Breast Cancer Survivorship and the Impact on Mental Health

By Leona Vaughn, Everyday Health
Three years ago, Hil Moss says she was lounging around, casually watching television and relaxing when she touched her chest and felt a lump. She was 28, and with no family history, she says her doctor reassured her that she had nothing to worry about. But after a few more appointments, they confirmed a diagnosis of breast cancer, likely caused by an ATM gene mutation they found.
After three years and a 14-month treatment plan — which included three months of chemotherapy, a double mastectomy, and a tissue-based reconstruction, later followed by hormone therapy — Moss, a student in the Yale School of Public Health in New Haven, Connecticut, and an advocate for cancer care, now considers herself a breast cancer survivor.
The American Society of Clinical Oncology (ASCO) defines survivorship as, “living with, through, and beyond cancer.” But some patients who get to the “beyond cancer” stage say they were unprepared for the toll this experience would take on their mental health.
When she was first diagnosed, Moss says she anticipated that the most difficult part of her experience would be receiving the treatment, but a fellow survivor warned her that it would actually be the months following her completion of it that would be the hardest. Sure enough, Moss says she found the first six months of her recovery period more mentally challenging than anything she had physically gone through, including the amputation of both her breasts.
“That just seems impossible to believe,” Moss says. “You’re in chemo, you feel horrible, how could it possibly be worse? But it kind of is. When you’re actively in treatment, you at least have this sense of what your day-to-day is, and sometimes that can feel like a safety blanket.”
“When you are removed from that, you are forced to essentially reckon with what’s happened. You have to come to terms with your own mortality,” Moss says.
Breast Cancer Survival Rates Are Increasing
Marleen Meyers, MD, a medical oncologist and the founding director of the Survivorship Program at Perlmutter Cancer Center at NYU Langone Health in New York City, says that breast cancer is a “hopeful cancer,” because more and more patients diagnosed with breast cancer are surviving, but that living through this experience “comes with a price.”
“I’ve been an oncologist for a long time, and early on, we were just happy that people survived,” Dr. Meyers says. “We didn’t really look at what their quality of life after survivorship was. I always like to say that the cancer treatment may be over, but the cancer experience is far from over.”
Experts say that the vast majority of patients struggle with mental health after receiving cancer treatment.
“There’s anxiety about what the next steps are, how they’re going to feel, how long it’s going to take for them to get better,” Meyers says. “The reality is, while you can give somebody an estimate, it’s impossible to predict.”
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