Coping With an Unexpected Diagnosis
- After surviving a car crash, Gloria Jeffery underwent a CT scan that unexpectedly revealed a hidden mass in her breast—despite a recent clear mammogram.
- A biopsy confirmed stage 3 breast cancer, prompting an intensive treatment plan including surgery, chemotherapy, radiation, and immunotherapy. Jeffery credits her faith for guiding her through the ordeal, saying, “I know it was God… I’m just so glad to be here.”
- Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to notable side effects, including fatigue, hair loss, and nausea.
- “Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”
- Radiation helps kill cancer cells in a targeted way, according to experts such as Dr. Chirag Shah, radiation oncologist and the division chair of Radiation Oncology at AHN Cancer Institute. With breast cancer, it is often used after surgery to kill off any cancer cells that may remain in the breast or surrounding area. Possible side effects may include swelling, fatigue, and scar tissue.
“I know I lost a car, but it saved my life,” Jeffery told WAGA News.
Read MoreUnderstanding Stage 3 Breast Cancer
Stage 3 breast cancer typically involves a larger tumor that may have spread to nearby skin, muscle, or lymph nodes. Treatment often includes chemotherapy, hormone therapy (if hormone receptor-positive), and surgery. As medical oncologist Dr. Elizabeth Comen explained to SurvivorNet, “Stage III breast cancer refers to a relatively larger-sized tumor that may have invaded nearby tissue, including, potentially, skin or muscle.”WATCH: Stage 3 Breast Cancer Explained
Jeffery’s treatment plan included surgery, chemotherapy, radiation, and immunotherapy—a comprehensive approach designed to attack the cancer from multiple angles.
- Surgery may involve a lumpectomy, mastectomy, or double mastectomy depending on the tumor’s size and spread.
- Chemotherapy travels through the bloodstream to target fast-dividing cancer cells, though it can also affect healthy cells.
- Radiation therapy uses energy beams to destroy lingering cancer cells post-surgery. “It damages cancer cell DNA and prevents recurrence,” said radiation oncologist Dr. Subhakar Mutyala.
WATCH: The Debates Around Radiation for Breast Cancer
Immunotherapy reprograms the immune system to recognize and fight cancer cells. “Each breast cancer is very different,” Dr. Comen noted. “They may be almost cloaked in an invisible shield… more research is ongoing to improve immunotherapy’s effectiveness.”
WATCH: Immunotherapy to Treat Breast Cancer?
Today, Jeffery says she is cancer-free—and credits her faith and the accident for revealing what might have otherwise gone undetected.
Help Coping With a Breast Cancer Diagnosis
If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.
“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.
WATCH: How to cope with complex and changing emotions.
If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.
SurvivorNet experts suggest that women need a little extra help coping with a breast cancer diagnosis.
- Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
- Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
- Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
- Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.
Breast Cancer Symptoms & Self-Exams
Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.
For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.
Below are common symptoms to look out for:
- New lump in the breast or underarm (armpit)
- Any change in the size or shape of the breast
- Swelling of all or part of the breast
- Skin dimpling or peeling
- Breast or nipple pain
- Nipple turning inward
- Redness or scaliness of the breast or nipple skin
- Nipple discharge (not associated with breastfeeding)
Expert Resources For Breast Cancer Treatment
Radiation Therapy: A Powerful Tool with Long-Term Considerations
Radiation therapy—using high-energy rays to destroy cancer cells—is a common follow-up to breast cancer surgery, especially for patients who choose a lumpectomy over a mastectomy. Its goal: reduce the risk of recurrence by targeting any lingering cancer cells in the breast or surrounding tissue.
While effective, radiation can come with side effects, both immediate and delayed. Common symptoms include:
- Fatigue
- Swelling
- Scar tissue
- Shortness of breath
One of the more serious concerns involves the heart, which can unintentionally absorb radiation due to its proximity to the breast.
“When the radiation is delivered, unfortunately, the heart happens to be somewhere very near to where they have their breast cancer, and it becomes an innocent bystander absorbing some of the radiation,” explained Dr. Jean-Bernard Durand to SurvivorNet.
This exposure can lead to complications such as fatigue, shortness of breath, and even heart failure—sometimes surfacing decades after treatment.
“We make it a point to see them on a regular basis so that we can catch these things very early and treat them,” Dr. Durand added.
Even advanced techniques like proton therapy, which aim to minimize damage to healthy tissue, aren’t immune to side effects. Fatigue remains a common complaint, and the risk of long-term injury still exists.
“Radiation is a form of energy… and when we give radiation, it has the ability to scatter,” Dr. Durand said. “Even though we may target one particular area, that scattering of energy can cause injury to the local surrounding structures, including the heart.”
Over time, this injury can lead to the development of scar tissue within the heart muscle, its electrical system, and blood supply.
“We believe it is what causes all the injury, that ultimately leads to the symptoms,” he explained.
For survivors, this underscores the importance of ongoing monitoring and open conversations with care teams.
Radiation treatment continues to evolve, with ongoing debates among experts about how to reduce side effects while optimizing outcomes. Dr. Shah outlined three key areas of discussion:
- Whole vs. Partial Breast Radiation: Shortening treatment duration and minimizing side effects are promising, though long-term data are still emerging.
- Identifying Patients Who May Not Need Radiation: Some individuals may not benefit from radiation, and omitting it could reduce unnecessary risks.
- Technique Optimization: Advancements in delivery methods aim to improve effectiveness while limiting harm to healthy tissue.
“I think the first debate that we have is whole breast radiation versus partial breast radiation and the idea of reducing duration of treatment and reducing side effects for patients, albeit with less than 10 years’ worth of long-term data,” Dr. Shah explained to SurvivorNet.
When to Screen for Breast Cancer
The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: When you’re getting a mammogram, ask about dense breasts.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.
Managing Chemotherapy and Its Side Effects
Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.
Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle.
“Neuropathy is probably one of the most challenging side effects,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”
Hair loss is another side effect of chemotherapy.
WATCH: Coping with hair loss.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.
It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.
Most patients can expect regrowth four to six weeks after treatment. However, it is possible that when your hair grows back, you may notice some changes in its color and texture.
RELATED: How are chemotherapy side effects managed for ovarian cancer treatment?
Tips for Navigating Chemo Side Effects
When dealing with fatigue, doctors don’t have an arsenal of weapons to combat fatigue in terms of prescription medications. However, you can do several things to help minimize the hit and restore your energy.
- Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer, who have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
- Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
- Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.
Treating Neuropathy Symptoms
Doctors have several strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to make sure it doesn’t get worse. Before each chemotherapy infusion, the attending oncologist will assess whether the symptoms have progressed. If the symptoms worsen, they may adjust the dose or delay treatment. They may also try switching to another chemotherapy drug.
How to Get a Handle on Nausea
Most of these anti-nausea medications last for more than eight hours. One of the infusions commonly used reduces the degree of nausea for up to three days.
Complementary approaches may also be helpful. A few favorites:
- Ginger: Studies consistently show that ginger helps alleviate chemotherapy-induced nausea. The powerful herb appears to have an anti-spasmodic effect on the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
- Pressure bracelets: at your local pharmacy, these bracelets provide consistent pressure on a particular acupressure point on the wrist to reduce nausea.
- Deep breathing: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.
WATCH: Managing chemo side effects.
Coping with Hair Loss
If losing your hair is a concern for you before cancer treatment, know you have options like wigs, hats, wraps, and scarves, among other things.
Another option that can minimize hair loss is cryotherapy, “just a fancy way for saying cold therapy,” says Dr. Renata Urban, gynecologic oncologist at the University of Washington in Seattle.
Cryotherapy involves wearing cold caps or special cooling caps before, during, and after each chemotherapy treatment.
Help Coping With a Breast Cancer Diagnosis
If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.
“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.
WATCH: How to cope with complex and changing emotions.
If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.
SurvivorNet experts suggest that women who need a little extra help coping with a breast cancer diagnosis.
- Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
- Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
- Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
- Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.
What To Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
- I’ve been having trouble sleeping. Do you have any treatment recommendations?
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