Metastatic breast cancer patients often face unique emotional and psychological challenges as they navigate a diagnosis that is both life-changing and complex.
To help those patients shoulder these new challenges, Allegheny Health Network Cancer Institute has launched a pilot program to provide mental health counseling to those being treated for this aggressive form of breast cancer.
The pilot at the North Side’s Allegheny General Hospital is being funded by a $50,000 grant from the Wexford-based A Glimmer of Hope Foundation. The seed money was raised at the foundation’s annual event, Pitch for Hope, held in partnership with Pirates Charities.
Considered to be stage 4, metastatic breast cancer occurs when it spreads from the original location in the breast to other areas of the body, such as the lymph nodes. The term “metastatic” or “metastasis” is used to define the process by which cancer cells spread to other areas of the body. Metastatic breast cancer is also called advanced breast cancer or distant breast cancer, according to the National Breast Cancer Foundation.
Metastatic breast cancer is treatable but incurable. Patients face a lifelong journey of treatment and often experience significant emotional distress, including anxiety and depression.
“A breast cancer diagnosis, regardless of stage, is a deeply stressful life event,” said Christie Hilton, director of Academic Breast Oncology at AHN and the director of the pilot program. “The effect on psychological well-being is significant and varies greatly from patient to patient. Common reactions include shock, disbelief, anxiety, fear, depression, anger and grief.”
She said it’s vital for patients to not only treat the physical aspects but the psychological impacts as well. “Untreated psychological distress can worsen physical symptoms, impair treatment adherence, negatively impact recovery, and reduce overall quality of life.”
Psychological support can help patients manage their emotions, develop coping strategies, improve communication with loved ones and navigate the many challenges ahead, Hilton said.
If counseling to alleviate stress and anxiety is available for patients, perhaps it will reduce emergency visits and hospital admissions brought on by those conditions, said Diana Napper, founder and president of A Glimmer of Hope Foundation.
This will be especially helpful for younger patients who have small children at home, said Napper, who in 1994 founded A Glimmer of Hope, a nonprofit organization dedicated to finding a cure for breast cancer.
Napper’s impetus to create the foundation was a promise she made to her friend Carol Jo Weiss Friedman before she lost her battle with breast cancer at age 50. Over the past 30 years, the nonprofit has raised more than $6 million for breast cancer treatment, equipment and research, with all of the money staying in the Pittsburgh area.
“I believe if we keep the body in a calmer state, it can reduce inflammation, which I would think would promote healing,” Napper said.
The Glimmer of Hope Metastatic Breast Cancer Clinic will be one of the first programs within the AHN Cancer Institute to offer integrated mental health support through a dedicated behavioral health psychologist.
In a 2023 study of 230,000 cancer patients, 10% of patients in the study had depression or anxiety before their cancer diagnosis, and 22% were diagnosed afterward — meaning a third of cancer patients were also diagnosed as suffering from anxiety or depression.
The study found that a new diagnosis of anxiety/depression was associated with an increase in health care costs of $17,496 per patient per year. The researchers concluded that screening and management of mental health conditions for patients with cancer should be part of coordinated oncology care.
Newly diagnosed depression and anxiety cases are most common among those with metastatic disease; suicide risk also increases acutely in the first six months after a cancer diagnosis, according to another study.
The new AGH program will staff a behavioral health psychologist specializing in oncology two days a week. The psychologist will see up to 20 patients a week during this six month trial, Napper said.
Several types of therapy can be beneficial to metastatic breast cancer patients, Hilton said. Those include cognitive behavioral therapy, which helps identify and modify negative thought patterns; supportive therapy, which focuses on emotional support and coping skills; and psychodynamic therapy, which explores unconscious patterns affecting behavior. Each individual's specific needs and preferences will dictate the best therapy approach, she said.
If the clinic is deemed a success, then decisions will be made on how to expand it.
“It is a pilot program that has limits because of funding. However, we have supporters who believe that this should be standard of care especially with metastatic disease,” Hilton explained, adding that the goal is to eventually expand the services to all breast cancer patients.
“While psychological treatment doesn't directly cure cancer,” Hilton said, there is strong evidence that it can positively influence physical health and boost immunity by reducing stress, improving sleep, reducing pain perception and more. “Essentially, a healthier mental state can contribute to a healthier physical state. It's a mind-body connection we strongly believe in.”
First Published: February 1, 2025, 10:30 a.m.
Updated: February 3, 2025, 7:41 p.m.
