ADJUSTING TO A “NEW NORMAL”
Life after breast cancer treatment.
Women undergoing breast cancer treatment hope that once their treatment (surgery, chemotherapy or radiation) is completed, life will return to normal and continue as it did before they went through the treatment phase. Unfortunately, many breast cancer survivors have said that they were ill-prepared and unaware of how different their life would be after treatment. There were new challenges and circumstances to face and this required a great deal of physical and mental preparation. In addition, there was the lingering, nagging fear that the cancer could return.
If you or someone you care for is completing treatment for breast cancer, it is advisable to be aware of the changes one can expect, in order to be better equipped to cope with the recovery process.
The treatment may be over, but the side effects could persist
The hair loss, nausea and vomiting will stop, but some side effects of chemotherapy could linger on for longer, like fatigue and difficulty in focussing and remembering, which were not present before the treatment. This is normal. I suggest that you make a note of all the changes you notice and discuss them with your doctor at your next check-up.
Here are some practical ways to cope with fatigue: plan your day in advance; pace yourself through the day; take short breaks and naps during the day; allow others to help you; and find easier ways to do your regular work, such as sitting while travelling or cleaning the house. If you are finding it difficult to focus or concentrate, try the following: write down your to-do lists for the day; stick post-it notes where you can see them easily or set reminders on your phone for important tasks; focus on one task at a time; and learn to relax and manage your stress.
Regular doctor visits must become part of your life
Schedule regular check-ups with your oncologist, as prescribed. You may also be required to do regular check-ups such as pelvic exams or bone density tests depending on the drugs you are taking.
A healthy lifestyle is an important aspect of recovery
There is no sure method that can prevent the recurrence of the cancer. A healthy lifestyle, however, can help you feel better, more energised and physically stronger. Some things that you must include are: healthy food choices, such as 5 to 9 daily servings of vegetables and fruit, less salt and less fat in your diet; regular exercise for at least 30 minutes a day to reduce treatment side effects such as anxiety, fatigue, nausea, pain and diarrhoea; no smoking because it increases the likelihood of developing cancers at the same or a different site; and reduced consumption of alcohol.
Your body may not be the same, but that is okay
For women who have had to undergo a mastectomy (breast removal surgery), losing one or both breasts can be very distressing. Even a breast-conserving surgery (lumpectomy) where only the tumour is removed, could lead to some scarring or a change in the shape or size of the breast. Some women respond to this by opting for a breast reconstructive surgery, whereas others choose to wear a breast
prosthesis. Whatever your choice may be, my advice is to accept the change your body has gone through, love your body regardless of this change and appreciate the fact that it all happened as part of your treatment and recovery. Choosing clothes that make you feel attractive and not self-conscious can also help.
Intimacy and sexual activity may be affected, but can be overcome
Women also worry about whether they will be able to enjoy the same kind of intimacy with their partner after breast surgery as they did before. Yes, after treatment you may have to approach sexual activity a little differently. An open discussion with your partner could be helpful. You may find that your worry was completely unfounded. It would be a good idea to also consult with a sex therapist. Whatever you choose, know that breast surgery and radiation do not usually decrease libido or sexual pleasure.
Every survivor has a different story to tell. Every story is special because it is a story of courage and hope in the face of overwhelming odds. The road to recovery can be managed with a little resolve on your part and support from family and caregivers. It helps to remember that one of the hardest parts of your breast cancer journey – the treatment – is over. It is time to celebrate and make lifestyle changes that will pave the way for living every day joyfully.
Dr. D C Doval Director Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi