How Will Breast Cancer Change My Life?

Temporary and Permanent Changes Will Transform You

Sitting on the exam table in the doctor's office, I was watching my surgeon pace and sympathetically shake his head. "You will never be quite the same after this," he said. Having discussed my surgical options, we had finally agreed on a lumpectomy. Dr. Worchel wanted to be sure that I knew how breast cancer was about to change my life. Having cared for his wife and her mother through their own bouts with breast cancer, he knew from experience about how breast cancer treatment could change someone. Knowing what changes to expect can help you cope with your journey through breast cancer treatment.

Emotional Adjustments And Stages

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You may 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.

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 – surgery affects your symmetry and may result in scars, changes in breast 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 possibility of hair loss and weight changes. Wigs, scarves, and hats can help you cope with hair loss, while diet and exercise can help 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. 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. If you had a double mastectomy, you might consider using a nursing supplementer device for breastfeeding.

Changing Places 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 faded.  You might find new friends in your support group or with coworkers and neighbors.  Be open to unexpected sources of support from other patients and 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.

Work and Finances

The expense of breast cancer treatment can cause financial stress. Adjust your budget to make room for copayments, 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.  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, for most of us at least 18 months. 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.



Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life.  Waljee JF, Hu ES, Ubel PA, Smith DM, Newman LA, Alderman AK. J Clin Oncol. 2008 Jul 10;26(20):3331-7.

Life After Breast Cancer. The Art Of Oncology: When The Tumor Is Not The Target.  Hester Hill Schnipper. Journal of Clinical Oncology, Vol 19, Issue 15 (August), 2001: 3581-3584

Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study.  Ali Montazeri, Mariam Vahdaninia, et al.  BMC Cancer 2008, 8:330.

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