According to the National Cancer Institute, more than 230,000 women in the United States learn that they have breast cancer each year.1 Because many of them have no family history of breast cancer or other known risk factors, the diagnosis often comes as a devastating surprise. The emotional turmoil that results can affect women’s physical health as well as their psychological well-being.
This question and answer fact sheet explains how psychological treatment can help these women harness the healing powers of their own minds.
What impact does a breast cancer diagnosis have on psychological well-being?
Receiving a diagnosis of breast cancer can be one of the most distressing events women ever experience. And women may not know where to turn for help.
Distress typically continues even after the initial shock of diagnosis has passed. As women begin what is often a lengthy treatment process, they may find themselves faced with new problems. They may find their personal relationships in turmoil, for instance. They may feel tired all the time. They may be very worried about their symptoms, treatment, and mortality. They may face discrimination from employers or insurance companies.
Factors like these can contribute to chronic stress, anxiety, and depression.
Why is it important to seek psychological help?
Feeling overwhelmed is a perfectly normal response to a breast cancer diagnosis.
But negative emotions can cause women to stop doing things that are good for them and start doing things that are bad for anyone but especially worrisome for those with a serious disease.
Women with breast cancer may start eating poorly, for instance, eating fewer meals and choosing foods of lower nutritional value. They may cut back on their exercise. They may have trouble getting a good night’s sleep. And they may withdraw from family and friends. At the same time, these women may use alcohol, cigarettes, caffeine, or other drugs in an attempt to soothe themselves.
A breast cancer diagnosis can also lead to more severe problems. For some women, for example, the news leads to depression, which can make it more difficult for them to adjust, make the most of treatment, and take advantage of whatever sources of social support are available. Some women become so disheartened by the ordeal of having cancer that they refuse to undergo surgery or simply stop going to radiation or chemotherapy appointments.
Depression can also decrease women’s survival, research shows. According to one analysis, mortality rates were as much as 26 times higher in patients with depressive symptoms and 39 times higher in patients who had been diagnosed with major depression.2
How can psychological treatment help women adjust?
Licensed psychologists and other mental health professionals with experience in breast cancer treatment can help a great deal. Their primary goal is to help women learn how to cope with the physical, emotional, and lifestyle changes associated with cancer as well as with medical treatments that can be painful and traumatic.
For some women, the focus may be on how to explain their illness to their children or how to deal with a partner’s response. For others, it may be on how to choose the right hospital or medical treatment. For still others, it may be on how to control stress, anxiety, or depression.
By teaching patients problem-solving strategies in a supportive environment, psychologists help women work through their grief, fear, and other emotions. For many women, this life-threatening crisis eventually proves to be an opportunity for life-enhancing personal growth.
Breast cancer patients themselves aren’t the only ones who can benefit from psychological treatment. Partners can also be suffering. In one study, for example, men whose partners were diagnosed with breast cancer were nearly 40% more likely than other men to be hospitalized for severe depression and other mood disorders.3
Psychologists can help spouses manage the challenge of offering both emotional and practical support while dealing with their own feelings. Children, parents, and friends involved in caretaking can also benefit from psychological interventions.
The need for psychological treatment may not end when medical treatment does. In fact, emotional recovery may take longer than physical recovery and is sometimes less predictable. Although societal pressure to get everything back to normal is intense, breast cancer survivors need time to create a new self-image that incorporates both the experience and their changed bodies. Psychologists can help women achieve that goal and learn to cope with such issues as fears about recurrence and impatience with life’s more mundane problems.
Can psychological treatment help the body, too?
Absolutely. Take the nausea and vomiting that often accompany chemotherapy, for example. For some women, these side effects can be severe enough to make them reject further treatment efforts. Psychologists can teach women relaxation exercises, meditation, self-hypnosis, imagery, or other skills that can effectively relieve nausea without the side effects of pharmaceutical approaches.
Psychologists can also empower women to make more informed choices in the face of often-conflicting advice and can help them communicate more effectively with their health care providers. In short, psychologists can help women become more fully engaged in their own treatment. The result is an enhanced understanding of the disease and its treatment and a greater willingness to do what needs to be done to get well again.
Psychological treatment may even boost women’s chances of survival. In one study, for instance, a decrease in depression symptoms was associated with longer survival in patients with metastatic breast cancer.4
Such findings underscore the importance of psychological interventions. In one study, researchers examined the impact of psychologist-led small group sessions that offered strategies for reducing stress, improving mood, changing health-related behaviors, and adhering to treatment and care.5 The breast cancer patients who participated in the groups had a 45% lower risk of their cancer coming back and a 56% lower risk of dying from breast cancer. The results were even more impressive when the researchers excluded patients who attended fewer than 20% of the sessions: The remaining participants’ risk of dying from breast cancer was 68% lower.
What type of psychological treatment is helpful?
A combination of individual and group treatment sometimes works best. Individual sessions with a licensed psychologist typically emphasize the understanding and modification of patterns of thinking and behavior.
Group psychological treatment with others who have breast cancer gives women a chance to give and receive emotional support and learn from the experiences of others. To be most effective, groups should be made up of women at similar stages of the disease and led by psychologists or other mental health professionals with experience in breast cancer treatment.
Whether aimed at individuals or groups, psychological interventions strive to help women adjust to their diagnoses, cope with treatment, and come to terms with the disease’s impact on their lives. These interventions offer psychologists an opportunity to help women better understand breast cancer and its treatment. Psychologists typically ask women open-ended questions about their assumptions, ideas for living life more fully, and other matters. Although negative thoughts and feelings are addressed, most psychological interventions focus on problem-solving as women meet each new challenge.
A breast cancer diagnosis can severely impair a woman’s psychological functioning, which in turn can jeopardize her physical health. But it doesn’t have to be that way. Women who seek help from licensed psychologists with experience in breast cancer treatment can actually use the mind-body connection to their advantage to enhance both mental and physical health.
How to Support a Spouse or Partner Who Has Breast Cancer
A diagnosis of breast cancer can be overwhelming to relationships. Partners play an important role in supporting patients with breast cancer. In fact, studies have shown that survival may be better for those with good social support.1
Breast cancer, whether in a man or woman, affects people in a number of ways. Treatment can cause body image changes, hormonal therapies can cause mood changes, and chemotherapy and radiation therapy bring a number of side effects.
Treatment for breast cancer leaves most patients feeling tired and more in need of support than ever. If you take a moment to think about how you feel when you are exhausted, then add these treatments to the mix, that’s a bit of what your spouse is feeling. Before we even go into ways of supporting your spouse, it’s important to mention patience. Because they will need your patience.
At the same time as your spouse is going through all of these changes, you are likely feeling what so many partners feel: helpless. If you’re someone who is accustomed to being a “do-er” you might not know where to begin. Let’s take a look at some ways that you can best support your partner as they navigate their breast cancer diagnosis and treatment.
A cancer diagnosis can be emotionally exhausting. As your partner moves through the stages of dealing with cancer, they may feel shock, disbelief, fear, sadness, anxiety, and more. There are ways that you can provide emotional support as you both navigate these complex emotions.2
- Let the feelings happen. The first step in managing emotion is acknowledgement. Once your partner understands what they are feeling, you can work together to cope. Encourage your partner to share both positive emotions (like hope and gratitude) and negative ones (like loss of control, anger or sadness) with you so that you can help process them.
- More positive, less negative: It is natural to have both positive and negative emotions. While it is important to stay positive and upbeat when possible, it is equally important not to keep negative emotions bottled up. Leaning into positive emotions can be helpful.
- Manage emotions with a plan. As you talk through emotions (both negative and positive), help your partner move forward. For instance, if your partner feels as though their life is out of control, a good plan to regain that control might be to learn as much as possible or make a list of questions to ask during their next medical appointment. Similarly, if your partner is feeling hopeful, they might consider reflecting on their faith or spirituality, or focusing on stories of patients with positive outcomes and good quality of life.
Depending on the type of therapy your partner receives, they may need support with physical care before, during, or after treatment.3
Before treatment, you can talk with your partner’s doctor to understand all pre-operative instructions to ensure they are met. These could include:
- Losing weight
- Eating healthier and exercising more
- Stopping smoking or avoiding alcohol
During and after treatment, you may need to:
- Learn how to take care of the wound (if your partner had surgery).
- Understand what to watch for (like an infection) that might immediate care.
- Take steps to manage treatment side effects, such as nausea after chemotherapy or fatigue caused by hormone therapies.
- Help with basic physical tasks, such as bathing or grooming, as your partner recovers.
Staying as healthy as possible is important for both you and your partner, whether you’re preparing for treatment or recovering from it. Take these steps to keep your body strong during your breast cancer journey together:
- Watch what you eat. This may not be easy to do when you or your partner are stressed or fatigued, but nutritious meals are the first step toward a healthy body. Taking time to prepare meals in advance or arranging a meal train with the assistance of friends can help ensure that you and your partner are getting the nutrients you need to keep your energy and spirits up.
- Exercise. After cancer treatment, your partner may not feel like walking or exercising much. When your partner is cleared for physical activity, one of the best things you can do is take an active role in helping them in this return to exercise and physical activity.
Keep the lines of communication open with your partner. Allowing them to share their feelings and fears with you can support their emotional health and help you work together through the process. Cancer impacts all facets of life, not just health, and having someone to talk to is critical. While it’s helpful to keep a positive attitude, research has shown that it’s important to also express the negative emotions that come with cancer.
As feelings run strong, there will be times when you and your partner experience a myriad of emotions. Providing support to your partner during these times is critical. They will need an emotional anchor, and you’re it, whether you like it or not.
Remember: Sometimes not saying anything is better than saying the wrong thing. Let your partner know that their emotions matter and understand that your actions tell them that you care, even if you don’t have the words to say it.
Keeping Up the Household
Life goes on, even during cancer treatment. If your partner traditionally manages the household, you may need to develop plans to help keep your home in order while you and your partner deal with cancer treatment. Things to consider include childcare, grocery shopping and meals, house cleaning, and how you will work with your spouse’s employer (or your own) while you cope with cancer.
Unfortunately, financial stress is an important consideration. Be sure to talk with your partner about insurance needs (co-pays, deductibles and prior authorization requirements) and your current financial situation. If your partner manages your monthly bills, it’s important to communicate about household finances so you can manage them if necessary while your partner undergoes treatment.
Planning a budget—including making a plan for emergency funds should you need them—is an important step in this process. Having financial peace of mind will give your partner one less thing to worry about as they focus on their health.
Though partners will take many roles in helping a loved one navigate cancer diagnosis and treatment, being an advocate is one of the most important.
Being a strong advocate means many things, including:
- Learning about your partner’s cancer and asking questions regarding treatments and next steps
- Taking notes during medical appointments
- Staying organized with paperwork, such as bills, prescriptions, lab reports and more
- Keeping a calendar of appointments, tracking medication, and maintaining contact with the care team
- Acting in your partner’s best interest and ensuring they get the care they want and need
- Following up with doctors and other providers as needed
- Encouraging your partner to be their own advocate and take an active approach to their care
Caring for Yourself
It’s easy to feel alone as a primary caregiver to someone with cancer. As you work to support your partner, don’t forget to take time to care for yourself as well. In addition to the tips above (which will also work for you), here are other ways to care for yourself during the cancer journey:
- Remember that you’re not alone. Seek support from friends, neighbors, and relatives. Not all of them may step up to assist, but you will be surprised at what some people will do if you just ask them. Seek their help in driving to appointments, staying with your partner while you’re at work, or doing errands you ordinarily do but don’t have time for anymore.
- Be open and honest. Everyone has a different attitude toward cancer. Some people will get up and run away if you try to tell them what’s wrong with your partner. Others will cry, get angry, or ignore the whole situation. You can’t control their reactions, but you can control your reactions to them.