57 CHAPTER 3: Analysis of Quality of Life Research on Living with MBC Musa Mayer1 , Katherine Crawford-Gray2 1 AdvancedBC.org, 2 Metastatic Breast Cancer Alliance Abstract Targeted treatment options and advances in supportive care are transforming MBC from a terminal illness with short survival into a disease many patients can live with over long periods. This lengthened survival of MBC patients has had an impact on quality of life research. Methods: Over 150 published, peer-reviewed research articles relevant to the experiences and needs of people with advanced cancers, including quantitative and qualitative studies of patients living with MBC and their families, were read and reviewed to summarize research findings about the reality of living with MBC. In addition, 13 MBC patient surveys were analysed. Results: The research base around MBC quality of life issues is extensive, permitting summary of findings into 6 categories: psychosocial distress; emotional support; information about the disease, its treatment, and resources; communication and decision making about care; relief of physical symptoms; and practical concerns: work, health insurance, and finances. Sources of emotional support, individual and group psychotherapy, and counseling, as well as adequate information about the disease, its treatments, and methods to alleviate symptoms and side effects have been shown to be useful in helping patients to cope with and adapt to MBC. However, MBC patients are typically not well informed in areas required for decision making about their care, and patient–clinician communication can be difficult to navigate. MBC symptoms and side effects of continuous treatment interfere with daily life and cause fatigue, sleeping difficulties, and pain as well as emotional distress for most patients; supportive and palliative care is often insufficient. Financial hardship is a fact of life for many families affected by MBC. Conclusions: The quality of life issues for patients with MBC and their caregivers are well understood; however, resources and intent to address them are still lacking. Targeted treatment options and advances in supportive care are transforming MBC from a terminal illness associated with short survival, into a disease some patients are living with over longer periods of time.