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How to lead a balanced life after breast cancer?

– Sara Vaillancourt, social worker, Hôpital du Saint-Sacrement, Québec City, in collaboration with Cathie Rossignol and Emmanuelle Beaudin, social workers at the Centre hospitalier universitaire de Sherbrooke, explains.

Fictitious Situation

Julie (fictitious name) is 48. Ten months ago, she was diagnosed with cancer in her right breast. The chain of events unfolded rapidly: leave of absence from work, surgery, chemotherapy, radiotherapy. She was “strong”. At times, she was the one who encouraged her loved ones. Her last treatment took place three weeks ago. Luckily, it’s all over—or is it?

She still feels very tired, but is increasingly reluctant to mention it. At times she worries. She still feels the need to talk about what she went through. When she does, she’s often told she should stop thinking about it and just move on. And yet this experience is still a big part of her life. She still has questions, she still has fears.

When the Disease Strikes…

When the disease strikes, its impact can be felt in many different ways. From the outset, the hectic pace of events turns life upside down: appointments, surgery, treatments and their side effects. All this can greatly upset everyday life.

Most women feel that cancer becomes a thing of the past at the point when the treatment (chemotherapy, radiotherapy) ends. Affected people and their loved ones anxiously wait for things to get back to how they “used to be”. Unfortunately this is just the end of a phase, and the adaptation process can last for some time.

Various Concerns

Each woman reacts in her own particular way as the disease affects everyone differently. She may still feel a lot of distress, even when “it’s all over”. In fact things could get worse, as quite often the people around don’t understand or accept how she feels. She herself can’t quite understand her own reaction, and the people around her are even more baffled by it.

When treatment is over, a woman who had breast cancer may go through a period of rather intense disruption (sadness, anger, disrupted sleep and appetite, loss of memory and ability to concentrate, isolation). In most cases this kind of reaction is temporary. Seeking professional assistance will help her to better understand this period of upheaval, provide the necessary support to help her get back on her feet, as well as direct her to the appropriate care she may need to deal with this state of mind, should this be the case.  

The disease can impact in many ways:  

  • fatigue (the most common concern during the year following treatment);
  • body image (weight gain, scars, hair loss, gaining control of one’s body);
  • lymphedema;
  • menopause and sexual dysfunction;
  • anxiety, fear of relapse;
  • feeling of abandonment;
  • impact on relationships—conjugal, family, social, etc.

Effective Strategies

When you “finally” reach the end of the active care period, it is a good idea to stop and think about the changes you’ve experienced and the impact these changes have had on your life thus far. It may take time to restore a satisfactory balance that is probably different from what you experienced before. You should also keep in mind that resuming normal activities is part of the adaptation process that follows the diagnosis. Here are some strategies that can help to restore balance:

  • have realistic expectations;
  • set your boundaries, name them and stick to them;
  • resume your normal activities GRADUALLY;
  • take some time for yourself;
  • accept that anger, fear and sadness are normal emotions;
  • accept that rehabilitation and recovery take time;
  • believe in yourself;
  • talk about your experiences with one of your loved ones, with people who had similar experiences, or with a professional counsellor;
  • have a positive mindset in accepting your limitations/be patient and cultivate a positive attitude towards life;
  • there are limits to what can be achieved through positive thinking; it’s best therefore to have a more realistic approach.

To Keep in Mind

It is of utmost importance to keep in mind that once treatment is over, things will not necessarily get back to how they were before you got sick. At times both yourself and those around you can have unrealistic, hasty expectations. Although well intended, these expectations can be a source of stress and make you feel as if you’re not “normal”. It is important to fully understand the repercussions of the disease on different aspects of your life, and to define the specific ways you can empower yourself while taking your new limitations into consideration. If you stop and think about how things have changed, it will be easier to set realistic goals that will allow you to gradually restore a satisfactory new balance in your life. Remember, you are not alone: many women are going through a similar process.