Coping with metastatic cancer

Many people think the worst when they are told that their cancer has spread, and the first thing they think about is dying. No one knows how long anybody will live, but with metastatic cancer your life may be shorter than if the cancer had not spread. 

Some cancers can be controlled for a number of years with modern treatments, and new treatments are being developed all the time, so it is possible to live with metastatic cancer for a long time.

If you have questions about what will happen next or how long you will live, we have more information on asking about your prognosis.

Another fear about cancer is pain. Even if you do get pain, there are many different types of very effective painkillers to control it. We have information on managing pain.

Many people find it very reassuring to talk to other people who are in a similar situation and facing similar challenges. 

Local cancer support services provide a range of helpful services such as counselling, complementary therapies, exercise programmes and other activities. They can also give you practical advice and support. Some also have metastatic cancer support groups. 

We have information on local cancer support services, or call our Support Line on 1800 200 700 for information on services and support groups in your area.

There are a number of hospital-based services that can help you. For example:

• Psycho-oncology services are specialists who can help you cope with the emotional impact of metastatic cancer.
• Dietitians can advise you on ways to eat as well as possible to keep your strength up, cope with side-effects and stay as well as possible.
• Medical social workers can support you and your family with practical issues and advise you on support services.

Peer Support is a free and confidential telephone service connecting people with similar cancer experiences. If you have a cancer diagnosis, you can be matched with a Peer Support volunteer who has had a similar cancer journey. Peer Support volunteers are fully trained to provide emotional and practical cancer support in a safe, responsible and kind way.

Call 1800 200 700 for more information or visit a Daffodil Centre. Ask if you can be put in contact with a volunteer who is living with metastatic cancer.  

It can be a great weight off your mind to share your feelings and concerns. You could talk to a friend or family member if you feel comfortable doing so. 

You could also speak to a specialist nurse in confidence by dropping into a Daffodil Centre or calling the Irish Cancer Society Support Line on 1800 200 700. Our booklet Understanding the emotional effects of cancer  also has tips to help.

Exercising can boost your mood and improve your energy levels. The type and amount of exercise you can do will depend on how you are, but even a little physical activity is better than none. Talk to your doctor or nurse about which activities are safe and suitable for you. 

Knowing what to expect can help to relieve anxiety and stress for some people. If it makes you anxious, ask a friend or relative to find out for you and tell you the important things.

Writing can help you to express your feelings, especially if you can't talk about them with other people.

You may find that if you do things for yourself it helps to make you feel more independent and in control.

Breathing exercises, visualisation or meditation can help with anxiety. Some cancer support centres provide groups to help you learn these techniques. 

For some people praying or talking to a leader or a member of your religious faith can be a way to find strength and meaning in times of stress.

Cancer can bring a lot of uncertainty into your life. It can be very difficult to face an uncertain future and feel you are no longer in control. One way to reduce stress of uncertainty is to make your plans day by day. Letting go of the past and not worrying about the future allows you to live fully in the present.

Complementary therapies like meditation, aromatherapy and massage may help to relieve the symptoms and side-effects of treatment and help you cope with fear and anxiety.  More about complementary therapies and cancer.

Many people find it puts their mind at rest to have medical plans in place and sort out legal and practical matters, even though they still hope to live for a long time. Planning ahead is useful for everyone, whether they have an illness or not. Read some advice about making medical and legal plans.

If you have a partner they are probably experiencing similar emotions to you. Cancer can bring you closer together or sometimes it can challenge a relationship that previously felt secure.

Talking about your feelings and fears can be very painful and this can make communication difficult at a time when talking openly is important. If you have problems working through issues it may be helpful to contact a social worker or counsellor. You could also talk to your GP or specialist nurse.

You can also speak to a cancer nurse in confidence by calling the Irish Cancer Society Support Line on 1800 200 700 or emailing supportline@irishcancer.ie. Our nurses can also arrange counselling for you, which is funded by the Irish Cancer Society and is available remotely or in local cancer support centres around the country.

Talking to children and teenagers about cancer is difficult. When you have metastatic cancer it can be even harder. Because your natural reaction is to protect your children, you may be tempted to say that everything will be fine. But in the long run, it is best not to give children false hope.  

One question that most parents dread is ‘Are you going to die?’

Here are some suggestions for ways you might want to respond to the question:

• "Sometimes people die from cancer. "Thankfully many people with advanced cancer are living longer. I hope that the treatment I am getting will control my cancer but I know it won't cure it. I will let you know if my treatment is working. If there is any change in my cancer I will let you know."
• "There is no way to know right now what’s going to happen. I’ll know more after the first treatments are finished. When I know more, I will tell you."
• "Right now we don’t know the answer to that question. But I’m going to give it my best shot and do everything I can to get well. I will always be honest with you about what is going on."

Even with metastatic cancer it is still important to balance hope with reality. By helping children face death together as a family, you are likely to help them adjust and recover from their grief quicker. 

At this time you will want to consider what is important for you, how you want to spend the time and how your children can be involved.

We have a free booklet called Talking to your children about cancer. It has practical advice, with specific tips for talking to different age groups. It also has information on supporting children and teenagers and helping them to deal with their emotions. If you would like a copy or more advice, call our Support Line on 1800 200 700, visit a Daffodil Centre or download it below.

No one knows how long anybody will live, but with metastatic cancer your life may be shorter than if the cancer had not spread. 

If you know that your cancer cannot be cured, it is natural to think about how long you might live. If you have questions about what will happen next or how long you will live, we have more information on asking about your prognosis (the likely outcome of your illness).