Dr. Ducharme’s Blog October 15, 2018: Coping with the Psychological Effects of Breast Cancer

October 15, 2018

Four words. That is all it takes to change your world forever. Four words …“you have breast cancer”. For many women the first thought that goes through their mind is “I am going to die”. And very often, as soon as the doctor says these words, patients hear little if anything else the doctor says in that meeting.

In the United States, more than 230,000 women and approximately 2,600 men receive a breast cancer diagnosis each year. Since the number of women is so much higher, I will use the term women in this blog. But I want to be clear that many men may have similar reactions. We are making enormous strides in treatment of breast cancer. Early diagnosis, better and more specific treatments have allowed so many women to live long and healthy lives after their initial diagnosis. As a psychologist, however, I think that a diagnosis of any type of cancer  has numerous emotional consequences that need to be addressed. Most of you know that I am all about mind body health. I strongly believe that if we have a physical problem we will experience emotional side effects. And quite often, if we are experiencing psychological pain we will probably exhibit some physical symptoms.

Here are some suggestions to help you and your loved ones cope better with the emotional consequences of breast cancer:

1. Always try to bring someone you trust with you to your initial test/biopsy results and follow-up medical appointments. As noted above, just hearing the diagnosis, most people tune out, lost in their own thoughts and fears. Having someone to listen and write down what the doctor says is incredibly helpful.

2. Understand that anxiety and depression are extremely common and expected after this diagnosis. Most women worry about body disfigurement. They fear they will no longer be appealing to their partner. They worry about their sexuality and their ability to ever feel attractive again. Many refuse to look at themselves in the mirror after surgery. If they are having chemotherapy there is the fear of losing one’s hair. The side effects of chemo and radiation are always a concern. Women worry about whether they will be too tired or sick to go to work. This often leads to worries about finances. Women also worry about the impact of the illness on their kids and spouses, especially since for many women, the first worry is simply about survival. And finally, a major concern is, “even if I am cured will it come back?”. Follow-up mammograms become days of anxiety and dread.

3. Let your doctor know if you are feeling anxious and or depressed. They often have a designated Nurse Manager to help guide you to appropriate resources.

4. Seek out support. The American Psychological Association notes that depression can decrease women's survival. According to one analysis, mortality rates were as much as 26 times higher in patients with depressive symptoms and 39 times higher in patients who had been diagnosed with major depression. Many times women are so overwhelmed with fatigue and fear that they stop doing things that can help them cope.

Psychologists and other mental health providers trained in working with patients diagnosed with cancer can be a very important part of treatment. For example, although it is very important to take the prescribed medications for nausea, utilizing techniques such as relaxation, meditation, self-hypnosis and imagery are generally very helpful. Many cancer centers also provide a holistic approach to treatment and  offer Reike sessions and even massage. It is important to give these a try.

5. Maintain a healthy life-style by eating well, getting some exercise and plenty of sleep. Let friends and family help you when you need it. You do not have to go through this alone. Take time to pamper yourself.

For some women, the main worry may be on how to explain their illness to their children or how to deal with a partner's response. For others, it may be on how to choose the right hospital or medical treatment. For still others, it may be on how to control stress, anxiety or depression. By teaching patients problem-solving strategies in a supportive environment, mental health professionals help women work through their grief, fear and other difficult and changing emotions.

Additional resources include:

The American Cancer Association.  800-227-2345. Their website is filled with information for both patients and their families.  https://www.cancer.org/treatment.html