Invisible Symptoms of Metastatic Breast Cancer and How to Cope

When people think about breast cancer symptoms, they often think of a lump in the breast or in the underarm. But for people living with metastatic breast cancer (MBC), the reality is often more complicated.

Metastatic means that the cancer has spread outside of the breast to other parts of the body, like the bones, liver, lungs, or brain. Along with visible symptoms, there are many invisible symptoms you can’t see or feel from the outside, but that still affect how you feel every day.

1. Fatigue That Doesn’t Go Away

This isn’t the kind of tiredness that a nap will fix. Cancer-related fatigue can feel like a deep exhaustion that affects your whole body. You might feel drained even after sleeping well at night. It may take a lot of effort to do everyday things such as taking a shower or cooking a meal.

Fatigue can happen because of the cancer itself, side effects of treatment, anemia (low red blood cell count), or emotional strain. Coping strategies include:

• Prioritize tasks that need to be done.
• Take short breaks throughout the day instead of pushing through.
• Incorporate gentle activity such as a slow walk or stretching.
• Stay hydrated and eat balanced, energy-supporting snacks.

Be sure to tell your cancer care team if fatigue is a major problem, as they can check for treatable causes and may suggest medications or physical therapy.

2. Brain Fog

Often called “chemo brain,” this is a common side effect during cancer treatment, but it can also continue for people living with metastatic breast cancer. Brain fog can make it harder to remember details, follow conversations, or focus on a task. You might forget why you walked into a room or lose your train of thought in the middle of a sentence.

To cope with brain fog:

• Write things down in a notebook or keep notes on your phone.
• Set alarms or reminders for appointments and important tasks.
• Create routines so you don’t have to rely as much on memory.
• Focus on only one thing at a time. 
• Do activities that keep your brain engaged, like puzzles or reading.
• Be sure to get adequate sleep. 

If brain fog is impacting your daily life, talk with your cancer care team to see if they have any specific strategies to help you manage these symptoms. 

3. Stress, Anxiety, and Emotional Overload

Living with metastatic breast cancer often means living with uncertainty. There may be stress about treatment, the future, or how the illness affects your loved ones. It’s normal to feel anxious, sad, or even angry. Some people also experience depression or symptoms of post-traumatic stress.

Ways to help manage emotional strain include:

• Talk with a mental health counselor or therapist who has experience working with people living with cancer.
• Join a support group, either in person or online, to connect with others who understand what you’re experiencing.
• Practice relaxation techniques such as deep breathing, meditation, or gentle yoga.
• Schedule activities you enjoy to have something to look forward to.

An additional part of managing the stress and emotional strain associated with cancer can be medication, such as antidepressants or anti-anxiety medications. If you’re experiencing these symptoms and they aren’t getting better, talk with your care team to see what they suggest.