Ways to Cope with a Breast Cancer Diagnosis

What happens when the treatment begins

As more women survive breast cancer, in part due to early detection, more hospitals are adding programs and services that address the full spectrum of difficulties breast cancer patients typically face, from the physical to the emotional to the practical.

Although every breast cancer patient’s experience is unique, there are common challenges, says Jessica Ryan, MD, a breast surgeon at Elliot Breast Health Center in Manchester. For starters, there is the emotional trauma of the breast cancer diagnosis itself. It can be a lonely time, Ryan says; Even a woman who is fortunate enough to have a robust support system with many involved family members and friends can feel alone and isolated as she struggles to emotionally process the diagnosis and its potential consequences.

From there, challenges quickly mount. Patients can be overwhelmed by the cancer diagnosis and struggle to understand their treatment options. In rural or remote areas like northern New Hampshire, patients often face issues around accessibility of care. Patients must contend with a changing body and with the side effects of chemotherapy, which can include nausea, fatigue, hair loss, nerve damage and impaired heart function. Patients’ sleep can suffer, leaving them more vulnerable to depression.

The financial burden that comes with a cancer diagnosis can also be a tremendous concern, says Lisa Delahanty, APRN, manager of the Concord Hospital Breast Care Center. Even medication that is covered by insurance can cost upwards of $100 per month, and patients often worry about missing work and having inadequate healthcare coverage.

There can be difficulties related to sexual intimacy, too, says Sharon Gunsher, MD, FACS, medical director of Concord Hospital Breast Care Center and general surgeon at Concord Surgical Associates. Some women are rendered menopausal from breast cancer surgery — an experience that is particularly difficult for younger women — and must suddenly contend with hot flashes, weight gain and other menopause symptoms in addition to everything else they are going through.

And the anxiety that begins upon hearing the cancer diagnosis can stay for life. Some patients describe experiencing PTSD-like symptoms when the time comes to report for their first mammogram following cancer treatment. “I’ve had many patients tell me they worry that it’s going to start the whole thing all over again,” Gunsher says. “It’s something they really struggle with.” Some patients never return for mammograms and follow-ups after treatment ends, Gunsher says, apparently choosing to risk that a problem will go undetected rather than subjecting themselves to the anxiety that the appointments will trigger.

The good news is, many hospitals are developing a wealth of what are known as “survivorship” services and activities. Survivorship focuses on life post-treatment, with a goal of helping patients not just survive but thrive. With the increasing attention and interest in this aspect of cancer care, “survivorship is becoming almost its own specialty” within the medical field, Ryan says.

A sampling of survivorship programs at Granite State hospitals includes anticancer lifestyle courses that help patients make beneficial changes in their lives; talks given by prosthetics professionals who provide guidance on options after breast cancer surgery; and lectures, activities and support groups that connect women with each other and with healthcare experts while easing the stress and anxiety that can plague breast cancer patients. In addition, some hospitals offer programs geared for care providers and family members.

Although the more social gatherings such as support groups are not everyone’s cup of tea, many women find them well worth the time. “Patients get a lot of support from hearing each other’s story,” Ryan says. “It just makes them feel that they’re not alone … They realize, ‘Oh, I’m not the only one going through this,’” which can be a source of great relief and comfort.

And research shows that the mind-body connection is real, providing evidence that support groups alleviate stress, improve quality of life and even reduce the risk of breast cancer recurrence, Delahanty notes.

While mind-body initiatives and other complementary techniques have clearly gained followers, Ryan cautions that complementary approaches should augment — rather than replace — conventional cancer care. But importantly, she says, such techniques provide women with an opportunity to focus on what should be their top priority: themselves and their well-being. Asked to name the most important person in their life, she says, most breast cancer patients name their husband or children. “They’ll list 12 people before it gets down to them,” Ryan says. “I tell them, ‘With this diagnosis, that needs to change. You have to be number one.’ And I think a big part of investing in survivorship programs and activities is really making that distinction.”

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