How does an average woman react to the terrifying diagnosis of breast cancer? Many women go through several psychological steps in learning how to deal with breast cancer.
First, there is shock. Particularly when you're relatively young and have never had a life-threatening illness before; it's hard to believe you have something as serious as cancer. It's all the more difficult to believe because, in most cases, your body hasn't given you any warning at all. Unlike, for example, appendicitis or a heart attack, there's no pain or fever or nausea - no symptom that tells you something is going wrong inside. You or your doctor have found this painless little lump, or your routine mammogram shows something peculiar - and the next thing you know, your doctor is telling you you've got breast cancer. Many women say this is the worst part of the journey. The initial shock can leave you feeling confused and not sure how to proceed. Along with the shock, there's a feeling of anger at your body, which has betrayed you in such an underhanded fashion. In spite of the horror that you feel at the thought of losing your breast, often your first reaction is a desire to get rid of it.
While this is a perfectly understandable emotional response, it's not one you should act on. Getting your breast cut off will not make things go back to normal; your life has been changed and it will never be the same again. You need time to let this sink in, to face the implications cancer has for you and to make a rational, informed decision about what treatment will be best for you both physically and emotionally.
Today there's much more emphasis on doctor and patient sharing the decision making process and there are more options to choose from. There's also a lot more knowledge available - there are manuscripts about breast cancer and its survival rates in both the medical and the popular press and on the internet.
So if the first stage is shock, the second is investigating your options. It is very important to reflect seriously on what the possibility of losing a breast would mean to you. Its importance varies from woman to woman, but there is no woman for whom it doesn't have some significance. Although many women will say, "I don't care about my breast", deep down this is probably not true for most of us. A mastectomy may be the best choice for you, but it will still have a powerful effect on how you feel about yourself. For many women, the loss of a breast can mean feelings of inadequacy.
Several studies have been done comparing conservative surgery and mastectomy with or without immediate breast reconstruction, looking for differences in psychological adjustment. Interesting enough, the important factor often appears to be the match between the woman and her treatment. That is, the way she feels about her body, about surgery, about radiotherapy, about having a part in the decision making process of her treatment and about a multitude of factors affects how she reacts to this new and enormous stress.
Along with the fears and stages of recovery, there are also a number of related issues that come up for people with cancer. One of these is the tendency to feel quilt for having cancer - a sense that you've somehow done something wrong. People have a tendency to blame themselves for being ill anyway and a woman will often feel she's betrayed her function as a caregiver by getting breast cancer.
For many women breast cancer never returns and they begin gradually to rebuild their lives. But sometimes, cancer does return. The emotional issues of breast cancer recurrence are so profound and complex that, if you do have a reappearance of the cancer, you may need the help of a mental health professional.
Michael Russell Your Independent guide to Breast Cancer
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