Managing Your Mental Health During Your Cancer Journey
- Actress Miranda McKeon, 24, is an advocate for young cancer survivors, sharing how therapy helped her process her stage 3 breast cancer diagnosis at 19 and rebuild her sense of self.
- Medical oncologist Dr. Elizabeth Comen says stage 3 breast cancer patients usually end up needing chemotherapy and hormone therapy if the tumor is hormone receptor positive.
- She says finding the right therapist took time, but prioritizing emotional recovery—rather than “boxing up” the experience—became just as essential as her physical treatment.
- Psychiatrist Dr. Lori Plutchik emphasizes that emotional responses to a breast cancer diagnosis are fluid and encourages patients to seek support through therapy, journaling, loved ones, and community groups to cope in healthy, constructive ways.
- McKeon was diagnosed with stage 3 hormone-positive breast cancer at just 19 years old. This type of cancer needs the hormones estrogen and/or progesterone to grow and thrive. To combat this, hormone therapy helps lower a patient’s estrogen levels, slowing the growth of the cancer or preventing it from returning.
- A side effect of hormone therapy is that it blocks or suppresses essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment. McKeon froze her eggs in case she wants to pursue motherhood in the future.
McKeon was diagnosed at just 19 years old with stage 3 breast cancer. Stage 3 breast cancer often involves a larger tumor that may have reached nearby skin or muscle, and it can include lymph node involvement. Most patients require chemotherapy as part of treatment.
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“I didn’t want it to be a case where I had that experience and was tucking it away in a box and putting it on a shelf,” she shared in an Instagram Story.
“I didn’t want it to come back up later in ways I wasn’t in control of.”
In addition to therapy, McKeon says that she is prioritizing her well-being.
Helping Patients Cope Emotionally 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.
Miranda’s Cancer Journey Started at a Young Age
McKeon was still a teenager when she was diagnosed with stage 3 breast cancer.
Stage three breast cancer typically refers to a relatively large tumor that may have invaded nearby skin or muscle tissue. It may also mean that lymph nodes near your breast and/or under your armpit are involved. In most cases, stage three breast cancers will need chemotherapy. If the cancer is also hormone receptor-positive, aggressive hormonal therapy may be offered as well.
WATCH: Understanding Stage 3 Breast Cancer
She said a small lump “the size of a jellybean” in her breast initially caught her attention.
“I stepped away into the bathroom. I peed, fixed my hair, and performed the classic boob scoop, a typical mid-party practice,” she wrote in an Instagram post. “I brushed across a lump that was definitely not there before. It was the size of a jellybean but powerful enough to sink my stomach and set off emergency sirens in my head.”
After going to see her doctor about it, she underwent a mammogram, which screens for breast cancer. She also underwent a biopsy and an ultrasound. The tests confirmed her diagnosis of stage 3 hormone-positive breast cancer in June 2021. Interestingly, the young actress said she did not have a family history of the disease.
“I spent most of that time confused and scared, but mostly in shock,” she told Coping magazine. Most of us go through life believing that we are untouchable. It’s a crazy feeling when the spinner lands on you.”
After chemotherapy, she underwent a double mastectomy and reconstruction, followed by 25 rounds of radiation.
“I never would have anticipated that going through cancer treatment would feel like working five full-time jobs at once!” she said.
WATCH: When to consider a mastectomy?
A mastectomy is the removal of the entire breast during surgery. There are several factors to weigh when considering a mastectomy, such as whether breast-conserving surgery (or lumpectomy) is possible. Your doctor will evaluate the size and features of your tumor and your family history to make a recommendation.
In some cases, a double mastectomy is a viable treatment option. During this procedure, both breasts are removed to get rid of cancer. A double mastectomy may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
Miranda’s Treatment Spawned Early Menopause
McKeon’s breast cancer is hormone-receptive, meaning it needs the hormones estrogen and/or progesterone to grow and thrive. To combat this, doctors may want to lower a patient’s estrogen levels to help slow the growth of the cancer or prevent it from returning.
The treatment McKeon is taking, Lupron (generic name leuprolide), is a hormone therapy shot that aims to reduce her estrogen levels so her cancer does not grow.
“This shot is what keeps me in medically induced menopause. What it does is quiet the ovaries…Lupron keeps them quiet like a little baby and lets the chemotherapy pass over without doing a ton of damage,” McKeon explained.
WATCH: Understanding hormone therapy for breast cancer.
Lupron (generic name leuprorelin) is a type of hormone therapy for breast cancer. It acts as an ovarian suppression drug that stops the ovaries from making the hormone estrogen.
Lupron is usually given by injection into a muscle once a month or every three to six months. The length of treatment varies, and your doctor can determine that information.
Some known side effects of Lupron may include tiredness or fatigue, hot flashes, spotting, and muscle or joint pain.
Hormone therapy is used for hormone receptor-positive cancers. When a tumor is “hormone receptor-positive,” it means tests reveal the cancer is positive for either the estrogen and/or progesterone receptor. Cancers of this type need estrogen and/or progesterone to grow.
Her treatment helped her reach remission, though she continues treatment to offset recurrence.
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
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.
Questions 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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