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Living well with MBC > Looking after yourself

Looking after yourself 

Living with advanced or metastatic breast cancer can take a real toll on all aspects of your life.1

That’s why looking after yourself is especially important. But what does looking after yourself mean? And how can you do it when you’re facing so many other challenges? There are simple things you can do each day that can help you feel better and live better with advanced or metastatic breast cancer. After all, small things can make a big difference.

Relax

Taking time to relax can be a good way to cope with the challenges of everyday life and with the challenges of living with advanced or metastatic breast cancer.2

When it comes to relaxing, sometimes it’s easier said than done. But just like anything else, relaxation is a skill that we can learn by practicing it. The trick is to give a few things a try and see what works best for you.

There are lots of ways to relax. Some ways are designed to relax your mind, and some focus on relaxing your body. Because the mind and body are connected, many help relax both the mind and the body. Here are a few you can try. Aim to schedule at least one relaxing activity each day. Most of these activities take as little as 15 minutes to do—but why stop there? If you continue longer, your mind and your body will thank you for it!

Relaxing your mind

  • Practice a breathing exercise. You can find a simple exercise here.
  • Listen to soothing music. Find a comfortable position. Close your eyes and notice the different musical instruments, the melodies, the chorus, and the different verses
  • Practice mindful meditation by focusing on things that are happening right now. Pay attention to your breathing: is it fast, slow, deep, or shallow? Notice your muscles: are they tense or are they relaxed? You could also listen to the sounds in your environment. Do you hear traffic, children, birds, or nothing at all? Be aware of these noises as they come and go3
  • Use visualization to take yourself somewhere else. Imagine yourself in a place that helps you feel calm and relaxed—maybe a favorite beach, a forest, or a garden. Tune in to your senses. What do you see? What do you hear? What do you smell? What can you feel? What can you taste?4

Be sure to talk with your contact nurse about which of these activities are appropriate for you.  

Relaxing your body

  • Select a few yoga poses you enjoy and practice them regularly2
  • Do some light stretching. You can stretch your fingers and toes, your arms and legs, or your torso. You can do it in a chair, on the floor, or wherever you’re most comfortable2
  • Practice a muscle relaxation exercise. You can find a simple exercise here.
  • Take a stroll around your neighborhood or do some other light physical activity—gardening and housework count too!
  • Get a massage or have someone give you a back rub2
  • Soak in a warm bath; add bubbles or an essential oil if you’d like. Pay attention to the water as it surrounds your body. Feel the bubbles, and smell the oil
  • Have a warm drink that doesn’t have alcohol or caffeine in it, like herbal tea or warm milk. Focus on how it feels as you drink it.

Get physical2

Exercise is an important part of looking after yourself5. It can help you feel better, both physically and emotionally. Pain and fatigue can make it harder to exercise, but exercise can ease these symptoms5. Be sure to talk with your contact nurse before you start an exercise program or change your level of physical activity.

Here are a few exercise tips:

  • Try to work some form of exercise into your everyday routine. Consider doing some housework or gardening
  • Exercise doesn’t have to mean going to the gym. Finding some gentle or moderate exercises you can do at home, such as yoga or tai chi, is a good place to start
  • You can benefit from exercise even if you do it for just a few minutes a day. Don’t be too hard on yourself if you can’t manage more than that in one day
  • Do an exercise you enjoy. This will help make exercise something you look forward to and help you stick with it longer
  • Remember to also get enough rest to help your body recover
  • Pay attention to your symptoms. Don’t exercise if you don’t feel well
  • If you’re not sure where to start, ask your contact nurse for some tips  

Pace yourself

It’s important to pace yourself throughout the day. Pacing is about finding a balance between times of activity and times of rest. Resting is important because it gives your body time to repair and recover. Even when your daily life is keeping you busy, remember that taking a break may help you do more over the long term.2

Pacing is also important when you’re feeling fatigued or out of energy, which is common for those living with advanced or metastatic breast cancer. When you feel very tired, being active is often the last thing you want to do.

These tips for pacing yourself may help2:

  • Plan your daily tasks in order and spend your time doing the most important ones first
  • Break a task down into smaller chunks. For example, instead of trying to clean your whole house in one day, try tackling just one room to start
  • If you need help getting something done, don’t be afraid to ask. People generally like to be able to help
Tips to manage fatigue

Sleep well

We often don’t appreciate sleep until we have sleep problems. If we don’t get the sleep we need, it can be harder to function during the day. It can affect how we think, feel, and behave. There are many types of sleep problems, like6:

  • Trouble falling asleep
  • Waking in the night and having trouble getting back to sleep
  • Waking early in the morning
  • Thinking you’ve slept long enough but still feeling tired

If you have a sleep problem, these tips may help you get a better night’s sleep, so you can get more out of your day.

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How much sleep do we need?

You may have heard that 8 hours of sleep is considered a good night’s rest, but everyone is different. For most adults, experts recommend anywhere from 6 to 10 hours of sleep each night. Older adults generally need less sleep. People being treated for cancer may tire more easily and need extra sleep7. They may also have a harder time falling asleep. If you have fatigue, you may also need more sleep. You should try to sleep as much as possible to rest your body. Talk with your contact nurse if you think you’re not getting the right amount of sleep. 7

Icon sleep

Improve your sleep habits

If you don’t think you’re getting enough sleep, give these tips a try. Some might lead to changes that are quite easy, while others may seem harder. Some people may already know what they need to change. For instance, if you drink a lot of coffee in the evenings, you may want to consider cutting back. 7,8 For others, it might be less obvious, so it will be worth trying a few tips to see what works.

Caffeine⁷ ⁸

Caffeine is a powerful stimulant that is known to get in the way of a good night’s sleep. It is found in tea, coffee, cola, some sports drinks, most energy drinks, chocolate bars, and some medicines

  • Try not to have caffeine within 6 hours of bedtime
  • If you like to have a warm drink before bed, try decaffeinated coffee, herbal tea, or a warm, milky drink

Alcohol⁷ ⁸

  • Alcohol interrupts our natural sleep cycle. Alcohol often makes us feel sleepy at first, but eventually we start to feel more awake. That’s why we tend to be more restless in the second half of the night if we’ve been drinking
  • Drink less alcohol, especially after dinner

Food⁸

  • Eating regular meals helps the body to get into a routine that signals sleep time
  • Try to have your evening meal at a regular time, 3 to 4 hours before going to bed
  • If you like to have a bedtime snack, try bananas or dairy products, such as warm milk. These foods are high in the amino acid tryptophan, which is thought to signal the chemicals that help the body sleep

Exercise⁶ ⁷:

  • Studies have shown that regular exercise can help us sleep better because it triggers chemicals that bring on sleep
  • However, it’s best not to exercise at least 3 hours before bedtime because it can make you feel more awake and energized. Instead, try to keep up a good level of activity that is right for you throughout the day

Nicotine⁸

  • Many people believe that a cigarette helps them to relax. This is untrue. Like coffee, nicotine is a powerful stimulant. Smokers tend to sleep more restlessly than nonsmokers
  • If you do smoke, try not to smoke within 2 to 3 hours of bedtime

The sleep environment⁸

  • Your bedroom can have a big impact on how sleepy and relaxed you feel. Try to make sure that it’s quiet, dark, and at the right temperature for you
  • Some people find that regular noise, called white noise, helps them sleep. This noise can be from an air conditioner, a fan, or a sound machine. Falling asleep with the TV or radio on may seem to be helping, but it can make your sleep more restless. The change in sound may stop you from falling into a deep sleep and may wake you at times during the night. If you have to fall asleep with the radio on, set a timer so that it turns off automatically
  • Some people find that they watch the clock when they’re struggling to sleep. That can increase anxiety. Put clocks out of sight, and don’t be tempted to peek

Anxiety and tension⁶ ⁷

  • Worrying about things can make it harder to get to sleep. Try setting aside time before bedtime to write down your worries and what you plan to do about them the next day. If you wake up in the night, remind yourself that you have given these worries time already and that going over them now won’t help
  • Try to get someone to rub your back or massage your feet before bedtime to help you relax

Sleeping habits

The body is very good at linking physical states (like sleepiness) with objects or places (like the bedroom). These are a few steps you can take to ensure that you rest better at night:

  • Sleep as much as your body tells you to, but when you are awake, try to exercise at least once a day, at least 2 to 3 hours before bedtime7
  • If you don’t fall asleep within 20 minutes of going to bed, get up and go to another room. Find quiet, mindless activities to do until you begin to feel tired, then go back to bed.9 Do this as many times as you need to
  • Take short daytime naps if needed (less than an hour) to avoid affecting nighttime sleep7
  • Take any prescribed pain or sleep medications at the same time every evening7
  • Avoid using electronic devices before bedtime8
  • Talk with your healthcare team about relaxation therapy to help you sleep better at night7

Be comfortable with your body

Living with advanced or metastatic breast cancer may have changed the way you think and feel about your body. At times, you may feel sad or anxious about the way you look. Maybe you feel less feminine. Those feelings are common. Breast cancer and its treatment can cause changes to your body and appearance.

It may be helpful to think about what being attractive or being feminine means to you.

  • What makes a person attractive? Is it based solely on how they look?
  • What makes a woman feminine? Are there ways you can still feel feminine in your body now?

It’s important to remember that our negative thoughts about our body might not be true. Our partners and those around us are generally more accepting of our bodies than we than we are.

  • Talk about how you feel about your body with people you feel comfortable. It may be helpful to write down your feelings in a journal and share them later10
  • Think about what you love about your body, like your smile, eyes, or nose. Focus on these aspects, rather than concentrating on the things you don’t like11
  • Replace critical thoughts with ones that are more neutral. For example, instead of saying, “My breasts look ugly,” perhaps say, “I have scars on my breasts from surgery”12
  • Wear clothes that make you feel good. Use clothing, makeup, and jewelry to enhance the physical features you like, such as your eyes. This will help you look and feel your best12
  • Try saying body positive affirmations, such as:
    • I love and respect my body
    • I am more than my body
    • My body has endured a lot and needs my support
  • Don’t try to compare your body to others (or to the time before you had breast cancer) 13
  • Remember you are more than your body. Try to focus on your qualities, values, and accomplishments. Perhaps you are a great cook, a talented writer, or a supportive friend


Your body has gone through a lot, and it continues to endure a lot now. Why not celebrate that? Your body deserves some love and care for all it is going through. Below are a few ideas for pampering it:

  • Get a manicure or a pedicure
  • Visit a spa for a massage or a facial
  • Take a long soak in a fragrant bubble bath
  • Buy a fancy moisturizer and massage it into your skin
  • Try a new hairstyle
  • Treat yourself to your favorite comfort food or a meal at your favorite restaurant

If you find yourself really struggling with body image issues related to your breast cancer diagnosis and treatment, there are programs that can help. There are psychologists and counselors who specialize in body image issues for those who’ve been diagnosed with cancer. 14 Ask a member of your healthcare team for a referral.

There are also support groups that can be helpful. Some local links are provided here.

Sex & Intimacy

If you’re struggling with issues affecting your sexuality, know that sex and intimacy can be difficult for many women with metastatic breast cancer. 15

The way that metastatic breast cancer affects your sexuality is a personal experience. However, women with MBC share these common concerns:

  • Changes in desire, function, and satisfaction15
  • Body image issues15
  • Anxiety and depression15

Some side effects of breast cancer treatment can impact your sex life:

  • For example, hormone therapy may cause a loss of desire as well as vaginal changes that can make intercourse painful15
  • Chemotherapy and other breast cancer treatments can lead to early menopause. This can cause changes in the body that can decrease sexual interest or desire. 15

Talk with your doctor about how you’re feeling to determine the options that are best for you.

Try to be open and honest with your partner about what you’re feeling. Talking with a couple’s therapist or sex therapist may also be helpful.15

If you’re single, telling potential new partners about your metastatic breast cancer diagnosis may make you nervous. It may help to take new relationships slowly.15

Share any concerns about your sexuality with your doctor. He or she may be able to refer you to resources, such as a counselor or a support group, to help you work through your feelings.15

REFERENCES

  1. Breastcancer.org. Depression or feeling unmotivated. https://www.breastcancer.org/tips/compliance/feelings. Accessed November 3, 2019.
  2. National Cancer Institute. Facing forward: life after cancer treatment. https://www.cancer.gov/publications/patient-education/life-after-treatment.pdf. Accessed November 4, 2019.
  3. HelpGuide.org. Benefits of mindfulness. A Harvard Health Article. https://www.helpguide.org/harvard/benefits-of-mindfulness.htm. Accessed September 23, 2019.
  4. Mentalhelp.net. Visualization and guided imagery techniques for stress reduction. Stress. https://www.mentalhelp.net/stress/visualization-and-guided-imagery-techniques-for-stress- reduction/. Accessed September 23, 2019.
  5. Cormie et al, 2018. Position Statement Summary. Clinical Oncology Society of Australia position statement on exercise in cancer care. Medical Journal of Australia, 209 (4), p. 184 – 187.
  6. Springboard Beyond Cancer. Sleep problems. Symptoms. https://survivorship.cancer.gov/springboard/symptoms/sleep-problems. Accessed October 15, 2019.
  7. American Cancer Society. Sleep problems. Treatment & Support. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/sleep- problems.html. Accessed October 15, 2019.
  8. Snyder C. 8 steps to a restful night’s sleep. American Society of Clinical Oncology [blog]. https://www.cancer.net/blog/2016-05/8-steps-restful-nights-sleep. October 15, 2019.
  9. National Sleep Foundation. What to do when you can’t sleep. Insomnia. https://www.sleepfoundation.org/insomnia/treatment/what-do-when-you-cant-sleep. Accessed September 23, 2019.
  10. CancerCare. Breast cancer: coping with your changing feelings. https://www.cancercare.org/publications/88-breast_cancer_coping _with_your_changing_feelings. Accessed September 18, 2019.
  11. Living Beyond Breast Cancer. Guide to understanding HER2-positive breast cancer. https://www.lbbc.org/sites/default/files/HER2%20Final%202016.pdf. Accessed November 4, 2019.
  12. MD Anderson Cooper Center. Coping with appearance changes. https://www.cooperhealth.org/sites/default/files/pdfs/Coping%20with%20Appearance%20Changes.pdf. Accessed November 4, 2019.
  13. MD Anderson Cancer Center. Advice from other patients on preparing for chemotherapy. https://www.mdanderson.org/publications/cancerwise/advice-from-patients-on-preparing-for-chemotherapy.h00-158906178.html. Accessed September 18,2019.
  14. Breastcancer.org. Program can help ease body image concerns and improve quality of life. https://www.breastcancer.org/research-news/easing-body-image-concerns-and-improving-qol. Accessed December 11, 2019
  15. Susan G. Komen. Sexuality and intimacy. Survivorship Topics. https://ww5.komen.org/BreastCancer/SexandSexuality.html. Accessed July 13, 2018.