You’ve been diagnosed with breast cancer, developed a treatment plan with your doctor (which may include surgery, chemotherapy, radiation, or hormone therapy), and started treatment.
Your prognosis is good for a full recovery but it’s not over when the treatment ends.
So, what comes next? What can you expect from life after breast cancer?
There are over 3 million women in the United States alone who have breast cancer, both invasive and noninvasive. The survival rate is good, 90% after 5 years for invasive and nearly 99% for those whose cancer remained in situ.
However, your body will go through changes so you should know what to expect. Such as how long it will take you to get back to “normal”, or your new normal. And, how will you look and feel long after treatment has ended.
What to Expect During Treatment?
Depending on the type of breast cancer you have, you may undergo surgery, chemotherapy, radiation, or hormone therapy. All of these treatment options come with possible side effects and some may linger long after treatment.
When you have a lumpectomy, or mastectomy in one or both breasts, it can change the way you look.
If you have cancer in only one breast, you may still opt for having a double mastectomy, to minimize the chance of recurrence.
Whether or not you keep your breasts, they are going to feel different. You may not feel as confident as you did before the diagnosis. You may feel as though your body has betrayed you. You may feel loss. All of this is entirely normal.
If you have a mastectomy, you’ll most likely need breast reconstructive surgery, and often they can do it at the same time as your mastectomy surgery. Some women opt for implants, or use a breast prosthesis, or breast form.
Talk to your doctor about all of your options, including lumpectomy, and choose the one that’s best for you.
During chemotherapy treatment, you may temporarily experience hair loss. Your hair should begin growing again soon after treatment ends.
You may experience nerve loss, including numbness in your hands or feet, and possibly weakness in your legs and arms. Also, loss of appetite, nausea or vomiting, and even diarrhea. You’ll be more fatigued. You may notice changes in your skin tone and nails.
Most of these symptoms are temporary and go away shortly after treatment is completed. However, let your doctor know right away, as they can help with specific symptoms like nausea, or numbness. Don’t suffer in silence.
Many breast cancer patients experience cognitive dysfunction or “chemo brain” which includes memory loss, trouble concentrating, and word dropping which is where you’ve can’t recall a word that you’ve always known. You may have trouble remembering names or appointments or recalling things. It may take you longer to complete tasks. Fortunately, it’s temporary for most women. For others it can last a few years after treatment. There are several things you can do to help with your chemo fog like getting enough sleep and eating a proper diet. Your doctor can also make recommendations.
Chemotherapy is one of the best ways to reduce large tumors so that other treatments will work better. It also can reduce the risk of your breast cancer returning. However, you and your doctor should discuss all the risks and possible long-term effects and decide whether chemo is right for you.
Radiation therapy is common after a lumpectomy to kill off any lingering cancer cells and lower your risk of breast cancer returning. It’s also used to shrink large tumors.
Radiation may cause pain and soreness at the application site, which should lessen soon after treatment. You may notice roughness, redness, or even peeling of the skin. Your doctor can recommend creams or pain medication which should help alleviate those symptoms. You may also feel fatigued for a few weeks after treatment. Most symptoms should go away once treatment is complete. Tell your doctor if you have any persistent pain, swelling or rash, fever or coughing.
The same hormones that naturally regulate our reproductive system (estrogen and progesterone) can also cause or feed a tumor. Hormone receptive breast cancers, also known as er/pr positive tumors, feed on the body’s estrogen (er) and progesterone (pr).
Hormone therapy (HT) to block the production of estrogen and progesterone is beneficial before surgery to reduce tumor size. It works by essentially starving the cancer cells of the hormones responsible for their growth. HT can also be used after surgery, chemo or radiation to reduce the risk of the cancer recurrence.
HT for cancer is not to be confused with hormone replacement therapy (HRT) or Menopause Hormone Therapy (MHT) which replaces lost hormones (estrogen and progesterone) that cause hot flashes/flushes and other symptoms during perimenopause.
In fact, women taking MHT would need to stop taking those medications if they have er/pr receptive breast cancer. In both pre and post-menopausal women, breast cancer hormone therapy can cause symptoms similar to those found in perimenopause.
Sometimes removing the ovaries (oophorectomy) is the best treatment for an er positive cancer in premenopausal women. Another option is ovarian ablation, or suppression by taking a medication like tamoxifen that will, prevent the ovaries from making estrogen. However, survival rates are higher for those that had their ovaries removed and then followed up with tamoxifen.
Your doctor will recommend different medications depending on your type of breast cancer and your menopausal state. Each will cause various side effects. The most common side effects are mood swings, loss of sex drive, bone loss, joint pain and possible nausea and headaches. There is also increased risk of blood clots, heart attack, and stroke. But you increase your survival rate and lower risk of recurrence while taking these medications.
After diagnosis, breast cancer treatment can last for a year or more. Weekly visits to the doctor, surgery, chemo or radiation treatment… You’ve spent a long time with your treatment team, and now it’s over.
You may also still have pain and other residual symptoms. Your treatment is over, but your recovery is not. You should be ecstatic, but instead you’re feeling anxious or even sad and have feelings of loss.
This is completely normal. Your medical team has been a constant source of support and now they are no longer needed. You may feel as if they are the only ones who understand you.
Breast cancer support groups can help. Joining a support group before treatment is over may help with your feelings of loneliness during this transition period. They’ll already be there at the end of your treatment journey.
Your medical team can help you find one.
Anxiety is a feeling that does not go away right after treatment. Worrying that your cancer may return is a valid fear, but one that should lessen over time.
But if you have severe anxiety or feelings of depression, either during or after treatment has ended, talk to your doctor. They may recommend therapy, or perhaps medication.
The important thing is to not take this on alone.
The Emotional Roller Coaster
You’ll experience several emotional stages while going through breast cancer from diagnosis through recovery.
- More fear and anxiety
These are all normal feelings, but you don’t have to go through them alone. If you’re feeling afraid, talk to someone. You’ll you need your family and friends too. However, sometimes it helps to talk with someone who’s gone through the same thing as you.
Your medical team can also answer your questions and provide a lot of support. If you have specific concerns, or feelings of anxiety and depression longer than a couple of weeks, they can recommend therapy.
There are resources online from the American Cancer Society and the BreastCancer.org, and the Susan Komen Foundation.
Your New “Normal”
It will take time to get back to a sense of normal. You’ve spent the last year sick in a constant stream of doctor visits, surgery, and treatments. Talking, thinking, and worrying about your breast cancer.
But now it’s time to get your life back on track. You miss your old “boring” “normal” life.
You want to get back to work and family. You want to stop thinking about your cancer.
Take things one at a time and don’t try to do everything at once.
Your life may have been thrown out of whack the instant you were diagnosed but getting it back will be a much slower road.
Here are some things you can do to put yourself on the right track to life after cancer:
- Talk with a professional or support group
- Take time out for yourself
- Take up a hobby
- Ask for help when you need it
- Eat a healthy diet
- Slowly go back to doing things you once loved (such as . . ..)
- Embrace your friends and family
- Meet other survivors either through a support group on online
There is life after cancer. It may not be the exact life you had before, but change isn’t always a bad thing. Find things to appreciate, accept help, and learn to love yourself again. You got this. You’re a survivor.