Breast Cancer: Emotional Issues

Most women with breast cancer face some level of emotional challenge both during and after treatment. Patients may worry about the possibility that the cancer will return, or may be concerned about changes in their physical health or psychological and social well-being. Memorial Sloan Kettering Cancer Center offers a range of psychosocial services for patients with breast cancer and their loved ones.

This section reviews some of the feelings you and those close to you may be experiencing during and after breast cancer treatment.

Your Emotions

A diagnosis of cancer is never an easy thing to face. While different people handle such an event in their own ways, many find that building a support network can be a great help. A support network gives you a place to talk about your fears, concerns, and the decisions you need to make.

You may have one close friend or family member who can serve as your sounding board. Or you may want to reach out beyond your loved ones and talk with other women who have dealt with similar issues in their own lives. Don’t be afraid to ask your doctor, nurse, or social worker for a referral to professional counseling or a support group. Such counseling and support groups are available at Memorial Sloan Kettering.

Memorial Sloan Kettering has established a program through which former patients who are now well are available to meet with patients who are still in treatment. Often, you can arrange to be visited by someone whose diagnosis closely matches your own. If you are interested in this program, speak with your doctor, nurse, or social worker.

Your partner, your children, and other family members may benefit from emotional support, too. Support groups or counseling are available for them as well.

Psychological Effects

Many cancer survivors report some level of distress during or after treatment, particularly if their physical side effects are life altering, they have had other stressful life events, or they have had difficulties coping with stressful events in the past. Your first reaction to completing treatment may be joy, but it may be tempered by uncertainty, grief, sadness, or anger.

Uncertainty about relationships can be another source of concern. While family support can be critical in helping to address these emotions, some survivors worry about imposing upon already burdened family and friends.

Anxiety & Depression

Anxiety and depression are not unusual in cancer survivors. Your doctors and nurses can provide you with a better understanding of the emotional changes you may experience during and after treatment. Psychiatrists, psychologists, and social workers can be very helpful with problems such as depression, panic attacks, feelings of isolation, and other feelings that concern you. Joining support groups, talking with family members, friends, and other cancer survivors, and listening to music or relaxation tapes may help.

Body Image Concerns

The cancer experience may have an impact on your self-esteem and your body image. While in some cases there may have been major changes in your body and its functioning, other physical changes — such as hair loss, sallow skin tone, and weight loss or gain — can leave you feeling like your “old self” is gone. These feelings are natural; you will probably feel and look much better in the coming months as your health, appetite, and energy return to normal.

Vulnerability

Almost everyone feels a heightened sense of uncertainty and vulnerability after an experience with cancer. But many patients say the experience makes them appreciate all the little things they never had time for before. Some say that after a diagnosis of cancer, they learned to “stop to smell the roses.

Isolation

The cancer experience can cause some patients to feel isolated or to withdraw from social interactions. Sometimes social supports disappear or are unable to provide the kind of help a patient needs or wants. Sometimes patients refuse support. Help is available; just ask a member of your healthcare team for a referral.

Fear of Recurrence

Fear of recurrence is a common and natural feeling. Having survived cancer makes some patients hypervigilant in looking for any physical sign that the cancer has returned. They find themselves second-guessing any new feeling and worrying about every symptom. This is normal behavior and should diminish with time.

Your doctor or nurse will discuss with you the particular health issues that should concern you and will give you a schedule for follow-up visits. These visits will become less frequent over time.

Transition

For many patients, months or years of treatment have conditioned them to a “sick role.” They may have felt ill and unable to carry on their usual activities. Now, at the end of treatment, they begin to feel better and can slowly resume normal activities. But leaving the “sick role” behind may take more than simply feeling better. Patterns develop, new behaviors take root, and anxiety and fear may remain. Be patient; the transition to the “well role” may take time.