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How breast cancer survivors can cope with 'the new normal'

Dr. Kenneth Miller is a medical oncologist at the Alvin & Lois Lapidus Cancer Institute at LifeBridge Health.

Better detection and treatment of breast cancer means that many women are surviving the disease. But life doesn't necessarily get easier for survivors right away. Some might suffer from depression and anxiety over whether the disease will reappear. Dr. Kenneth Miller, medical oncologist at the Alvin & Lois Lapidus Cancer Institute at LifeBridge Health, talks about how women can get through the early phases of survivorship and eventually take pride in beating such a difficult disease.

What are the different phases of survivorship?


The first phase of diagnosis and treatment is referred to as acute survivorship, followed by transitional survivorship at the completion of treatment, then extended survivorship, which often is five years of surveillance for recurrence, and finally permanent survivorship. More than 60 percent of cancer survivors are five or more years past their diagnosis.

What are some of the emotions women experience when they are breast cancer survivors?


I tell my patients that the minute they are diagnosed with breast cancer, they are already survivors. So many emotions come with that diagnosis, and these are normal because each woman processes the news in her own way.

However, some common reactions that women undergo are shock and disbelief, becoming upset and angry, negotiating with a higher power to help them get through it, being overwhelmed because of treatment decisions that must be made, sadness and even clinical depression, and acknowledging it.

Many breast cancer survivors report elation about completing treatment but also mild depression. Others worry that they are not "doing something" more actively to fight the cancer. This typically resolves with time.

Subsequently, some fear of recurrence is very common. At first it may feel like it fills the house, but over time, it typically surfaces less often and less strongly.

With all the worry and fear that accompany a cancer diagnosis, it is also important to recognize that down the road, many cancer survivors report a sense of pride in getting through a tough, unexpected illness.

How does it affect a woman's self-image and social interactions?

Women's self-image and body image are related to the medical treatment they receive, their personality and background.

Typically, what I see after breast cancer is women not only bounce back but even "bounce forward" to embrace life positively. They use their battle with breast cancer to remember who and what [are] important in their lives. They then actively spend more time with the people they love and the events that make them feel good rather than continuing with business as usual, sweating the small things.


What are some techniques to deal with the fear of the cancer returning?

Time is an important element in coping with the fear of recurrence. As weeks, months and years go by, most women note that breast cancer is less of a daily worry and their confidence in their own health and wellness returns. A healthy diet and regular exercise are incredibly helpful in re-establishing that self-assurance.

Additionally, encouragement from family and friends is crucial for this process. Women of faith also tell me how comforting it is to put themselves in the hands of [God] and their doctors. Some women, but not all, also find that support groups are helpful because they are with people who understand their experiences. Finally, survivors say that humor, where you wouldn't think there is any, is tremendously beneficial.

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How does it affect a woman's career and finances?

Many breast cancer survivors report that the cancer experience affected their career path and finances. Family medical leave has helped to buffer this, but sometimes employers may subtly change their expectations for employees who are being treated for cancer. It may be helpful for a cancer survivor to share, at their discretion, some information about their recovery with co-workers. While undergoing treatment, it may be useful to define any limitations that are needed and then, after treatment is completed, to redefine their capabilities.


What can she do, in general, to deal with "the new normal"?

Commonly, survivors return to normal and also to a "new normal" after completing cancer treatment. I encourage cancer survivors to find and appreciate their own resiliency and to give themselves credit for their strength in dealing with an illness that was not expected. Life after cancer is different, but oddly enough, it can be better than before. There is the phenomenon known as "post-traumatic growth" in which cancer survivors note that their lives are richer and fuller.