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Treating Metastatic Breast Cancer

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Navigating the Mental Maze of Cancer Treatment: A Guide

Medically Reviewed By Meredith Goodwin, MD, FAAFP
breast cancer_Dr Alexea Gaffney_Navigating the Mental Maze of Cancer Treatment A Guide

As a physician who has traversed the challenging journey of breast cancer treatment, I am intimately aware of the toll it takes on survivors, not just physically but mentally as well.

For many, a cancer diagnosis is often accompanied by feelings of fear, anxiety, and depression.

Managing these emotions is crucial, as mental health plays a pivotal role in the treatment outcomes of any disease, especially cancer.

Here, I share some insights and strategies to help fellow survivors cope with these psychological impacts.

Understanding the emotional impact

The moment a cancer diagnosis is confirmed, it can feel like a sudden plunge into uncertainty. The fear of what lies ahead — treatments, side effects, the impact on our families and livelihood, and of course the prospect of recurrence — can be overwhelming. It’s normal to experience a roller coaster of emotions, but acknowledging them is the first step towards managing them. So feel all the feels, good, bad and indifferent. Process them and deal with them so you can be on your way to coping and  healing.

Strategies for coping

1. Establish a support system

I learned firsthand the importance of leaning on family, friends, and support groups. These networks provide not only an emotional crutch but also practical help and a repository of shared experiences and advice. Professional help from counselors or psychologists who specialize in cancer-related issues can also be invaluable. There are support communities for every situation and circumstance, including adolescent and young adult (AYA) cancer communities, metastatic thrivers, communities for mothers of young children, communities for different breast cancer subtypes, communities for BIPOC individuals, and communities for LGBTQ survivors, as well.

2. Stay informed

Knowledge is empowering. Understanding your diagnosis, treatment options, and what to expect can help reduce anxiety caused by the unknown. However, it’s important to source information from reputable and reliable platforms and professionals. Avoid misinformation, which can increase treatment-related stress and anxiety.

3. Practice mindfulness and relaxation techniques

The day I was diagnosed with stage 3 breast cancer, I made up my mind about a daily gratitude practice.  Not every day is a good day, especially when you are facing cancer treatments and surgeries, but there is good in every day. You just have to find it. A daily practice of gratitude did wonders for my mental health. Techniques such as meditation, yoga, and deep-breathing exercises can also significantly alleviate stress and anxiety. These practices help center your thoughts and keep your mind from wandering to “what-ifs” or help reframe negative thoughts to more positive or hopeful ones.

4. Maintain a routine and engage in activities

Keep up with as much of your normal routine as you can reasonably manage, and engage in activities you enjoy. This can lend a sense of normalcy and control. Whether it’s reading, painting, or listening to music, these activities can provide a much-needed escape from the stress of treatment. 

5. Prepare for physical changes

Physical changes during cancer treatments can also trigger emotional distress. Prepare for these changes by discussing them with your healthcare team.  At the time of my diagnosis, I didn’t realize how quickly I would lose my hair. I was shocked when my doctor told me my hair loss would begin very quickly after my initial treatment. Just like clockwork, on day 14 my hair began to shed. Having a timeframe allowed me to prepare by purchasing wigs and headwraps. In retrospect, I wish I had cut my hair in a fun or funky style or colored it to take back control and alleviate some of the stress of losing all my hair to cancer. The same was true for my surgery. Understanding the physical limitations I would face helped me to plan for an appropriately timed work leave and to guide my support squad on how to best meet my needs. It was also important to be able to explain to my then 6-year-old how these changes would impact her, as well. Understanding and accepting these changes can reduce fear and anxiety. 

6. Take up journaling

I found activities such as journaling to process my emotions were a helpful addition. Writing down your thoughts and feelings can be a therapeutic outlet. Reflecting on your journey and documenting your experiences can help in processing emotions. It doesn’t have to be long, eloquent entries, just what you feel. Highs, lows, in betweens – it’s all worth exploring. Journaling is also a great way to look back over how far you’ve come since your diagnosis. 

7. Prioritize long-term emotional care

After the completion of cancer treatments, the journey isn’t over. The fear of recurrence can linger, affecting your mental health. Continuing with regular counseling, maintaining a healthy lifestyle, and staying connected with your community and support squad are essential. Regular follow-ups with your oncologist can also help manage this fear by providing reassurance through physical exams, lab monitoring or imagining.  Whenever the fear of recurrence creeps in, I remind myself of all the data that I have that says otherwise: NED (no evidence of disease) on a PET CT a few months back, normal tumor markers and routine labs, a negative circulating tumor cell DNA blood test, and no lumps or bumps on my self-exam. 

Dealing with breast cancer is as much a mental battle as it is a physical one. By employing these coping strategies, you can help mitigate the emotional and psychological impacts of your diagnosis and treatment. Remember, it’s okay to seek help, and it’s okay to not be okay at times. As someone who has been down this path, I understand the challenges, but I also know the strength that we can garner from within and from those around us. Let’s walk this path together, supporting one another in every step of the journey.

By prioritizing mental health and employing strategies to cope with the emotional aftershocks of cancer, we can not only survive but also thrive.

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Medical Reviewer: Meredith Goodwin, MD, FAAFP
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