Breast cancer is the most frequently diagnosed cancer in women according to the American Cancer Society. This year alone, more than 234,000 cases of invasive breast cancer will be diagnosed in the United States. Most women with breast cancer do quite well and have long lives after completing treatment. One of the hardest things for survivors is living with the worry that the cancer may come back. We recommend scheduling regular follow-up appointments with an oncologist and following the screening and/or prevention guidelines that your provider recommends. I also tell my patients to try, as best as they can, not to worry.
It is easy to see how breast surgery, radiation, and some of the side effects from systemic therapy (which, depending on treatment, can include hair loss, nausea, fatigue, weight gain, hot flashes, joint aches, or other unpleasant symptoms) can wreak havoc on a woman’s self esteem. In addition, many women are used to serving as a support system for their spouse, children, parents, or other loved ones; and to being responsible for important matters at work and at home. Learning to accept help and support rather than giving it can be very challenging. I always recommend honest conversations with family and loved ones, and involving a social worker, psychologist, or psychiatrist if patients are interested and willing to pursue this. Sometimes it can be helpful to talk with someone outside of one’s immediate network of family and friends to try to sort through some of the feelings surrounding the diagnosis and treatment of breast cancer. Support groups can also be helpful; hearing from others who are going through the same thing (perhaps at similar points in life and/or stages of the disease), can help normalize the experience.
Physical changes to the breast – scars from lumpectomy or mastectomy, getting used to the look and feel of reconstructed breasts (if this approach is chosen), and radiation-related changes – can make women less comfortable with their bodies and therefore less comfortable being intimate. These changes can also make them worry about whether a partner will still find them attractive. In addition, some of the systemic treatments used in breast cancer, such as chemotherapy or anti-estrogen therapy, can change hormone levels and decrease interest in intimacy. I always recommend sharing these concerns with your doctor or health care team. Talking with a social worker, psychologist, or even sex therapist can be helpful in dealing with some of the complicated feelings surrounding the look and feel of the breasts after treatment for breast cancer. There are also a number of options for managing symptoms like vaginal dryness, which can be a result of chemotherapy or anti-estrogen therapy and can make intimacy uncomfortable. Finally, open communication with significant others is critical, as they too may be struggling to find the best way to show affection in this new situation. I have actually seen many situations where the diagnosis of breast cancer actually brings couples closer together, as they navigate the path from diagnosis to treatment and finally to recovery together.
About Dr. Meisel
Jane Lowe Meisel, MD, joined the Glenn Family Breast Center at Winship Cancer Institute as a practicing physician in January 2015. Prior to her arrival, she was Chief Fellow at Memorial Sloan Kettering Cancer Center in New York. Dr. Meisel is a medical oncologist with a special interest in women’s health and in cancers that affect women, including breast, cervical, endometrial, and ovarian cancers. Her goal is to provide exceptional, state-of-the-art individualized care to patients fighting these diseases and to conduct research that improves treatment options for these patients.
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