Bracing up after the battle

Hiba Siddiqui

Being diagnosed with breast cancer can be a devastating event in a woman’s life. Many times the distress stays even after the initial shock of the diagnosis has passed. When the treatment begins, which is often long term; many women begin to notice a significant impact on their personal relationships, their profession as well as their social engagements. 

Impact on mental well-being

Breast cancer impacts a woman in many ways. It may induce feelings of helplessness, loss of hope and a shift in perspective about one’s own self and image. Surgical procedures such as breast removal, reconstruction surgery or lumpectomy, have often been reported to induce sadness and fears around body disfiguration, insecurities, embarrassment and guilt. 

Many individuals on chemotherapy also experience hormonal changes as a result of heavy medication that can induce mood swings, low-frustration tolerance and outbursts, along with memory and concentration issues. It can be uncomfortable for patients as well as their caretakers, family and friends. Chemotherapy in itself causes loss of hair and skin pigmentation, which may also induce body-image issues. Stress and fatigue may also cause diminished sexual desire, intimacy and desirability. It only adds to already existing mental trauma of the patient. 

Transitioning from a tedious treatment to recovery can be problematic for many. Affected people need to figure what’s the new normal for them. They need look at life in a different perspective. There will be changes in daily living, one’s own sense of security, the way one eats or even their support systems. 

Importance of seeking psychological help 

Psycho-oncology focuses on psycho-social aspects of patients and caregivers, along with compliance building, supportive and grief counselling, dealing with loss, coping strategies, resilience building, pre and post-operative counselling and lifestyle changes. A psycho-oncologist can play an important role in dealing with the psychological responses to cancer, such as the initial trauma, denial, anxiety, depression, fear, anger, etc. This is necessary for building support and developing coping skills as well as lifestyle management for both the patient and the caregiver. 

Treatment and coping interventions

Treatment can help empower patients to make informed choices in conflicting situations and communicate better with their health-care providers. 

One-on-one counselling sessions focus on strength building and preparing a patient to control negative emotions and develop positive thoughts. Family counselling and psychological intervention requires caregivers to share their experiences and develop a better functional way of dealing with a patient’s needs. For instance, a psycho-oncologist must ensure that the sessions allow the patients to gain a sense of independence, maintain work-life balance and adapt to the changes in the family relations.

Support groups are also effective for both patients as well as their family members, as these create shared spaces for common experiences, a sense of connectedness and empathy. Support workshops focus on themes such as dependency, sense of self, body image, confidence, loss and self-esteem along with building healthy communication and coping patterns within the family. Such experiences are cathartic and open spaces for self-expression and exploration.

Educating oneself, families and friends is of utmost importance. The medical causes underlying their condition needs to be explained by the treating oncologists. Sometimes patients tend to get irritable and angry and they need to realise that ‘It’s OK’ to experience these feelings. These emotional reactions also need to be recognised by the caregivers. 

The after-care

Last but not the least, go for regular medical checkups, because prevention is definitely better than cure. Make an effort to be aware of your symptoms (physical, mental and psychological), do educate yourself about the illness and also encourage your family members to seek regular checkups. 

Lifestyle changes

Recreation: Keep yourself engaged. It will help your mind stay occupied and keep negative thoughts at bay. 

Have Me Time: Give adequate attention to your own self and your needs because the most important person here is ‘YOU’!

Social support: Do not hesitate to reach out for help and support from friends and family.

Stay active: Exercise and relaxation can help you stay healthy. The risk for recurrence of cancer is lowered and can lead to longer survival. Walking, swimming, yoga, etc. can improve your mood and reduce fatigue and lethargy.

Quit smoking: Smoking may cause an increase in build-up of cancer cells and also lead to a recurrence on the same or a different site.

Avoid alcohol: Alcohol consumption increases vulnerability to certain cancers.

Eat well: Talk to your nutritionist and doctor to eat the right kind of foods. Healthy eating reduces your chances of cancer or recurrence.

—The writer is senior psycho-oncologist, Max Institute of Cancer Care, New Delhi