The Emotional Impact of Advanced Breast Cancer
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Dealing with advanced breast cancer can take a large emotional toll as well as a physical one. In fact, nearly half of women with advanced breast cancer feel isolated and worried, according to two surveys published in the August 2019 issue of the journalBreast.
This may be due to the fact that when you’re living with advanced breast cancer, you’re likely coping with a swirl of emotions that may come on fast and furious and change from moment to moment, says Nicole J. Sachs, LCSW, a clinical social worker/therapist in Lewes, Delaware, and the author ofThe Meaning of Truth: embrace your truth. create your life.
Counseling, medication, and other approaches can help, according to the National Cancer Institute (NCI). “It’s about finding a solution that helps you work through what’s going on in your body and mind,” Sachs says.
Cancer and Emotions
If you have advanced breast cancer, there are many ways to deal with the emotions you may be feeling, such as:
Loss of control:“Women with advanced breast cancer may feel a loss of control and a deep sadness for what they will be missing,” says Sachs, who counsels many such women.
What may help? Talking with a therapist, joining a support group, or journaling allows you to feel more in control of what’s to come, she advises.
Guilt:“Guilt and regret travel together, so if guilt comes up, it may be that a woman feels she didn’t lead a healthy lifestyle and that’s why she got breast cancer,” Sachs says. You may also feel guilty about upsetting your loved ones, or worry that you’re a burden to them, according to the NCI. “It’s important to release guilt,” Sachs says. “It’s one step forward, two steps back when you blame yourself.”
What’s the best way to deal with guilt? Let it go. Guilt can get in your way and affect treatment choices and decisions, says Heather McGinty, PhD, a licensed clinical psychologist at The Ohio State University Comprehensive Cancer Center in Columbus. “Cancer is not your fault. Even people who lead healthy lives get cancer.” Sharing your feelings with a counselor or support group may also help, according to the NCI.
Denial:“There can be a lot of denial just after learning you have advanced breast cancer,” Sachs says. ”It’s a defense mechanism.” Denial can be positive if it allows you to stay optimistic and hopeful, but not when it gets in the way of doing what you need to do to save your life, such as seeking treatment and making healthy choices, she adds.
What may help? Give it time. According to the NCI, people usually work through feelings of denial on their own, over time. “Denial is often replaced with acceptance,” Sachs says.
Loneliness:“This is common among anybody who’s suffering,” Sachs says. The researchers who analyzed the surveys published inBreastfound that 41 percent of the respondents felt that support from family and friends decreased over time. Also, more than half of the women with advanced breast cancer felt like a burden to their family. “This can be isolating,” Sachs says. “The fear is that you have to deal all on your own.”
What may help? Group therapy can be a lifeline, Sachs says. “It can provide a respite for one hour where you can speak to people who are exactly where you are and then return to your life with renewed energy,” she adds.
Self-pity:“Poor me, woe is me, why me? Moments of self-pity like this are normal when dealing with advanced breast cancer,” Sachs says.
What may help? Give yourself a break. It’s okay to feel bad or sorry for yourself as long as it doesn’t get in the way of doing what you need to do, she says. “It’s not always authentic to remain positive,” Dr. McGinty adds.
Anxiety:“When we are in danger, anxiety helps us get away by releasing the flight-or-fight hormones,” Sachs says. This is great in a pinch, but not so much when dealing with a longer-term situation such as advanced breast cancer.
What may help? Ultimately, acceptance will help release anxiety, Sachs says. “You can’t worry about outcome, but what you can do is take next right considered action,” she explains. This may be starting treatment or scheduling follow-up testing. Journaling can be quite helpful here. “It’s free, anyone can do it, and you can throw it out when you’re done,” she notes. “It’s not about keeping it forever. You just need a release valve.”
Sometimes medication can also help, adds David Straker, DO, an adjunct assistant professor of psychiatry at Columbia University Medical Center in New York City. “If you treat anxiety, it can improve your quality of life,” he says. “The emotional can help the medical.”
Shock:This is a normal reaction to hearing that you have advanced breast cancer or that an earlier breast cancer has returned. “It can be hard to hard to process feelings and information and really digest what is happening,” McGinty says.
What may help? Look for a peer mentor, she suggests. “Having a single contact who you can reach out to, who is or has been in a similar situation, can be helpful,” she notes.
Depression:“Depression is more than a sad mood,” McGinty says. Other symptoms include the inability to find pleasure in things you normally enjoy, fatigue, helplessness, and hopelessness.
What may help? If you suspect depression, see a mental health professional to help tease apart the physical and mental causes, she says. Talk therapy, medication, and lifestyle changes may all help.
Anger:Anger is a part of coping with cancer, Dr. Straker says. “You may feel frustrated and not know who to blame,” he adds. “Anger can be directed at God, the doctors, yourself, or loved ones — and it can interfere with treatment.”
What may help? Spirituality can help defuse anger for some people, he says.
Video: Coping with Advanced Breast Cancer | Dana-Farber Cancer Institute
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