Finally, the day you thought might never come has arrived. Your treatment for breast cancer is behind you. No more surgery, no more chemo, no more radiation. You're in recovery mode. That's good!
But it may take a while for things to get back to normal. Fatigue, worry, stress and treatment side effects don't necessarily disappear overnight. And new concerns may be added.
Fortunately, there are plenty of resources to help you get through this time, just as there were during your treatment, says Greta Greer, LCSW, past director of survivor programs for the American Cancer Society (ACS).
And there is a good chance that your quality of life will be restored or only minimally affected in the future, says Debbie Saslow, PhD, senior director for HPV-related and women's cancers at the ACS.
Some common concerns
Fear that cancer will return. It's normal to worry that cancer will return. And it could. But there are ways to handle your fears, Greer says. "Don't let fear affect your ability to love, live and laugh today. Learn to let go of things you can't control and take control of the things you can."
Some women, for example, find that engaging in activities they enjoy allows them to avoid focusing on fear. Others gain confidence by setting goals, such as celebrating a wedding anniversary, a birth or a college graduation.
"Each person finds their own pathway. There are no cookie-cutter solutions," Greer says.
Tamoxifen troubles. Tamoxifen may be taken for up to 10 years after cancer treatment ends to help prevent cancer recurrence. Side effects can include tiredness, hot flashes and vaginal discharge. However, these undesirable reactions are generally treatable.
Newer medicines—called aromatase inhibitors—cause fewer side effects, Dr. Saslow says. These are usually given to women who are past menopause and whose cancers are hormone-receptor positive.
Whatever course of treatment is prescribed should be completed, Dr. Saslow says, because it could save your life.
Lingering side effects. Some side effects of treatment may linger. Most can be treated; others may resolve on their own. For example:
- Fatigue after the end of treatment usually eases with time and rest. Exercise, with your doctor's permission, can also help. If weariness persists, you may have anemia, which is treatable.
- Post-radiation pain is uncomfortable, but it won't last forever. "It's more like a sunburn, so that will heal," Dr. Saslow says. In the meantime, moisturizing the skin with aloe vera, lanolin or vitamin E may help.
- You could experience early menopause or have menopausal symptoms, such as hot flashes. Talk to your doctor about managing the symptoms.
- Lymphedema can cause arm or hand swelling on the side of lymph node surgery or radiation. Lymphedema may develop at any time, and it can recur months or years later. Range-of-motion exercises can help restore arm movement. Mild lymphedema should be treated by a physical therapist, says Dr. Saslow, whereas moderate or severe lymphedema is most often treated by a specialized professional who will help you with skin care, massage, special bandaging, exercises and fitting for a compression sleeve.
Body image/sexuality. Losing a breast (or both) and hair can be traumatic for some; others take it in stride. But hair will grow back, and breast reconstruction is possible if you're interested, even if it isn't done immediately.
Changes in physical appearance may raise concerns about your partner's reaction and how the changes will affect your sexuality. Find a time to talk openly about your needs and your partner's feelings, Greer advises. And seek professional counseling if necessary.
Depression and anxiety. When you aren't feeling well physically and emotionally, depression and anxiety may follow. Just like the cancer itself, these feelings need to be treated. To find out if you might be experiencing depression, take this short risk assessment.
Return to usual activities. Every person is different, Greer says. When and how much you can do now depends on your level of activity before cancer, as well as treatment side effects, depression or other factors. Talk to your doctor if your ability to resume your usual activities takes longer than expected.
Your hospital can be an excellent source for support services you need, including nursing, social services, nutrition information, rehabilitation facilities and spiritual services.
Some women turn to individual or group counseling or self-help groups for support. Others may rely primarily on family and friends.
"No one person is going to meet all your needs," Greer says. "You may go to Sally, who's a good listener, to Jane for advice or to Mary if you want someone with connections who can help you meet new goals, such as getting a job."
Free online support programs on the ACS website at cancer.org include the Reach To Recovery volunteer program and the Cancer Survivors Network, an online community created by and for cancer survivors and their caregivers to share stories, support and practical tips for living with cancer and its effects.
You can support yourself, too, by making healthy life choices. To speed recovery, eat right, engage in regular physical activity and try to maintain a desirable weight.