Defining the illness trajectory of metastatic breast cancer

Longtermsurvivor

This is a 2012 medical journal article from the UK, but should be accessible to patients and our personal and professional care providers who want to consider the different phases of living and dying with metastatic breast cancer.

It may also help those of us in support groups to better support one another as we traverse different phases of our shared diagnosis.

There are four figures or graphs of the illness trajectory between diagnosis and death that are worth reviewing.

This article and the figures help me to visualize what I've read and heard and witnessed from many living and dying with MBC and other cancers.

From the discussion section:

"This study suggests that for many women with metastatic breast cancer, cycles of decline and reprieve are the norm over an extending lifespan. Both the number of decline-reprieve cycles, and the time interval between these, can become extended because of the availability of a large number of new treatment options. The consequence of this is that women's lives are dominated by treatment and they endure chronic pain and symptoms that they largely manage for themselves. Women find themselves in a complex relationship with their oncologist where cycles of treatment are offered, accepted and endured as the only option for prolonging life at whatever cost, with little apparent planning for moments of decline resulting in admissions to hospital and the final months of life are characterised by disintegrated dying."

"Women are not in 'denial' over the seriousness of their illness, but find themselves with their oncologists, caught in a constant bid for further illness reprieve. Oncologists are hampered by the difficulty in recognising when the final decline has commenced or may occur, or that women may die from the consequences of treatment itself."

Free full text article at:

http://spcare.bmj.com/content/early/2013/07/23/bmj...

Warmest healing regards, Stephanie

kt1966

Fantastic article, longterm. I just printed it out & my hubby & I sat together reading it.

I called hospice yesterday & they are coming to see me on Monday. I feel like I'm doing the right thing. Here in NZ you can have hospice support & be on active treatment at the same time (I asked on Friday).

Having just been diagnosed with Leptomeningeal mets I feel like I'm coming to the hard part of my journey & I'm not feeling ready or prepared for it. I start WBR on Tuesday - I hope it buys me more time. My kids are 18 & 21, not grown up enough yet....

I want to share the article with my family & fellow metsers in my support group- so thanks so much for finding it & posting it here

zarovka

Thank you LTS - Living box three at the moment. It's good to have a map. Hope I am brave enough to quit when it is time.

>Z<

Longtermsurvivor

Very good article on illness trajectories and palliative care for others who enjoy maps, graphs, charts and timelines.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC557152...

best, Stephanie