Educated Patient® Metastatic Breast Cancer Summit Addressing Psychosocial Issues Presentation: June 11, 2022

Metastatic breast cancer not only affects a patient’s physical health, but also their psychological health, so it is important for them to communicate any distress they may be going through emotionally with their care team or family and friends.

Dr. Wendy Baer, a psychiatrist at the Winship Cancer Institute at Emroy University and Healthcare in Atlanta, explained at the CURE® Educated Patient® Metastatic Breast Cancer Summit that psychological distress can affect every patient differently; it depends on where they are in their cancer journey and who they are.

Some may experience it as a result of their metastatic diagnosis, others after their treatment has ended and some may enter their diagnosis with a pre-existing mental health issue.

“How people emotionally respond to the metastatic diagnosis really depends on who they are as a person,” she said in an interview with CURE®. “Certainly, as people meet with their treatment team and figure out a plan to manage their cancer, the psychological impact seems to diminish some.”

Some specific psychological distress that patients with metastatic breast cancer may experience include concerns around whether their body can tolerate treatment, a sense of sadness that a perceived health status is now gone and guilt about past activities that they may think led to this diagnosis. She added that there is also worry about relationships, and whether the people in their lives will stick by their side through a cancer journey.

“Those are distinct from somebody who may develop an anxiety disorder or clinical depression, that comes with a certain set of symptoms that when people meet criteria for those diagnoses, we really want to pay attention so that we can treat them if they’re experiencing an anxiety disorder or episode of clinical depression,” she explained.

This distress that patients are feeling can then impact their daily life. It can be difficult to focus at work, or to do daily tasks that might include taking care of a family or house — it can begin to feel overwhelming, Baer added. There is also “a tax on time,” she called it, where treatments, appointments and other medical needs are taking up time that gets in the way of someone’s normal daily routine, or when they would be able to visit with family and friends.

“I think when (a patient) is dealing with a normal range of emotions, those are magnified when (they) receive a diagnosis or are early in (their journey of receiving) treatment,” she said.

How to Help

Baer explained that today there are many resources for patients to go to if they are feeling psychologically distressed during their diagnosis, and most care teams are made up of many experts who may take holistic approaches to help them in this aspect; however, patients still need to bring it up themselves and talk about it.

“I think if people are getting treated in a place where they don’t feel heard, or that some of their emotional concerns are not getting addressed, it’s worth bringing up. It’s worth talking about it with (their) team to see if a conversation can go anywhere,” she added.

A conversation about how a patient is feeling emotionally during treatment with a doctor or nurse can lead to another direction of resources. They can point patients towards a therapist, a support group or someone who has gone through a similar journey that can provide insight or encouragement.

There can also be a conversation held with a trusted family member or friend. As a patient, it could be helpful to hear from an outside party — someone who can give gentle feedback — about whether they seem like their regular selves, or if others have noticed a change as well since the diagnosis, she explained.

“By having that conversation, you can start to open doors to things that might be helpful,” Bear concluded.

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