Self-Care Is Important When You’re Living With HER2-Negative Metastatic Breast Cancer

When you’re living with HER2-negative metastatic breast cancer, it can be easy to get wrapped up in the feeling that the odds are against you. And sometimes, you might not be sure what to expect. After all, there’s a lot to keep track of, many appointments to attend and a whole lot of information to process.

Understanding HER2-negative metastatic breast cancer

HER2-negative metastatic breast cancer is an aggressive form of cancer. It can be difficult to treat because it tends to have lower levels of human epidermal growth factor receptor 2 (HER2) proteins.

Not only are these proteins responsible for breast cell growth and repair, but if you have triple-negative breast cancer, it may also be unresponsive to specific therapies that target HER2 receptors because they’re not easily targetable.

When breast cancer metastasizes (spreads) to other areas of your body, the goal of treatment focuses on slowing the spread of cancer and reducing the severity of your symptoms.

But palliative medicine specialist Nivia Ruiz, MD, says learning how to live differently rather than just focusing on survival is important.

“People often don’t take time to care for themselves because they’re so focused on treatment and prolonging their life that they’re forgetting the small things that are making them live and enjoy their life while they’re going through treatment,” says Dr. Ruiz.

“That part of self-care is so important to your treatment, and at times, just as important as any other part.”

Dr. Ruiz shares ways self-care can make a big impact when you’re living with HER2-negative metastatic breast cancer, and what that might look like on a day-to-day basis.

What does self-care look like when you have HER2-negative metastatic breast cancer?

Self-care can look like a lot of things to a lot of people. For some, it’s about tapping into moments of guilt-free indulgence. For others, it’s about doing something you’ve always wanted to do but haven’t had the time to do before.

But no matter how you approach self-care, the core of the idea is centered around the fact that you’re doing things that bring you joy and make you feel like life is worth living to the fullest as you cope with having a cancer diagnosis. Essentially, you’re doing what you can to improve your quality of life.

When you’re living with HER2-negative metastatic breast cancer, think about funneling self-care into three different categories:

• Treatments and activities you need to do to manage and reduce the severity of your symptoms.
• Modifications that make your life more enjoyable, comfortable and accessible at work, at home and in other areas of your life.
• Impactful, meaningful moments that bring you joy and satisfaction.

“It’s about living, it’s not just about being alive. So, you want to focus on how you want to live your life and that switch in focus can make a big difference,” reinforces Dr. Ruiz.

Manage your symptoms

This can sometimes feel like a box that needs to be ticked off. If you’re feeling unwell, what can you do to get yourself to feel better? Treatment and symptom management are often the key, but sometimes, even treatments have unwanted side effects when you’re trying to improve your quality of life.

That’s why building self-care into symptom management comes down to making sure you’re utilizing every supportive resource you have at your disposal.

“It’s not just about the pharmacological approach to your symptoms. It’s about connecting with support groups, asking for help when you need it, applying for financial assistance when you need that extra lift, and talking to someone about your anxieties because anxiety can even cause a lot of symptoms,” explains Dr. Ruiz.

For instance, alternative therapies like acupuncture might offer some relief for nausea and pain. Meditation and yoga might help focus your mind on other things outside of your treatment plan and bring awareness to other areas of your life that need tending. And working with a therapist can help take some of the weight off of the emotional burden you may feel as you navigate through these experiences.

“Putting your mindset on something else rather than just focusing on your symptoms can be helpful for some people who are under a lot of stress and anxiety,” notes Dr. Ruiz.

Modify your lifestyle

When you’re living with HER2-negative metastatic breast cancer, you may need to change some of the ways you go about certain physical activities like exercise, work and other responsibilities at home. And while change can be hard, it doesn’t always have to be viewed as a bad thing. Dr. Ruiz suggests being realistic about what you can do and allowing yourself to be confident in those decisions.

“Being confident doesn’t mean that you’re not realistic. But hoping for the best and keeping your mindset on that light at the end of the tunnel is going to be your goal,” explains Dr. Ruiz. “You want to focus on that and on what you want and how you want to live.”

So, when you’re living with HER2-negative metastatic breast cancer, you may need to modify your life to minimize risks and maximize comfort and joy. For example, if you’ve always been the kind of person to run five miles a day, but your cancer has spread to your bones, joints or other areas of your body that makes running more difficult, maybe go for daily walks instead of five-mile runs.

“A lot of breast cancer metastasizes to the bone, and sometimes, that leads to fractures that require surgery,” says Dr. Ruiz. “For people who are runners who are very active and go to the gym every day or run three miles at a time, sometimes, they may only be able to run a half-mile and sometimes, they may not even be able to go to the gym and they can just go for a walk.”

Be realistic about what you can do

The idea is that you’re looking at all the things you love doing and that are still important to you, and you’re trying to find workarounds and modifications that make sense for you and your body — wherever you are with your stage of cancer and in your current state of treatment.

Other modifications may include things like the following:

• Instead of going out to eat three times a week, maybe go out once a week.
• If traveling or spontaneously visiting with loved ones becomes difficult, you could plan ahead for extended visits or request they come to you.
• If traveling abroad is something that interests you, perhaps you could look at taking day trips closer to home or book a single-day cruise to maximize on that passion.
• If you’re a full-time worker, you might consider modifying your position at work so you’re doing less physically strenuous activities. You might also want to adjust your schedule so it better accommodates your medical appointments. Or drop down to part-time employment if working is still important to you.

“You’re trying to look at things that make you feel good and have those people in your support system next to you that are positive and make you have a good outlook on life because all of those things make a difference,” encourages Dr. Ruiz. “On dark days, you need that support next to you more than ever.”

Make room for meaningful moments

“From the moment you wake up, ask yourself, what’s important to you? Take the time to reflect and remember who you are and the things you love,” advises Dr. Ruiz. “Just because you have cancer doesn’t mean you have to stop living.”

Some take this time to start passion projects that involve self-reflection. You could write a memoir or autobiography of stories that have happened in your life and share those stories with people who are important to you. You might even find new passions in art therapy or music therapy. Or perhaps pick up painting as a hobby to calm your mind and explore new forms of creativity.

Evolving self-care

Over time, as the cancer progresses, self-care will likely evolve as your goals change.

“As you start declining, that’s when your support system is going to come into play because you may not be able to do some things in the same way or as often as you used to do,” explains Dr. Ruiz. “Your support system can help take care of you, help you achieve some of those goals, or help you change some of those goals.”

For example, if going for a walk becomes more difficult, perhaps you choose to paint or write instead, or arrange assistance getting in and out of the house to experience impactful moments during different times of the day.

“Goals tend to change as we decline, and that’s the hardest part,” recognizes Dr. Ruiz. “But even the smallest things like having the goal to sit outside in the morning and have a cup of coffee with your spouse or your children is something we can do to build into your routine.

“You may not be as active, but we can work on making those smaller moments more impactful and more meaningful.”