When we think of Breast Cancer Awareness Month, our thoughts usually go directly to the physical devastation that this cancer wreaks on its victims and what we can do in order to make our contribution to the research to find the cure. However, little consideration is ever given to the toll that this disease takes on the mental health of its victims, their caregivers and even their medical team members, particularly for those dealing with advanced breast cancer. This awareness was graphically brought to my attention when I recently viewed the survey results of a study that had first been shared in 2014.
Therefore, I was extremely grateful to have a chance to discuss these results with Dr. Helen L. Coons, Ph.D, ABPP who has specialized in psychosocial oncology for over 25 years and is also a breast cancer survivor as well. As she explained, it is perfectly natural upon initial diagnosis to have to focus on the physical as we make our way through surgeries and treatments but we know that there is something else going on and as women, we just kind of put that away. But, studies show that different things occur at different levels as well as different stages of treatment.
In the beginning, when treatments change, the patient experiences anxiety and that level goes way up when she has experienced two or more changes in the context of advanced breast cancer. Dr. Coons was quick to point out however that women at any stage of breast cancer should appreciate that no one set of feelings may be in play and that they need to respect and acknowledge those that are individually their own. Any patient can have a broad range of reactions at any one time but just because you are having feelings doesn't mean that you aren't coping well. Feelings of concern that you will not be there to experience certain benchmarks of members of your family are certainly normal. What is not wanted is to have patients feel isolated about the results of their next PET scan or their next treatment or another surgery. It's important that you not feel isolated so that you can reach out and get the support that you need in order to deal with these types of situations. Patients with depression and anxiety would most definitely benefit with another level of intervention from a mental health provider.
Dr. Coons has also had extensive work in helping those to which she includes in her "Moms with Mets" category. As the data proves, patients want to know how to have conversations with their children of all ages and how to plan to talk to them. In addition, patients also need to plan for and have conversations with their partners if they choose. However, there are those who don't have the language or the courage to talk about issues with their families. These patients would definitely benefit from coaching from someone who can give them a voice in order to share not only the information about their treatment but also about how they are feeling and what they need on a personal basis by way of understanding how a breast cancer diagnosis is changing them.
Help is often needed in having conversations in a whole host of other arenas as well. Discussing sexual health and needs and connecting or reconnecting with a partner after surgery are some of the hardest topics for many women. Hopefully if you are someone who needs this help but can't handle it yourself, you might want to consider having your partner seek help either alone or with you in seeing a professional but if this is not an option, at least you can get help and direction for such situations by yourself. If a partner is afraid of hurting you or does not understand about your fatigue and other changes that you are experiencing following surgery and treatment, you may find that they will respond by withdrawal of the physical, sexual and/or emotional intimacy that you may need the most. Therefore, finding new ways for intimacy may be needed on many levels and help in doing so is available if you are willing to seek it.
You may also need help with major issues such as body image whether this was an issue before surgery or not. Issues about the uncertainty of life and having conversations about this subject most likely are some areas in which a person needs help and support. Concerns about other people's responses are also an area for discussion. When to have conversations and with whom to have those conversations are also topics for consideration. The list is endless.
For anyone dealing with breast cancer, these are hard and difficult issues no matter how you present yourself and despite any and all efforts you make to hide away your true feelings and emotions. But, the reality is that not only is the patient affected psychologically but also those who are connected to the patient are affected in ways that we don't normally even consider. Most important to remember is that there is help available and hopefully you will consider adding a mental health provider with expertise in psychosocial oncology to your team so you have the help that you need in dealing with the non-physical issues that are also a part of any and all breast cancer patients' lives. The bottom line is that you and the issues with which you are dealing are not unique and the professionals have the help available to share with you to make this aspect of your life a bit easier in so many different ways. Just do yourself a favor and ask for the help. You will be glad that you did.