Emotional Stages of Breast Cancer
By Pam Stephan
Fact checked by Ashley Hall
Updated on April 28, 2020
People often experience a wide range of emotions with breast cancer, and these can change with different stages in the journey. What might you or a loved one expect at the time of diagnosis, during treatment, and on to survivorship? It's important to note that every person is different and experiences breast cancer in their own unique way. That said, it can be comforting to know you're not alone with some of the feelings you have; feelings that may have left you feeling isolated and alone. We will highlight some of the emotions and concerns that are common at three important times in your journey.
When You Are First Diagnosed with Breast Cancer
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Breast cancer is a life-threatening disease that requires rigorous treatment. If you have been diagnosed with breast cancer, you, your family, and friends will be experiencing waves of emotion (likely tidal waves at times).
Just as your diagnosis may differ from those of other people with breast cancer, your emotional experience may also differ. Knowing what other survivors have experienced and getting help early in the process can be helpful in navigating your way through this experience.
You may not have all of these emotions, but it's normal to have a range of emotions as you progress through treatment. Here are some emotional states that are similar to Kübler-Ross's Five Stages of Grief:
- Denial and shock
- "This can't be true."
- Anger and rage
- "This isn't fair."
- "Why wasn't I protected from this?"
- "Why me?"
- Stress and depression
- "My life is already busy, I can't stop to deal with this."
- "I feel so sad."
- "Why should I get treatment? I'll die anyway."
- Grief and fear
- "I'm going to die, but I don't want to."
- "I'm going to lose part of my body."
- "I will never feel safe again."
- Acceptance and adjustment
- "Okay, it's true. I've got breast cancer, but I don't have to like it or let it define who I am."
- Fight and hope
- "I'm going to fight for my life! I'm getting all the help and support that's out there for me."
A Few Tips for Coping
Coping with a new diagnosis is challenging, and you may not know where to begin. One of the best first steps is to ask for help. And when you ask, be willing to receive help. Being diagnosed with breast cancer is not a time to be a hero. Many survivors look back and comment that one of the benefits of being diagnosed is that they learned to accept help, and accepting help can sometimes deepen relationships in a way that's responding. Being willing to experience the take part of give and take.
During Your Treatment for Breast Cancer
After diagnosis, you'll talk with your healthcare team about your options for breast cancer treatment. Patients are more involved in treatment decisions now than they were 50 years ago. But having more control doesn't mean that you won't experience the powerful emotions that come along with going through this process.
Whether your treatment course includes surgery, radiation, chemotherapy, hormone therapy, or a combination, you may have lots of unanswered questions. Educating yourself about these treatments and associated side effects can help reduce your concerns, including:
- Concern about disfigurement
- "After surgery, will I still be attractive?"
- "What will happen to my sex life?"
- Fear of the unknown
- "What will this be like?"
- "Can I survive the treatment?"
- Worry about side effects
- "It sounds really bad. Is there some alternative?"
- "How will I cope?"
- "Will my treatments be really effective?"
- Suspense about test results
- "When will the bad news come to an end?"
- Family and work concerns
- "How is this affecting my family?"
- "Will I lose my job?"
Tips for Coping
Speak to your doctors as well as other patients who have gone through this experience to get the answers and the support you need. It can also help to find a local support group.
At this point in your journey you may have thoughts of doing bad things to the next person who says to you, "all you need to survive cancer is a positive attitude."
Yes, staying positive with cancer can make you feel better, but it's very important to express your negative emotions, too. While there aren't any studies that tell us having a positive attitude is effective, suppressing negative thoughts can lead to depression; and the consequences of depression. Find a nonjudgmental friend you can share these less-than-positive thoughts with and vent.
Continue to Ask for Help
As treatment continues, it's common to find yourself feeling very alone. It's common for family and friends to gather round early on after a diagnosis, but as time goes on, many of those people will seemingly go back to their own lives. Not you. It may feel uncomfortable for you to reach out again, but in the long run you'll be glad you did. Breast cancer treatment is a marathon, not a sprint.
Explore Mind-Body Therapies
There are many mind-body therapies that have been found to help people with cancer cope during treatment and on into recovery. Distress is common in people with cancer, reported to affect roughly 45% of people in treatment. Therapies that have been found to be effective in reducing distress include meditation, yoga, relaxation, and imagery. In fact, it's thought that it would be cost effective to cover these services for people coping with cancer.
After Your Treatment for Breast Cancer
When your primary treatment ends, you shake hands with your oncologist and wave goodbye to your nurses. What happens next? You may still be taking hormone therapy and going for follow-up visits, but how are you feeling now?
Good communication with your healthcare team can help you move forward with the collection of emotions that accompany survivorship, including:
- Fear of recurrence
- "Will my cancer return?"
- "Will it spread?"
- "Is that pain I'm feeling just a pulled muscle or could it be my cancer has returned—is it my old enemy, breast cancer?"
- Feeling vulnerable
- "I'm done with treatment. How do I guard my health?"
- Fear of continued pain
- "My chest is sore."
- "I'm exhausted."
- "Will I ever feel normal again?"
- Fear of death
- "My family needs me. I'm not prepared for this."
Tips for Coping
When you finish active treatment (or when you are stable but still receiving treatment), you may feel discouraged by your "new normal." A very large percentage of people who have received cancer treatment suffer from late effects. This can include the long term side effects of chemotherapy, the long term side effects of radiation, radiation fibrosis, pain from reconstruction, and more.
Fortunately, many of these symptoms can be reduced, and sometimes even eliminated via a good cancer rehabilitation plan.
Since cancer rehabilitation is a new concept (with cancer that is, it's been standard after conditions such as a heart attack or hip replacement for many years), you may need to ask for a consult yourself.
A Note About Depression
A National Academy of Sciences study found that depression is common in breast cancer patients, and it usually develops in the first three months after diagnosis. A 2015 study quantified this, and found that the rates of severe depression was 36%.
Let your healthcare team know that you're experiencing stress or sadness, so they can suggest counseling and perhaps medication. Depression is more common in people who have previously experienced depression, but is common in people with no history of depression as well.
The alternative therapies mentioned above can be helpful. With support from other survivors, family, friends, and your doctor, you can get through your breast cancer journey more easily.