Starting Over After Breast Cancer—It May Not Be What You Expected

Congratulations! You've made it through tests and treatments that sometimes seem as brutal as the disease itself. Finally, it's here: the light at the end of the tunnel. Except maybe it's not as bright as you expected.

"Patients say they feel like they've been dropped into a void," says Julia Rowland, PhD, director of the National Cancer Institute's Office of Cancer Survivorship. "People don't realize that transitions are stressful." Even some doctors' recognition of the difficulty of cancer recovery is still evolving. "Some people get this blip up of distress, and it takes them by surprise," says Rowland. "'Why am I anxious and nervous?' they ask. 'I should feel good about this.' "

But it's hard to feel good when you're...

...exhausted: Many patients enter recovery still reeling from the aftereffects of some treatments. They may suffer fatigue, pain, "chemo brain" (the memory and concentration problems reported by some patients), or have trouble adjusting to a new body image. For the physical side of things, Rowland looks to the date of your first symptom—whether that was when you first felt a lump or were told you had an abnormal mammogram—to roughly estimate your recovery time. If it took nine months from that first sign through the completion of treatment, your recovery may take at least that long.

...pressured: Family and friends, no matter how well-meaning, often expect you to go back to being the person you were before. "But cancer is life-altering. You won't be the same," says Rowland. It's not "a total negative," she notes. The problem is "we don't prepare survivors for it." Adds Hendy Dayton, 48, of San Francisco: "When you're going through it all, people write notes telling you how strong you are, how brave. But I would think: I have no choice; this is what I have to do. It's only when it's over that you look back and think, 'Oh my God, what just happened to me?' "

...worried: Who wouldn't be concerned—even anxious—about the cancer returning?

...rootless: When you were going through treatment, your schedule was set: Whether it was showing up for radiation treatments or quelling nausea after chemo, you had a routine, a purpose. It was a lousy plot line but you were the star of the show, with a team of medical professionals taking care of you, and, if you were lucky, the focus of love and support. Now you might feel alone.

One tool that might help you take charge of your new experience is the National Cancer Institute's online booklet Facing Forward: Life After Cancer Treatment.