosis? What about a metastatic cancer diagnosis? If there is, I don’t know what it is. Sorry to disappoint you.

I was 50 — my birthday actually — when I found out I very likely had cancer. Within a few weeks, the oncologist scheduled me for tests to rule out metastasis since I was the right age and right cancer subgroup for a clinical study.

Those tests told a very different story from the one I’d heard up to then: “In six months you’ll be celebrating,” said one clinician. “You’re young,” said another. “Breast cancer isn’t a death sentence,” said a third.

For a lot of women, all those sentiments would — and will — ring true. Not for me.

A week after the tests, the oncologist sat me down and said I no longer qualified for the clinical trial. I knew immediately the news was bad.


It took a while to pick myself back up. I’m starting my third year of living with breast cancer and I still learn better ways of confronting and accepting this diagnosis almost any day of the week.

My nine-step plan, newly developed as I start day 800, is a pep talk for myself and words of hope (I hope) for those newly diagnosed.

Step 1: Throw out everything you think you know about breast cancer because if every patient you’ve known has been something other than stage 4, you probably don’t know much. If you believe, as I did, that you would be “cancer-free” in six months, throw that little bit of “knowledge” into the trash.

Step 2: Cry a little or cry a lot or do whatever you need to do to face the future.

Step 3: Accept that metastatic cancer is cancer for life. Maybe it won’t always be that way — there’s so much fast-moving research — but for now, a metastatic diagnosis means you’ll be receiving treatments of one kind or another for the rest of your life.

Step 4: Know that those treatments are maybe, hopefully, fingers-crossed, saving your life so that you can do most — maybe even all — of the things you did before cancer and planned to do in the future.

Step 5: Be grateful for the doctors, the nurses, the medicines, the research, Joe Biden, NIH, NCI, the friends, the family. You are in their hearts and on their minds.

Step 6: Grief and a sense of loss are OK. Imagine if you had been told you had, at best, a chronic but terminal disease and you didn’t feel grief. Once in a while, I wallow in it. It’s easy to get carried away to a point of feeling sorry for myself. When that happens, I remind myself that’s not grief, that’s self-pity and that’s an emotion that is no help to anyone.

Step 7: Stay away from digging online for articles about metastatic breast cancer that give you prognoses and life expectancies and such. Cancer research is happening so fast that even the internet can’t keep up.

Step 8: All those healthy things, eat your vegetables, get your protein, limit sugar, get some exercise, get enough sleep, do a little meditation or praying… all of it, yes, even the veggies, has made my life better.

Step 9: Keep dreaming. I know it’s tempting to curl up in a ball and hide. But your life is now, and that life also includes metastatic cancer. May you make the most of it.

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