Let’s Talk: Stage I-III Breast Cancer vs. Stage IV—The Metastatic Kind

Okay, so here’s the deal—we all know someone affected by breast cancer. It's everywhere. But not all breast cancer is the same, and honestly, I think we really need to talk more about Stage IV. Because it's different. Like, completely different. I learned that myself when I was going through Stage IIB breast cancer 15 years ago and let me tell you...it was a jolt of reality and eye opening for me.  In our breast cancer support groups, Stages I-3 were in one group, and Stage IV (Metavivors) were in another group. The conversations, the advice, the meds, the med plans are all very different. 

Many of you remember my friend, Tiffany...we were in the same chemo class together in May 2010. She started out with Stage IV Metastatic breast cancer right off the bat. But, we became breast friends and she taught me so much about being a Metavivor.  She looooooved jewelry and she would buy some jewel and then I would buy her old stuff to try to even out the money and hide the spending from her husband. haha!!  I loved her and I keep an eye out to watch her beautiful daughter thrive. 

My friend Amanda was a Metavivor, that girl drove down from PA after 2 conversations with her and did the Susan G. Komen walk with me in June 2010 when I first started chemo!!  It was selfless, incredible and exactly what I needed at the time. She did treatments with all her might for many, many years. Just recently I reconnected with her on FB and messaging each other and I went to check in on her on FB and did not even know she had died and her funeral had already taken place. I would have went, I felt terrible and awful.  I don't say this to scare you or be doom and gloom, I say this because that connection to people was very important to her. She was the master at reaching out, checking in on other people and she thrived on her relationships with other for a long time and I believe that is what kept her fueled for trying new treatments.  

We often celebrate people as survivors after treatment (and yes, that’s amazing - I was one), but there’s a whole group of incredible women—and men—out here living with metastatic breast cancer who don’t get talked about the same way. These are the Metavivors.

They’re not in remission. They’re not “done” with treatment. They’re living with it every single day, managing it like a full-time job.

Let’s Break It Down:

Stage I – Found early, usually a small tumor. Probably hasn’t spread much. Treatment might include surgery, radiation, maybe some meds. This is the “we caught it early” stage. People often do really well here.

Stage II – A little bigger or maybe it’s in a few lymph nodes. Still very treatable, but it’s more involved. This was me. 

Stage III – This is considered locally advanced. Cancer might’ve spread to more lymph nodes or chest wall, but not to other organs. It’s serious, but people still get through it with some pretty intense treatment.

Stage IV (aka Metastatic Breast Cancer) – This is the big shift. The cancer has left the breast and spread to other parts of the body—like bones, liver, lungs, or brain. This isn’t something you “beat” or finish. It’s a forever kind of thing. You treat it, monitor it, treat it again. You live with it.

Let’s Call Them What They Are: Metavivors

The term survivor doesn’t fit for people with metastatic breast cancer. Because they’re not just surviving something that’s over. They are living through something that’s still happening. They’re navigating constant treatments, scans, side effects, and that heavy emotional weight of knowing it’s not going away.

So we call them Metavivors—and if you know one, you’re lucky. These folks are strong as hell. They’re real, raw, often tired of the “rah-rah pink ribbon” vibes. They don’t need slogans. They need understanding, real connections, meaningful conversations, and as little drama and life stress as possible.

This is a great video that covers HOW METASTATIC DISEASE

By the Way, Their Color Isn’t Pink

Here’s something I didn’t know until I was going it through BC the first time: the color for Metavivors isn’t pink. It’s green, teal, and pink. That combo tells a bigger story:

• Green for the triumph of life

• Teal for healing and spirituality

• Pink because, yes, they still have breast cancer—just not the “early stage” kind most people think of.

So when October rolls around and the world goes all pink and glittery… maybe pause and ask, are we including the Metavivors in this conversation too? 

How Do We Show Up for Someone With Stage IV?

You don’t need the perfect words. Honestly, just being real and not disappearing makes a world of difference.

Here’s what helps:

• Check in. A simple “Thinking of you today” text can brighten a heavy day. Don’t wait for updates or perfect timing.

• Don’t say ‘Stay positive.’ Seriously. They’re allowed to be mad, sad, hopeful, tired… whatever they’re feeling that day. Just ride the wave with them.

• Offer something concrete. Like “Can I drop off dinner Tuesday?” or “Want help getting to your appointment next week?” The open-ended “Let me know if you need anything” is well-meaning, but exhausting for them.

• Remember their life is still happening. Talk about normal stuff, too. Work, vacations, dogs, home projects, bad reality TV. They’re still them, not just their diagnosis.

• Say Metastatic. Say Metavivor. It matters. Awareness leads to research, funding, and less isolation. And if you’re the praying type or the manifesting type—send all that good energy their way.

So yeah, breast cancer awareness is important. But let’s make sure we’re not just talking about the early stages. Let’s include the Metavivors in every conversation, every fundraiser, every ribbon wave. Because they are still here, still fighting, and still LIVING.

If you know a Metavivor, send them a message today. No agenda. Just love. And if you are one—thank you for showing the rest of us what strength really looks like.

-Jill