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Coping with Life Changes after Treatment

coping with changes after breast cancer treatmentWhen treatment ends, you may expect life to return to the way it was before you were diagnosed with breast cancer. But it can take time to recover - and normal may now be different.

Although the psychological issues of recovery are likely to be the most consuming, there are other, more practical, concerns that you may face. Some of these include the following:

Physical Recovery

It will take a number of months to fully regain your energy and sense of good health, and you will need follow-up medical care. You might feel that your body has betrayed you. Rebuilding trust in yourself takes time.

Fatigue following cancer treatment is a common problem. It is likely caused by an accumulation of the physical and psychological stresses you have endured. Go easy on yourself and understand that a sense of good health will return eventually, but not for some time. In the meantime, you may want to function on a somewhat reduced schedule. You may need more sleep, and feel less interested in your usual activities. As you are able, begin or resume a reasonable exercise program. Studies demonstrate that regular, moderate exercise contributes to both physical and emotional well-being.

Menopause

Most women in their 40s or older, who undergo chemotherapy for breast cancer, stop having their periods. This can also happen to younger women, although they have a greater chance of resuming their menstrual cycles.

This sudden menopause can feel like one more way in which you were victimized by the cancer. Women who had hoped to have children may feel the worst, but many women are devastated by having the choice taken away from them, and by suddenly feeling old.

The two menopause-related issues that are the most difficult are hot flashes and changes in sexuality. The frequency, duration and intensity of hot flashes vary enormously from woman to woman. They often are worse at night, in times of stress, and when the weather is very warm. There are a number of strategies that might help. Talk with other women and with your doctor. And remember that the hot flashes will diminish over time.

Friendships

You might experience some changes in your personal relationships. Some people you were close to may seem to abandon you. As hurtful and infuriating as it can seem, remind yourself that your diagnosis was likely terrifying to many around you, and some people just cannot manage their own feelings. However, you may find that others, who you knew less well, have grown into dear, supportive friends.

"It is likely that friends will assume that cancer is 'done,' that the person has been cured and can fully resume a 'normal' life," says Hester Hill Schnipper, LICSW, Chief of Oncology Social Work at BIDMC. "Unfortunately, it's not that simple."

Hill Schnipper recommends trying to be prepared to handle these changes. Some find it helpful, she says, to have a few remarks ready when someone asks if you are cured. For example, you can say "I hope so" or "Only time will fully tell."

If you have joined a support group or met other women who have had breast cancer, you may have made new friends who seem the closest of all. When it comes to friendship, your experience with cancer reminds you that life is short, and that you do not have to squander time on less important relationships. Spend time with those people who make you feel good.

Career

You may or may not have taken time off from work during your treatment. But you certainly have spent less time on the job, and have been less emotionally invested in it than usual. Most women find that their employers and colleagues are supportive and flexible, but not everyone is so fortunate. If you have experienced major difficulties at work, and wonder whether you have been discriminated against due to your diagnosis, it may be worth speaking with an attorney.

Much more commonly, you will have to decide how and when to return to work, or to your previous work schedule. Many women find that their priorities have shifted since their encounter with cancer, and your work life may seem much less important than it used to. Some women make job or career changes. Some women find other activities that seem more fulfilling than their jobs. Try not to make any major changes for at least a year, however. Give yourself time to recover and become reacquainted with yourself and your life.

It is less common now for people to feel trapped in their current jobs because they have had cancer. Most potential employers appreciate that most people who have had cancer go on to live full and healthy lives. Recent legislation has minimized the problem of changing medical insurance carriers once you have a pre-existing condition. It is still very important to ask about this, however, before you cancel your existing policy for any reason.

Financial Concerns

Having cancer is expensive. If you took a leave from work, your salary may have been reduced. Your medical insurance may not have covered 100 percent of your bills. There were probably additional expenses for more prepared food, household help, child care and clothing (not to mention that wig).

The longest-lasting financial impact of cancer will probably be your ineligibility for disability or life insurance. Your diagnosis of cancer means that you are now limited to the amount of disability or life insurance that you had prior to your diagnosis. At some point you may want to speak with a financial or estate planner about how to manage your financial life, both for yourself and for your heirs.

Resources to Help

Time will be your biggest ally in recovery.

"It helps to have supportive family and friends, though you may discover that they can't fully appreciate your feelings and experiences," says Hill Schnipper. "I often suggest to patients that they consider joining a support group for women who have completed treatment."

At BIDMC, a dedicated breast cancer social worker helps women with all of the changes they face as they transition to life after cancer treatment. Services include counseling, educational programs and resources, and programs such as Take Sail, to help patients get on with living. For more information, contact Hester Hill Schnipper at 617-667-2661 or the BreastCare Center at 617-667-2900.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

March 2012

Contact Information

BreastCare Center
Beth Israel Deaconess Medical Center
Shapiro Building, Floor 5
330 Brookline Avenue
Boston, MA 02215
Phone: 617-667-2900
Fax: 617-667-9711

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