Young people and metastatic breast cancer

Although metastatic breast cancer is a life-changing illness for all people, young people can experience a unique set of challenges and concerns. From a medical point of view, people with metastatic breast cancer are considered ‘young’ if they have not yet reached menopause.

If you are in your twenties, thirties or early forties, you may be facing very different issues compared with people in later stages of their lives. You might be enjoying single life, focusing on finding a partner, or partnered/married with a young family. You may just be starting out in your career, pursuing further studies, or spending time travelling. You might be saving for your first home, or living in a share house, or sharing a house with your partner. You may be thinking of having children – or not thinking about it, if that is something you planned to put off until later. You may be pregnant or caring for a young family, either with a partner or on your own.

There are many crucial changes and milestones happening in a young person’s life. And as a young person, a diagnosis of metastatic breast cancer may feel especially frightening, confronting and isolating. You may be worrying about issues such as: 

Emotional wellbeing and caring for yourself 

A diagnosis of metastatic breast cancer can have a powerful emotional impact on you. You may feel overwhelmed at first with a sense of fear or anger at the diagnosis.

As a young person, you may feel a deep sense of grief about your opportunities being narrowed – the chance to pursue your career, to have children or grow your family, or to travel and explore. It can feel sometimes like the cancer has robbed you of hope and a future, just when you have been starting out, or hitting your stride in life. These feelings are normal and understandable.

Over time, most people come to realise that hope hasn’t gone. Your hope may now centre on long periods of disease control and feeling well, or enjoying a trip or a special event, or quality time spent with family and friends.

Understanding how to care for your emotional wellbeing can help you to feel more optimistic and in control. 

Building your support network

Looking after your emotional wellbeing is easier if you have a strong support network. Friends, partners and family are a crucial part of that support network.

Many people find that connecting with other young people with metastatic breast cancer is also very helpful. 

Connecting with people through support groups can help with building new friendships, sharing feelings with someone in a similar position and finding a different perspective. You can search for an all-ages support group in your area on BCNA's Service Finder.

Many people tell us that it is difficult to find fact-to-face support groups where they can connect with other young people with metastatic breast cancer. You may find it easier to connect through online groups, such as BCNA's Online Network.

Relationships  

Relationships with partners, children, friends and family are important sources of support, but sometimes it can be hard to talk to people about your disease or how you are feeling. You might find that some people don't know what to say to you, or what they can do to help you. It is helpful to be open and honest about how you are going and what you need. 

Communicating openly with trusted people in your life, and allowing them to help you where they can, can give you more energy for doing the things that matter and that give you pleasure. 

Single and dating  

If you are single, you may not have 'one' person you turn to in times of need. Instead, you might draw more on your connections with parents, relatives and friends. Some people find that spending time with their parents brings the comfort and support they need. Others so value their independence that they would rather not have to rely on parents for care and financial support.

For independent young people, it can be tempting to avoid asking close friends or family for help as you don't want to feel like a burden. Think of it instead as a positive way that you can help others to help you and show their love for you.

Remember, too, that allowing others to help means that you can keep your emotional and physical reserves for things that matter and give you pleasure. 

If you are thinking of dating, it can be helpful to talk with friends and family about opportunities to meet new people. Dating or starting a new relationship can be daunting at times. You may have a lot of questions and worries, such as when and how to tell a potential new partner about your diagnosis. 

Sometimes you might find that if you are stressed or feeling down, it can make it more difficult to start a new relationship. A counsellor or psychologist may be able to work through these issues with you and help to clarify your needs and values. 

A diagnosis of metastatic breast cancer can have a devastating impact on your partner, especially when you might just be starting a new life together or caring for a young family. Your partner may feel helpless or uncertain about how to help and may find it hard to express their own feelings about the situation. Sometimes partners can be afraid that talking about it will be too painful (with thoughts like, 'I have to hold it together!'). If you have young children, your partner may have added feelings of grief and anxiety about the future. 

Communicating openly and honestly is usually the best way to keep your relationship healthy. You should both feel able to express your fears and discuss your individual needs and your needs as a couple or family. Trying to keep strong feelings to yourself is hard work. 

Recognise that your partner will need space at times. Having some personal time will help your partner have more energy to be there for you. It is also helpful to schedule some regular time out for yourselves as a couple. This will help to strengthen your communication and the quality of your time together. 

There are many resources that can help you and your partner.  

Sometimes the emotional impacts of metastatic breast cancer can also impact on your sexual wellbeing. You may feel a loss of confidence, have concerns about your body or appearance, or feel anxious or upset. Very often, it is a combination of different factors that impact on your libido and sexual intimacy. This can place a strain on existing relationships or make it more challenging to establish new relationships.

Many people experience these kinds of concerns, and it can be reassuring to know that you are not alone. The good news is that there are things you can do to empower yourself and manage challenges with your sexual wellbeing. For in-depth practical advice and strategies to help with building up intimate relationships after a breast cancer diagnosis, you can download or order BCNA's free booklet Breast cancer and sexual wellbeing. 

The thought of telling your parents about your diagnosis can be daunting and upsetting. To help in the process, you might choose to share information in stages and give them updates if your condition changes. 

Depending on your circumstances and your relationship with your parents, you might decide not to tell your parents about your diagnosis until you have all the information you need. You need to do what feels right for you - and of course, you may come to think about this differently over time. You might want to talk to a health professional such as a counsellor to get some help around talking with your parents about your illness. 

Sometimes it may become necessary to move back with parents for a time so they can care for you and give some financial support. If you require additional assistance at this time, it can be helpful to connect with your GP or social worker who can link you and/or your parents to local services and supports.

If you have children, especially young ones, concern about their welfare and how they will take the news of your diagnosis can be the most distressing issue of all. You will undoubtedly worry about how they will understand and accept your diagnosis and treatment. It may be difficult for you to find the right words to say to them, and to know how much to tell them. Discussing cancer with children, and how they react and cope, will be influenced by their age and maturity.

For more information about the resources available to help you talk to children about metastatic breast cancer, see The people in your life.

Employment and returning to work  

For many young people work can be an important source of meaning, income and wellbeing. You may want to keep working for as long as you can because you enjoy your job or because it gives you financial security. Or you may want to give up work to concentrate on other things in life.

Sometimes you may have to give up work to concentrate on other things in life. Sometimes you may have to give up work because you are too unwell. Every person's experience and priority are different.  

Planning to return to work  

If you are planning to return or stay at work, your employer can help you by making adjustments to your work duties or changing your hours. Although it may sometimes to feel uncomfortable to disclose a diagnosis, the benefit of telling your employer is that they can assist you in making any adjustments that are needed to help you.

It is important to communicate regularly with your employer, and to agree on a return to work plan if you are returning after a period of leave. It is also important to find out about your entitlements and rights. 

Things you can do: 

• BCNA's booklet Helping a friend or colleague with breast cancer contains a section particularly for the workplace that provides some helpful suggestions for managers and workplace colleagues.  

Support with discrimination and other workplace issues 

Most employers are supportive when an employee is diagnosed with breast cancer. However, if you are worried that your employer is not understanding, or you are in danger of losing your job after disclosing your diagnosis, you can talk to an adviser at the office of Fair Work Ombudsman. They can provide advice on your rights and your employer's obligations, and also investigate any complaints. You can talk to an adviser online at the Fair Work Ombudsman, or by calling 13 13 94.