After months or years of constant treatments, tests and checks by oncologists, your time as a breast cancer patient is over! You are free to start your post-cancer life, and your friends and family are happy. But what is that nagging feeling you have? Why aren’t you as happy as you thought you would be? Could this be the post-cancer stress you’ve heard about?
Lisa Iannucci, a writer from Hudson Valley, NY, remembers her initial feeling of elation after completing treatment for triple-negative breast cancer in 2018. But that didn’t last long. She didn’t expect this to happen because this wasn’t Iannucci’s first encounter with cancer. She was successfully treated for thyroid cancer in 2001 and experienced no lingering anxiety. But treatment for thyroid cancer is usually not as intense or as long as for breast cancer. So it’s not surprising that this happened to Iannucci. She admits that her feelings after breast cancer treatment overwhelmed her. “You think you’ll be excited when your treatment ends. But you are afraid.”
There’s no doubt about it: going to the clinic for cancer treatment is stressful. But once you get there, people look at you and take care of you, Iannucci says. This gives a feeling of comfort during the process. But when treatment ends, so does that comfort, and worries can go unchecked. What Iannucci describes is a safety net provided by the cancer support team. Once treatment is over, this safety net is gone.
Up to half of breast cancer survivors worry that their cancer may return. For many, it goes beyond worry, and the anxiety can be immense, leading to increased stress and anxiety. The loss of regular contact with the treatment team certainly plays a role in this. “That feeling was very intense for me,” says Iannucci. Her oncology check-ups were instituted every three months for five years, and every six months thereafter. “I was scared about going to six months,” Iannucci says.
After Donna Deskin, a retired administrator in Montreal, Canada, completed her breast cancer treatment in late 2019, her care returned to her primary care doctor, who orders her mammograms and keeps an eye on things. ‘I wouldn’t say that [life after breast cancer] is scary to me, but it’s even more disturbing,” she says. “I’m nervous about going for the mammogram and I’m extremely nervous about waiting to make sure they get the shots they need.” Deskin says that just calling patients when there is something that concerns the doctor about the images does not help with the concerns because you are left with the unknown. “So you wait and wait, and you jump on the phone when it rings. I insisted that my doctor call me just to let me know.”
As a breast cancer survivor, you may find yourself noticing every ache, pain, and twinge. Before your diagnosis, you may have passed it on due to aging or exaggerating from the day before. However, after breast cancer treatment, your thoughts may go deeper as you wonder if your cancer has returned. Experts say this is normal, especially in the first year after finishing treatment. Some women are so scared that they go to the emergency department to make sure everything is okay. And of course there are the visual reminders that can cause stress. A study published in 2019 found that breast cancer scars result in negative body image and affect the mental health of most women. “The scars are there,” says Deskin. “Every time I look in the mirror or shower, they are there.”
Post-traumatic stress disorder (PTSD) is not limited to people who have been in a violent situation or witnessed something horrific. People who survive life-threatening illnesses can also develop PTSD. About a third of women diagnosed with PTSD after a breast cancer diagnosis still have PTSD symptoms four years later. In some cases, symptoms get worse even after treatment ends. Factors that cause PTSD vary from person to person.
“I have some lymphedema in my left shoulder that is causing pain in my left arm,” says Iannucci. “One night I was lying in bed watching a video on my phone and I got an itch. I went to rub my wrist and I felt a lump. I was right back where I was.” Iannucci says it could have just been a knot in the muscle, but feeling that lump actually brought back the fear of cancer.
Constant stress can affect your physical health and keep you from moving forward now that your cancer treatment is over. So what can you do to help yourself? Here are some practical tips:
- Physical activity can be helpful. Regular exercise has many physical and mental benefits, whether you regularly walk around the neighborhood or go to a gym.
- Work on a hobby you used to enjoy or start a new one. Distraction can help you refocus your thoughts.
- Try to get enough sleep. While this may be easier said than done, a good night’s sleep can help alleviate negative thoughts.
- Eat a healthy diet. According to the Mayo Clinic, dieting can’t cure anxiety, but it can help you feel better physically, which in turn can ease unpleasant feelings and thoughts.
- Work on relaxation reduction techniques. They may include deep breathing, meditation and counseling.
- Socializing has many benefits, if you feel like it. Whether you join a faith-based group, take classes, or volunteer in your community, interacting with others can benefit your mental health.
- Medicines can help. Many people don’t like the idea of depending on medications to manage stress, but sometimes it is necessary. Some people need anti-anxiety medications to get to the point where they can effectively use relaxation techniques. Some may need them longer.
- Join a support group. Whether you get support online or in person is an individual choice, but talking about your concerns with someone who understands can be invaluable.
- Complementary therapies such as acupuncture, journal writing, massage and guided imagery – to name a few – can also be helpful in managing stress or anxiety.
There’s no doubt about it. Stress after cancer is real for many people. If you’re struggling, don’t wait. Get help like you did when you found out you had breast cancer. If you are in serious distress, call the 988 Suicide and Crisis Lifeline.