Living with Metastatic Disease

You did everything you were supposed to do: the tests, the treatments, the weeks of coping with side effects and rebuilding your strength. Finally, your cancer treatment ended and you started moving forward with your life again.

Months, even years, later, a follow-up exam or test discovers that the original cancer is back and has metastasized, or spread, to another part of your body. This distant recurrence means some cancer cells weren't destroyed by treatment. Instead, they grew and moved on to other organs or tissue.

In metastatic disease, the cancer in the new location is the same cancer that occurred in the original site. This means that if you were treated for prostate cancer, but a few cells survived, moved into your bones and grew, the second occurrence is still prostate cancer, not bone cancer. Sometimes, metastatic disease is found when there was no known cancer before - so the original cancer doesn't get identified until after the spread is discovered.

Many people living with metastatic disease have fulfilling, prolonged lives. Depending upon the cancer and previous therapy, there are treatment options - including chemotherapy, radiation, or biologic therapy. Clinical trials around the country are exploring new approaches to metastatic cancer that may be effective.

It's not easy to hear the news that you have metastatic disease, yet you may be better equipped to handle your cancer experience now than you were before. And treatments, both for the cancer and side effects, may have improved in the intervening time.

Here's more to help you with living with metastatic disease:

· Get a second opinion. You won't offend your doctor by doing so. Having another expert look over your tests and cancer history can help you consider treatment goals and choices. Consider possible side effects balanced against potential results.
· If you experience symptoms such as pain or difficulty breathing, get help as soon as possible. Comfort or palliative care, which treats and prevents symptoms and side effects, is now seen as an integral part of care for all cancer patients. For more on easing and preventing side effects, go to Side Effect Management. 
· Hearing that cancer has spread can stir up strong feelings in you, from disbelief to fear. Although anxiety and depression are common among people with cancer, these conditions can be treated. Seek help if you're experiencing an ongoing sense of hopelessness.
· Let yourself off the hook. You may worry that you should have chosen a different treatment, or returned to the doctor sooner. Or you feel responsible for the worry that your new diagnosis will create for family and friends. Try to ease up on the guilt. Use your energy for more important, enjoyable activities. If your guilt feelings persist, talk with a counselor, your doctor or a support group.
· Explore what you love to do. Set attainable goals for each day that include things that give you pleasure. When you feel worried or stressed-out, take a walk, listen to music you find calming, write in a journal or draw, watch a movie (or read a book) that makes you laugh, do relaxation exercises, garden, play with a pet, or chat with a friend.
· If you haven't already done so, talk about what future care you would like with your loved ones. Express your care decisions by filling out advance directives, a living will, and a durable power of attorney for health care. Take care of other legal matters, such as creating a will. Having such information in place doesn't mean you've given up. It helps you and your family go forward.