Living Well with Metastatic Breast Cancer: A Practical Guide to Facing Each Day with Strength

Most survivorship articles focus on finishing treatment and learning to ease into the new norm. But for women living with metastatic (stage IV) breast cancer, the journey looks different. Treatment continues, emotions shift, and “normal” evolves into a new routine with its own challenges. This article is written specifically for those living with ongoing Stage IV disease, where cancer remains a part of daily life – not as a setback, but as a reality that requires strength, adaptability, and purpose.  Understanding Advanced Breast Cancer “What does it mean to be Stage IV?” Advanced breast cancer, also known as metastatic breast cancer or Stage IV breast cancer, is cancer that has spread beyond the breast to other parts of the body like bones, lung, liver, brain, or other organs [1] [2]. Sometimes it may be found at first diagnosis, or it can develop as a recurrence [2].  While it is not curable, advancements in treatments have made it possible to relieve symptoms, slow cancer progression and improve quality of life.  Receiving this diagnosis can feel like the ground has shifted beneath you. You may experience disbelief, anger, fear, sadness or helplessness. Even small physical sensations can suddenly carry more weight, leading to heightened vigilance and worry [3]. These feelings are normal. Give yourself compassion and time to process everything before looking ahead. When Survivorship Takes a Different Shape “What does ongoing treatment mean for my life ahead?” For early-stage breast cancer, survivorship often means transitioning from active treatment to surveillance and the gradual rebuilding of daily life . There can be pressure, both spoken and unspoken, to “bounce back”, return to routine, and leave cancer behind.  However, metastatic breast cancer brings a different kind of survivorship: Treatment is ongoing, not completed You may navigate cycles of stability and progression Discussions may include symptom management, palliative or supportive care and long-term planning [4][5] Living meaningfully “right now” becomes just as important as preparing for the future You may not always consider yourself a “survivor” in the traditional sense, but you are – in the way you adapt, carry on, and remain present every day.  Finding Your Voice and Embracing Support “How can I learn to let others in?” Honest communication with your care team can help you understand what lies ahead and manage common side effects such as fatigue, neuropathy, pain, hair loss, insomnia and vaginal dryness [2].Viewing this condition as a chronic but not life-limiting illness may may also help [6]. Asking about sensitive topics, including end-of-life concerns, can help reduce uncertainty and help you make confident, informed decisions. Without this clarity, you may feel anxious and turn to less reliable sources on social media or experience a flood of well-meaning but overwhelming advice from loved ones, which can worsen distress [2]. Support from loved ones can make a world of a difference. Family and friends may not always understand your experience or know how to help. This can make you feel drained and you may feel tempted to withdraw. But, isolation can magnify your symptoms and emotions.  It’s common to hesitate asking for help, worrying about being a burden or feeling pressured to stay positive. However, needing support doesn’t mean showing weakness, and asking for help is a form of strength.  Loved ones can support you by: Driving you to appointments and sitting in with you Helping to research questions about the disease and management to clarify with your healthcare providers Assisting with daily household tasks or errands  Helping with child care, pet care or care of elderly dependents Offering quiet companionship and a listening ear or positive encouragement Support groups and peer communities can be especially meaningful [7]. Many women find comfort in speaking with others who truly understand the journey of uncertainty, emotional complexity and resilience required to live with metastatic disease. Quality-of-life concerns including physical and emotional distress, body image struggles, disruption of daily routine, and an awareness of life’s brevity can cause distress and open communication with loved ones can improve psychological adjustment [3][8]. You may need to take the lead in expressing your needs, but remember that advocating for yourself doesn’t mean you’re responsible for others’ emotions.  Living for Yourself in the Face of Metastatic Cancer “Each day holds moments to cherish, even with cancer as part of my story.” Cancer can disrupt routines and create instability. Rebuilding pockets of predictability in your life can help you feel grounded and in control.  Here are some strategies that many women find helpful :  Keep Yourself Engaged Continuing work, hobbies or daily routine – when you are able - can bring stability and reduce the focus on cancer. Set Attainable Goals Small goals, such as short walks or trying a new recipe, and long-term goals, like completing a course or project, can bring purpose and help you celebrate wins as they come. Engage in Hobbies and Practise Mindfulness Diving into new passions such as art, journaling, music, yoga, or meditation, or rekindling joy in existing ones can help reduce stress, ease anxiety and strengthen emotional resilience. Honour Your Energy Some days will be better than others. Adjust your expectations and routines based on how you feel. What matters is not productivity – it’s honouring your needs. Consider Long-Term Planning as Empowerment For many, long-term planning can bring comfort and peace of mind. This may include: Setting practical arrangements Discussing future goals with loved ones Clarifying preferences around medical care Identifying meaningful “life projects”, such as photo albums, letters or personal legacy work Long-term planning is not about giving up – it is a way to create stability and ensure that your voice remains central in all decisions. A lifelong illness can sharpen your appreciation for meaningful moments: shared laughter, a nice meal, or time with loved ones. These moments matter. They are not small–they are anchors. Hope isn’t Gone, it Persists “I’ll take things one step at a time.” Hope for women with metastatic breast cancer often shifts away from cure and toward living fully and meaningfully, despite the uncertainty.  It can be difficult when others see only “the cancer patient” instead of the whole person. Staying connected with your identity – your interests, values, quirks, dreams – can help you reclaim the space cancer often tries to occupy.  You remain a whole and beautiful person. You deserve care, dignity and joy – not because of your diagnosis, but because of who you are. You Are Not Alone At Solis and Luma, we recognise that every woman’s journey is uniquely hers. Survivorship is defined by the quiet strength it takes to live each day with intention, no matter your stage.  *Article reviewed by Dr Tan Sing Huang, Senior Medical Oncologist at OncoCare Cancer Centre. Dr Tan Sing Huang is also a contributing author of The Breast Years of Your Life: Living Well After Cancer, a compassionate guide on healing emotionally, navigating advanced breast cancer, and living with purpose.  Learn more or get your copy at: https://www.solis.sg/the-breast-years-of-your-life/  References [1] Cleveland Clinic, Metastatic Breast Cancer [2] Solis Breast Care & Surgery Centre, The Breast Years of Your Life: Living Well After Cancer [3] The Breast Journal, Living with Metastatic Breast Cancer: A Qualitative Analysis of Physical, Psychological, and Social Sequelae [4] Journal of Surgical Oncology, Breast cancer survivorship [5] ASCO Educational Book, Survivorship Care for People Affected by Advanced or Metastatic Cancer: Building on the Recent Multinational Association of Supportive Care in Cancer-ASCO Standards and Practice Recommendations [6] PLOS One, Exploring the experiences of women living with metastatic breast cancer [MBC]: A systematic review of qualitative evidence [7] European Society for Medical Oncology, The Guide for Patients on Survivorship [8] National Library of Medicine, Metastatic breast cancer: Learn More - Living with metastatic breast cancer 
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From Communication to Connection: Rebuilding Intimacy and Sexual Wellness After Breast Cancer

For many women, intimacy after breast cancer can feel like unfamiliar ground. Your body has changed, emotions have shifted, and the idea of pleasure may feel distant. Yet intimacy isn’t lost, it’s transformed. Rebuilding closeness begins with understanding these changes, communicating openly, and learning to define pleasure on your own terms—in new, meaningful ways. Listening to Your Body’s New Language Breast cancer surgery may alter the look and feel of your breasts [1]. Treatments like chemotherapy and hormone therapy can cause vaginal dryness, fatigue or reduced desire [1] [2]. These physical shifts can affect how you relate to your body, and how confident you feel about resuming intimacy. It’s common to wonder: “Will my partner still find me attractive?” “Will sex feel the same?” [3] [4] Partners may also hesitate, afraid of causing pain or not knowing what’s “okay” [4] [5] [6]. Over time, silence and assumptions can create distance—even when love remains strong [7] [8].  Acknowledging these changes—in your body, your sense of self and your relationships—is a vital step in healing. Your body has carried you through cancer. Listening to it, with kindness instead of judgement, is an act of self-compassion. Boundaries as Bridges, Not Barriers Rebuilding intimacy begins with open communication. After treatment, your needs and comfort levels may have changed, and sharing them honestly helps strengthen trust and deepen connection [9].  Boundaries aren’t walls. They’re bridges that help you and your partner meet each other where you are.  Research shows that couples who communicate openly about fears, desires and limitations experience greater satisfaction and less distress [10].  You can also speak with your doctor about symptoms like pain, dryness or loss of sensation [1]. Your care team can suggest ways to manage these and make intimacy more comfortable for you.  It’s normal to feel shy about discussing sexuality. But remember: talking about sex is a natural, healthy part of reclaiming yourself [11]. The first conversation may feel awkward—but it opens the door to healing closeness.  Redefining What Closeness Means When you think of sexuality, you may first think of intercourse. But pleasure can be found in small acts of connection—holding hands, gentle touch, laughter or emotional intimacy [1] [7] [9]. Exploring touch gradually and broadening your idea of connection beyond penetrative sex can reduce anxiety and help you rediscover comfort in your body in new ways [7] [9]. Studies show that couples who approach intimacy with openness, flexibility and acceptance rebuild stronger connections [12].  If pain or numbness occurs, try different positions that take the pressure off your chest, or take breaks [7] [13].  Remember: pleasure is about comfort and connection, not performance.  Moving Forward and Finding Your Rhythm Again Desire may not feel as spontaneous, but closeness is always within reach. Whether through gentle touch, warm conversation or shared laughter, intimacy begins when you feel safe, seen and loved.  Be patient with yourself. Some days, you will crave closeness; others, rest will be what you need most. Both are forms of healing.  At Solis and Luma, we believe that living well after breast cancer means nurturing joy, confidence, and intimacy—in a way that works for you. Every journey is unique. Don’t be discouraged if something that works for others doesn’t feel right for you [14]. Let this new chapter be where you redefine intimacy—not as something lost, but as something newly yours.   Article reviewed by Ms Dian Handayani, Sexologist and Certified Sex Coach at Nambani. Dian is also a contributing author of The Breast Years of Your Life: Living Well After Cancer. From emotional resilience and fertility to nutrition and exercise, the book offers compassionate, practical guidance for survivors rediscovering wellness and confidence after treatment. To learn more or grab a copy, visit https://www.solis.sg/the-breast-years-of-your-life/ References: [1] Solis Breast Care & Surgery Centre, The Breast Years of Your Life: Living Well After Cancer [2] American Cancer Society, Body Image and Sexuality After Breast Cancer  [3] Breastcancer.org, Sexual Health During and After Breast Cancer  [4] Current Opinion in Supportive and Palliative Care, Sexual identity after breast cancer: sexuality, body image, and relationship repercussions [5] MD Anderson Cancer Center, Sexuality and Cancer: A Guide for Patients and Their Partners [6] Women's Health, Care for breast cancer survivors in Asian countries: A review of sexual dysfunction [7] Breast Cancer Now, Your Body, Intimacy and Sex [8] Psychooncology, Everyday Protective Buffering Predicts Intimacy and Fear of Cancer Recurrence in Couples Coping with Early-Stage Breast Cancer [9] BMC Cancer, Constructions of sex and intimacy after cancer: Q methodology study of people with cancer, their partners, and health professionals [10] European Journal of Oncology Nursing, Factors contributing to sexual dissatisfaction in women with breast cancer: The specific role of conjugal relationship quality [11] American Cancer Society, How Cancer Can Affect Sex and Intimacy [12] Frontiers in Psychology, Coping With Changes to Sex and Intimacy After a Diagnosis of Metastatic Breast Cancer: Results From a Qualitative Investigation With Patients and Partners [13] The Oncologist, From diagnosis to survivorship addressing the sexuality of women during cancer [14] Psycho-Oncology, Wearing my heart on my chest: dating, new relationships, and the reconfiguration of self-esteem after breast cancer
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From Screening to Strength: Courage in the Face of the Unexpected

Breast cancer can strike unexpectedly, often without warning. For Tracy*, a 53-year-old mother of four and passionate hobbyist potter, a routine MRI changed everything. What began as curiosity about advanced screening became a journey of discovery, courage, and empowerment - showing that knowledge, vigilance, and support can make all the difference in living well after cancer. Please share your name, age, and a little about yourself. My name is Tracy, I’m 53 years old, a mother of four boys, and a hobbyist potter. Can you tell us about your journey with breast cancer — how you first discovered it and what went through your mind at diagnosis? I had no physical symptoms and no family history of breast cancer. Living abroad, I had been told during regular mammogram screenings that my dense breast tissue was common and “nothing to worry about,” though I was advised to continue six-monthly mammograms. These frequent screenings were inconvenient, so when I read that MRI was considered the “gold standard” for dense breasts, I decided to try it while visiting Singapore. I expected a clear MRI that would allow me to reduce the frequency of mammograms. My doctor at Solis was curious why I wanted an MRI, as my mammogram and ultrasound showed nothing concerning, but she agreed to order it. To my surprise, the MRI revealed a suspicious non-mass enhancement in my right breast, visible only on MRI. A biopsy followed, initially showing atypical ductal hyperplasia (ADH), which surgery later upgraded to Ductal Carcinoma In Situ (DCIS). Within two weeks, I went from reassurance to shock. I questioned why this had happened to me despite having no risk factors or symptoms. I berated myself for assuming the MRI would be clear and panicked over how much time I might have left with my children and husband. Why me? What was your biggest concern or worry at that time, and how did you go about finding information or support? My foremost concern was to remove all the traces of cancer from my body. I followed my doctor’s advice and underwent radiotherapy and endocrine therapy. I read every report, learned every medical term, asked informed questions, and explored ways to reduce the risk of recurrence. Knowledge became my way of regaining control.  What helped you find strength during your treatment and recovery? I was mostly alone in Singapore with one of my sons who was serving National Service, while my husband and other sons remained abroad. But my extended family and friends came out in full force for me. They jostled to accompany me to doctor visits and radiotherapy sessions, waited for me before and after surgery, surrounded me with prayers, nourished me with food, and gave me space to cry and ruminate — always making sure I knew I was not alone. What does “survivorship” mean to you, and how do you define “living well” after cancer? Survivorship means living intentionally. It has been just over a year since my diagnosis, and I take comfort in knowing the cancer was localised and treated accordingly.This experience has taught me to live more purposefully – to see each encounter and interaction as a meaningful step toward the next chapter of my life. Each year of living cancer-free is a blessing and an accomplishment.I’ve also become more conscious of my lifestyle. I now eat less red meat and focus on more vegetables, fruits, legumes, and soy. Taking ownership of my health feels empowering. How has this experience changed your outlook on life, family, or work? I’ve learned to let go of control and trust that life is molded through challenges, much like clay on my pottery wheel. Every experience shapes us. I now focus on what truly matters: meaningful relationships, gratitude and moments of joy. What advice would you give to other women going through a similar journey - or to young women about breast health and screening? Many Asian women have dense breast tissue, which can make cancer hard to detect. Family history and lack of symptoms do not guarantee safety. Be proactive, ask questions, and ensure your screening is thorough. Trust the expertise of your surgeons, radiologists interpreting your scans, and pathologists – and trust your instincts. What mantra or lesson do you carry with you today? Know and trust your gut instinct. If something seems off or keeps bothering you, ask questions until you find peace of mind. From diagnosis through treatment and into survivorship, Tracy’s story reminds us that life after cancer is not just about recovery - it’s about reclaiming control, finding purpose, and living fully. With determination, knowledge, and the support of loved ones, survivors can face uncertainty with confidence and grace.  Her journey is a testament to resilience and the power of trusting oneself – inspiring others to prioritise their health, seek understanding, and define their own path to living well.  *Name has been changed to protect the individual’s privacy.
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