Facing a breast cancer diagnosis can be overwhelming. Your stress levels may skyrocket. You may worry about finances and about your body image. You may also be asking yourself difficult questions, such as whether to write a living will. With education and supportive care, you may be better able to deal with the many issues and emotions you're experiencing.

What causes stress among breast cancer patients?

You may experience stress due to the uncertainty of your future, the unpredictability of the cancer, disability, and financial difficulties. In addition, you may be worried about your physical appearance after mastectomy, hair loss from chemotherapy, and possible skin changes--including darkening and thickening of your skin--from radiation therapy. You may be worried about how this diagnosis will affect any family and work situations.

Common signs of stress can include disturbed sleep, fatigue, body aches, pain, anxiety, irritability, tension, and headaches.

How can I reduce stress?

Stress can build, influencing how you feel about life. Prolonged stress may lead to frustration, anger, hopelessness, and depression. To reduce stress:

  • Keep a positive attitude.
  • Accept that there are events you cannot control.
  • Be assertive instead of aggressive. "Assert" your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
  • Learn to relax.
  • Exercise regularly. Your body can fight stress better when you are physically fit.
  • Eat well-balanced meals.
  • Rest and sleep. Your body needs time to recover from stressful events.
  • Don't rely on alcohol or drugs to reduce stress.
  • Keep your medical appointments.

How can I learn to relax?

There are a number of exercises that you can do to relax. These include breathing, muscle and mind relaxation, relaxation to music, and biofeedback. A few that you can try are listed below. First, be sure that you have a quiet location that is free of distractions, a comfortable body position (sit or recline on a chair or sofa), and a good state of mind. Try to block out worries and distracting thoughts.

What are some effective relaxation exercises?

Two-minute relaxation

Turn your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles relax completely. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.

Mind relaxation

Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a phrase such as "I feel quiet." Continue for 10 minutes. If your mind wanders, gently remind yourself to focus on your breathing and your chosen word or phrase. Let your breathing become slow and steady.

Deep breathing relaxation

Imagine a spot just below your navel. Breathe into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.

Listen to our podcasts to help with relaxation.

What can I do if I start to feel overwhelmed?

The most important step you can take is to seek help as soon as you feel less able to cope. (See "What types of help are available?" below.) Taking action early will enable you to understand and deal with the many effects of your chronic illness. Learning to manage stress will help you maintain a positive physical, emotional, and spiritual outlook on life.

How do I keep track of my medical information?

Don't be afraid to ask your health care provider to repeat any instructions or medical terms that you don't understand. Your health care providers should always be available to answer your questions and address your concerns. Also:

  • Make use of resources and support services offered by your hospital and community.
  • Learn more about breast cancer. This can help you feel more comfortable with your treatment.
  • Ask your family and friends to help you sort through the information you receive.
  • Talk with other patients and families about breast cancer and its treatment.
  • Bring a family member or friend with you to your medical appointments. It may help with remembering what your health care provider discussed with you and also provide emotional support.

What types of help are available?

There are many sources of help available to provide support for breast cancer patients and their families. Among them are:

Social workers

Social workers are just one part of the caregiving team that can offer treatment in a compassionate setting. These professionals can help you and your loved ones discuss any concerns about your diagnosis, treatment, or your personal situation.

Social workers can also provide education, counseling regarding lifestyle changes, and referrals to community or national agencies and support groups. Your social worker can also help your family find temporary lodging in your community, provide information about community resources, and help you with any other needs.

Individual counseling

Sometimes people have problems that are better addressed in a one-on-one atmosphere. By participating in individual counseling, you might more effectively express sensitive or private feelings you have about your illness and its impact on your lifestyle and relationships. Counseling services can help you and your family discuss issues of concern and develop and enhance coping abilities.

In addition, mental health care providers are available to create a treatment plan to meet your specific needs. Strategies can be designed to help you regain a sense of control over your life and improve your quality of life, something everyone deserves. At times, if depression is present, medicines specific for treating depression may be prescribed.

Support groups

Support groups are a very useful sharing experience. They provide an environment where you can learn new ways of dealing with your illness and gain insight from others who have been through similar experiences. Group members may be able to explain things differently than your health care providers, and you may also want to share approaches you have discovered with them. You will also gain strength in knowing that you are not facing hardships alone.

Remember that others may share information or experiences that do not apply to you. Never replace your health care provider’s advice with that given to another patient.

Financial counselors

Financial counselors are available through your hospital and can help answer questions you may have about financial issues related to your medical care.

What if I become unable to make decisions about my health care?

Information about advance directives, such as living wills and durable power of attorney for health care, is also available.

The living will expresses someone’s right to refuse or accept medical treatment that artificially prolongs his or her life. This document is prepared while the person is fully competent, in case he or she becomes unable to make this decision at a later time. The living will provides clear instructions regarding the person’s choice of extended medical care.

The durable power of attorney for health care allows you to appoint another person to speak for you if you become incapable of expressing your medical treatment preference. An attorney should prepare this document so that it conforms to your state laws and court precedents.

Should I write a will?

No one likes to think about his or her own mortality, but a will is necessary to ensure that those who survive you will know how to carry out your wishes. This document should be prepared with your attorney.

What should family members and friends keep in mind?

The diagnosis and treatment of breast cancer is stressful and may be a difficult time for your family and friends. Here are some tips your family and friends can use:

  • Feel free to ask the health care provider questions if you accompany your loved one to her appointments.
  • Be prepared for changes in your loved one's behavior and mood. Medications, discomforts, and stress can cause your loved one to become depressed or angry.
  • Encourage your loved one to be active and independent, as much as possible, to help her regain a sense of self-reliance and confidence.
  • Be realistic about your own needs. Be sure you are sleeping enough, eating properly, and taking some time off for yourself. It is hard to offer much help when you are exhausted. If you take care of your needs, it may be easier to meet the needs of your loved one.
  • Don't hesitate to ask other family members and friends for help. They may appreciate the opportunity.


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