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Coping with Breast Cancer

    • While your focus will be on your physical health and all your tests and treatments, it is important not to forget about your emotional, psychological and spiritual health. They can affect your physical health and play an important part in your recovery.

    • Emotional support

    • Have family members or friends help you get your house ready before you have surgery or chemotherapy. There are a lot of small adjustments that can make your life easier, such as:

      • Having a small step stool available to eliminate the need to reach high.

      • Using a hand-held shower hose when bathing.

      • Stocking up on supplies that you may need (thermometer, toiletries, food to settle your stomach, etc).

      • Prepare a phone list of "helpers." It can include family, friends and neighbors or volunteers from the American Cancer Society's Reach to Recovery program (call 1-800-ACS-2345).

      • Try to find someone you can reach out and open up to. It should be someone you feel safe sharing your thoughts, fears, anger and hopes. Support groups also offer a safe place to share your thoughts and emotions. Be sure to consult with your health care provider for local groups in your area or call the American Cancer Society at 1-800ACS-2345.

      • Find inspiration and hope in the things that bring you joy (i.e. reading, music, family, etc.).

    • Family and partner/spouse issues

    • Every person has a different way of handling news that a loved one has cancer. Many people react with shock, disbelief, and even anger when they first receive the news. Keep in mind that there is no "right way" for you or your family to feel about your diagnosis. Sharing and being open with one another is one of the best ways for families to deal with their feelings.

    • Should I tell my children that I have cancer?

    • Many parents don't want to burden their children with worries and fears about their illness. They keep the truth from their children in hopes of sparing them some pain. But even the youngest of children can sense when something is wrong. Many parents choose to tell their children only what they feel their children really need to know. How much you tell depends upon a child's age and maturity and how much you feel your children can handle. Be prepared to offer your children a lot of reassurance.

    • How can my family members help me?

    • Asking your family members for help during this time benefits you and them.

      • Assign specific tasks to each family member. Don't hesitate to ask for help with everyday tasks like cooking, cleaning, yard work and driving children to their activities.

      • You might ask several people to provide different kinds of emotional support so that you always have someone to call on.

    • What legal issues do I need to discuss with my family?

    • When you've been diagnosed with cancer, you want to concentrate on getting better and coping with your treatment. It's also a good idea to make some important decisions with your family and doctor while you are still feeling well. Things you may want to discuss include:

      • An Advance Directive This document contains written instructions specifying the type of future medical treatment to be used in the event you become unable to speak for yourself.

      • A Durable Power of Attorney for Health Care This legal document authorizes another person to make health-care decisions for you if you became physically or mentally unable to make these decisions yourself.

    • Suggestions for strengthening hope for you and your loved ones

      • Maintain a healthy balance between optimism and reality.

      • Find support in prayer and/or religious faith or philosophy of life.
      • Share a sense of hope with one another.

      • Develop trust in the skills of your doctor and other health care team members.
      • Learn from the stories of other cancer survivors. Both you and your loved ones are encouraged to participate in support groups.

      • Find creative ways to bring pleasure to each day.

      • Appreciate the beauty and wonder present in life each day.

    • Should I join a support group?

    • People diagnosed with cancer and their families face many challenges that may leave them feeling overwhelmed, afraid and alone. It can be difficult to cope with these challenges or to talk to even the most supportive family members and friends. If this is the case, you and your family may want to join a cancer support group. Cancer support groups can help you and your loved ones:

      • Feel less alone.

      • Improve your ability to deal with the uncertainties and challenges that cancer brings.

      • Meet others experiencing the same problems and fears and discuss ways to cope.

      • Find a confidential atmosphere where you can discuss the challenges of your illness or of having a loved one with cancer without feeling judged.

      Sometimes, others who have been through similar experiences can explain things differently than your health care providers. Be aware, however, that others may share information or experiences that do not apply to you. Never replace your doctor’s advice with that given by another patient.

      Check with your doctor, local health care facilities or the American Cancer Society (1-800-ACS-2345) for a listing of support groups in your area.

    • Fear and anxiety

    • About 30 percent of women with breast cancer suffer from prolonged anxiety and depression, which are natural responses to the loss of a breast or fear of the disease. The fear of cancer reoccurring is also a natural and very powerful response. After a cancer experience, your sense of self is altered forever. You know that you are not protected from losing your health. You may feel fearful, anxious or uneasy for a long time after your last treatment. It is important to
      deal with these feelings so that cancer doesn't rob you of living your life to the fullest. Here are a few helpful tips:

      • Talk about your fears and other feelings with someone you trust.

      • Take control of your life. Be aware of the cancer, but don't let it dictate the way you live.

      • Redirect your anxiety into energy for taking action.

      • Become knowledgeable about your cancer. Knowledge is power.

      • Remember to have regular check-ups.

      • Understand that there will be days where you will have fearful thoughts. But also know that there will be days where you don't.

      • Focus on the here and now. Enjoy each day and remember that life is a precious gift.

    • Depression

    • It is common for breast cancer patients to experience some form of depression during their diagnosis and treatment. This is called situational depression. If you feel you are becoming depressed, please tell your doctor, nurse or therapist. They are there to help you and can offer suggestions to get you through this difficult period.

    • Sexuality

    • Breasts symbolize many things in our society, such as femininity, nurturance, motherhood and sexuality. Losing a breast through mastectomy or having your breast change from a lumpectomy can affect your self-esteem and image as a sexual person. The treatments you undergo after surgery can also impact your sexuality.

      Chemotherapy can have the most dramatic effects on a woman’s sexuality, including:

      • Nausea

      • Fatigue

      • Hair loss or skin and weight changes that can negatively affect your self image or self esteem and make you less interested in sex.

      • Medical menopause and its symptoms, such as:

        • Loss of ovarian hormone production

        • Hot flashes

        • Vaginal dryness. Different positions during sexual activity may help sex be more comfortable. There are also products available that provide moisture to the vaginal area. Try using a water-based lubricant, such as Astroglide, Moist Again, Women’s Health Institute Lubricating Gel, Replens or K-Y jelly. (Warning: Oil-based lubricants can weaken the latex in condoms and diaphragms.)

        • Infertility. You may want to discuss alternative options with your health care provider.

        • Tamoxifen. Tamoxifen probably does the least amount of harm to a woman’s sexual life. It is an “anti-estrogen,” which means that it blocks the action of estrogen in breast tumors. Women can often get pregnant while on Tamoxifen; however, most doctors advise against this due to concerns about birth defects. It is important to use birth control if you are taking Tamoxifen and have not gone through menopause yet.

      Pain medication and medications used for depression
      These medications can affect sexual desire and cause tiredness and constipation.

      Thinking about what you need
      As you recover from the trauma of diagnosis and treatment, sexual feelings and how you express them will regain importance. Remember to be patient and give yourself time. It’s normal to feel uncomfortable and anxious. Confidence and comfort should return in time.
      • Give yourself time to get used to the changes. Spend time alone, looking at your body.

      • Talk to friends or your partner about your feelings regarding your new appearance.

      • Join a support group.

      • Consider ways to increase your comfort level in your first post-treatment sexual experience, such as:

        • Wearing attractive lingerie.

        • Planning sex when you are feeling stronger and energized; this may be earlier in the day or at times between treatments.

        • Having some quiet time first with your partner which includes affection to get used to each other again.

        • Take the pressure off by expressing your sexuality using other means (such as oral sex, massage, kissing and fondling) without it having to lead to intercourse or orgasm.

        • When you feel ready for intercourse or more intense sexual activity, talk with your partner to find positions and activities that provide the most pleasure and minimize any discomfort. Stop the activity if you feel discomfort and help your partner understand what you were experiencing. Try changing positions or using extra lubricant.

        • Exercise can be very helpful. It can lift your mood by releasing endorphins and shape and tone your muscles, which can add to your confidence and make you feel more attractive.

      Things to talk about with your health care provider
      • Your feelings about breast reconstruction.

      • Information about ways to help alleviate some of the physical changes, such as vaginal dryness or pain.

      • How to reassure your partner who may be worried about harming you during sexual activity.

    • Getting a good night’s sleep

    • Despite exhaustion and fatigue from treatment and stress, between 30 and 50 percent of cancer patients report problems falling asleep. It may be helpful to:

      • Keep a record of your sleeping patterns for two weeks. When do you go to bed? Do you fall asleep immediately? When do you wake up? Are hot flashes waking you up at night? Is pain interfering with your ability to sleep?

      • Share this record with your doctor and come up with a “sleep plan.” This may include medication and lifestyle changes.

      The National Cancer Institute recommends the following to help promote rest and treat sleep disorders. Create an environment that decreases sleep interruptions by:
      • Lowering noise

      • Dimming or turning off lights

      • Adjusting room temperature

      • Placing pillows in a supportive position

      • Wearing loose, soft clothing to bed

      • Eat a high protein snack two hours before bedtime.

      • If you can’t fall asleep or stay asleep, leave your bedroom and engage in a quiet activity in another room. Don’t let yourself fall asleep outside the bedroom. Return to bed when you are sleepy.

      • Maintain a regular wake-up time.

      • Distract your mind. Try reading, watching a video, or listening to books on tape.

      • Avoid caffeine within four to six hours of bedtime.

      • Avoid the use of nicotine close to bedtime.

      • Don’t drink alcoholic beverages within four to six hours of bedtime.

      • Avoid strenuous exercise within six hours of bedtime.

    • Do I need medication?

    • There are many situations throughout your recovery process where medication may be warranted. Any symptom that is interfering with your quality of life should be discussed with your doctor or health care provider. These may include:

      • Anxiety

      • Bone loss

      • Constipation

      • Depression

      • Hot flashes

      • Insomnia

      • Nausea/vomiting

      • Pain

      You are your best advocate, so don't be afraid to speak up and talk with your doctor.

    • Genetic counseling

    • If your mother, sister, aunt or grandmother had breast or ovarian cancer, genetic testing is a way to determine if you or family members carry a gene mutation – an alteration in the genetic material – that increases the risk of these developing diseases. Some breast cancers, for instance, are caused by BRCA1 or BRCA2 genetic mutations. These are most often diagnosed before a woman reaches menopause around age 50.
      Before taking the test, it is important to fully discuss the test and its possible implications with your doctor and a genetic counselor. If you decide to do the test, a small sample of your blood will be sent to a genetic laboratory. Your DNA will be studied to detect mutations or changes in the genes. A report of the findings will be sent to the doctor that ordered the test, and he or she will share the results with you.

      Genetic testing may help you learn if you are at increased risk for ovarian cancer or a second breast cancer. However, having the gene for a specific cancer does not mean that you will develop that cancer. It only means that you may have a tendency toward developing the cancer and that the gene may be passed down to your children.

      Health Insurance Concerns
      Federal legislation went into effect in 1997 to prevent genetic testing from being used to deny women access to group health insurance. If you have concerns about this, please discuss them with your social worker who can guide you in the right direction.

    Take the breast health assessment