How Will Breast Cancer Treatment Change My Life?

Temporary and permanent changes that will transform you

When you are first diagnosed with breast cancer, you might have no idea how cancer will change your life. You may think it's just a small bump in the road and you'll return to "normal" when treatment is done. On the other hand, some people fear that they will never feel normal again.

Having had breast cancer—no matter the stage—will change your life. There will be challenges you hadn't anticipated. You might realize that the tiredness you once complained of was nothing relative to cancer fatigue. But there will be positive changes as well. We are actually learning that many people who go through cancer treatment experience what's been termed "post-traumatic growth." In other words, having cancer can change you in good and positive ways as well.

While everyone experiences cancer differently, there are some changes that are nearly universal. Knowing what changes you might expect at the onset may help you cope just a bit easier as you journey through your breast cancer treatment.

Emotional Adjustments and Stages

stressed woman
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You'll probably go through some emotional stages after a diagnosis of breast cancer. Hester Hill Schnipper, a two-time breast cancer survivor and oncology social worker writes, "Women speak of having to adapt to a new physical sense of self as well as a new sense of emotional vulnerability." You might feel betrayed by your own body and have a sense that you've lost control of your health.

Give yourself time to process the shock, move toward acceptance, and engage in the battle. If you are an optimistic person, you may be able to sustain that during treatment, but when faced with a life-threatening illness, many of us temper our outlook with caution. Feelings of fear, anger, and depression are normal—but do get help if you feel overwhelmed.

Most people don't progress evenly through the stages of a life-threatening diagnosis and arrive at "acceptance" all at once. Instead you may experience the stages of denial, bargaining, anger, and depression back and forth, sometimes all in the same day. Be kind and gentle to yourself. No matter what any of us has faced in the past, a diagnosis of cancer has a deep impact.

Changes in Appearance

Your body image may change during breast cancer treatment as well as how others perceive you. Your breasts may be an important part of your female identity, but surgery affects their symmetry and may result in scars, changes in shape, or loss of one or both breasts.

At the University of Michigan Medical Center a study of lumpectomy patients showed that a significant loss of symmetry could cause increased fear of recurrence and a greater risk for depression. You might consider breast reconstruction, a breast prosthesis, or counseling.

If you need chemotherapy there is the very real possibility of hair loss and weight changes. Wigs, scarves, and hats can help you cope with hair loss, and some women may wish to try a preventive scalp cooling cap. Diet and exercise can be very helpful with your weight and health.

Physical Challenges

Side effects of breast cancer treatment can cause some temporary physical changes. If you're having radiation, you can expect skin changes, some fatigue, and possibly swelling in the treated area. Your oncologist can help you cope with these symptoms, which should fade with time.

Chemotherapy impacts your whole body and causes a variety of side effects, including nausea, fatigue, chemobrain, skin and nail changes, loss of appetite, changes in smell and taste, menopausal symptoms, and sleep disturbances. There are medications and coping strategies that will get you through these temporary symptoms, and it's important to note that some people have little or no nausea at all with current prevention regimens.

If you have a lymph node biopsy you may be at risk for lymphedema, but you can do arm exercises to reduce arm swelling.

Fertility Frustrations

Young fertile women have some special challenges from breast cancer treatment. Chemotherapy and follow-up hormonal therapy can have an impact on your fertility and family plans. Many chemo drugs reduce estrogen levels and cause medical menopause. You may become temporarily or permanently infertile.

If you have not had children or have not yet completed your family, treatment may change your expectations about motherhood. Be sure to discuss these concerns with your oncologist before starting treatment. Ask about options for preserving your fertility. For women who have a mastectomy, breastfeeding with one breast is possible.

Changing Roles in Relationships

If you have always been the supportive person for your family and friends—the home remedy nurse, mistress of the thermometer, primary chef, and chauffeur—then you may find that your roles and relationships may change during treatment. As you experience emotional and physical changes, you can learn how to accept support and care from those around you.

Likewise, if people begin to withdraw, you may wonder where your friends have gone. Celebrate your strong relationships and be willing to let go of friendships that fade. Some people, though kind, are not equipped to handle the emotions of facing cancer. You might find new friends in your support group or with coworkers and neighbors. Be open to unexpected sources of support from other people going through cancer treatment and breast cancer survivors.

Sexuality and Intimacy

Breast cancer affects every aspect of your love life—your body changes, your treatments take a toll, and even when you've recovered, scars remain. It may be difficult to deal with a new romance or a long-term committed intimate relationship during breast cancer treatments.

Satisfying sex requires libido, energy, and enough moisture to prevent pain—all of which may be in short supply during treatment, depending on your side effects. You may crave intimacy and affection, but because of chemically induced mood swings, low libido, vaginal dryness, and fatigue, sex might become challenging. Practice effective communication with your partner and keep things honest and real. Be willing to compromise and ask your gynecologist for help.

Check out some of the ways in which you can nurture your sexuality during treatment, but if you are struggling, talking to a therapist is very helpful.

Work and Finances

The expense of breast cancer treatment can cause financial stress. Adjust your budget to make room for co-payments, insurance premiums, and medication costs. Contact your insurance provider and make sure you understand your coverage and responsibilities. Beware of indulging in retail therapy, even though it may be a tempting way to spend your recovery time.

If you are working at the time of your diagnosis, understand how federal laws protect your job and how you can keep your health insurance in case of a layoff. Be sure you know the sick leave policy at your workplace and how to keep good records to prevent future misunderstandings with the management. And save receipts for tax time—you may benefit from medical tax deductions.

Heading Into Recovery

Once treatment is over, you may want your old life back. However, you will have changed and a full recovery takes time. Those who specialize in cancer rehabilitation claim it usually takes around 5 years before you are back to normal or at least at your "new normal." Use the time during treatment to reassess your self-identity and examine your priorities.

Many survivors feel like they have a second chance at life after treatment and are more willing to take risks and fulfill their dreams. Plan on ways to rebuild your health after treatment with a program of gentle exercise and a well-balanced diet. Spend time valuing each day of the present and not taking the future for granted. Having almost kissed the face of death, you may fall in love with life—albeit cautiously—all over again.

Some people find journaling their cancer journey to be a blessing. If you do this it's often a way to make note of, and celebrate, the silver linings of your diagnosis. And if you're feeling discouraged, take a look at the research which tells us cancer changes us in good ways too. You may already have noted your increased compassion and empathy. Don't be afraid to lean on your family and friends. Those who hang in there with you through your journey are likely to be the recipients of that new and better normal!

Sources:

Casellas-Grau, A., Ochoa, C., and C. Ruini. Psychological and Clinical Correlates of Posttraumatic Growth in Cancer: A Systematic and Critical Review. Psychooncology. 2017 Mar 20. (Epub ahead of print).

Towers, R. Psychological Issues in Breast Cancer Survivorship. Breast Cancer Survivorship. 2016:249-259.

Gonzalez-Fernandez, S., Fernandez-Rodriguez, C., Mota-Alonso, M. et al. Emotional State and Psychological Flexibility in Breast Cancer Survivors. European Journal of Oncology Nursing. 2017 Oct 30:75-83.

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