How Treatment May Impact Your Emotions
You may feel a range of emotions during treatment. These feelings may come from worries and stresses about breast cancer but may also be related to treatment itself.
Breast cancer treatment often involves more than one therapy: surgery, radiation, chemotherapy and hormonal and targeted therapies may be considered. Many side effects of treatment are short-term and can be prevented or lessened. Still, both short- and long-term side effects can impact your emotional health.
Always consider sharing your emotional concerns with one or more members of your care team, especially if you feel more upset than usual or have trouble with daily activities. Some treatments can cause fatigue and insomnia, which can make you irritable or angry.
Some women with early-stage breast cancer develop anxiety and depression during treatment. Several factors increase the risk, including a history of depression. Let your healthcare team know about your mental health history so they can get you support.
Here are the major types of breast cancer treatment and some of the impacts they can have on your emotional health.
It’s normal to have a range of emotions during treatment. You may feel sad or anxious, or quiet and resolved. As treatment progresses, you may find that you want to loudly celebrate or privately note as you move away from one phase of your experience. Worries about the future, side effects from new treatments, or what finishing treatment means may be on your mind. Getting the information you need, when you need it, will help you feel stronger and more confident.
It’s also true that many breast cancer treatments cause side effects that can feel like stress, anxiety, or depression. Some treatments can directly affect your emotions, while others may impact sleep or your desire for food or sex. These changes can influence your mood.
As you move through treatment, new feelings may come and go, then lessen and, at some point, go away. This may not always be the case, so recognize when your reactions are normal for you and when they feel more intense than you might expect. You know yourself better than anyone. Feelings of sadness and worry are normal and do not mean you are coping badly. But if you have intense feelings of depression or anxiety, seek help from a provider as soon as possible.
Almost everyone diagnosed with breast cancer has some surgery. Based on the type of cancer and its traits, your doctor may recommend lumpectomy, removing the tumor with a small rim of normal tissue, or mastectomy, removing one or both breasts. You may also choose to have your breast rebuilt in a reconstructive surgery.
Surgery can result in discomfort and fatigue. Anesthesia can cause nausea or may make you feel foggy. Your body needs time to heal. Rest, good nutrition and gentle activity will help you heal more quickly.
Knowing the cancer was removed can be reassuring, but it can be jarring to see the impact on your body, scars, and changes in the shape or size of your breast. If you had a mastectomy, your feelings about losing a breast can be powerful. You may feel less attractive or like your sexuality has been diminished. However you see things, talking to your provider about any physical or emotional pain is important.
It will take time to adjust to the changes in your body and how you feel about them. Be gentle and kind to yourself.
Radiation therapy, sometimes given after surgery, uses high-energy x-rays to kill any cancer cells left in areas of your body at high risk for cancer return in your breast or chest wall, with or without the nearby lymph nodes. Radiation therapy can be grueling, especially if it is given every day for many weeks. There are many treatment schedules and some different ways of giving radiation therapy, so discuss your options with your doctor.
Fatigue is common with radiation therapy and may affect your mood. It tends to build up in your body over time as treatments go on. This fatigue is due to treatment itself, but it also may be related the stress of having to get therapy every day for several weeks. Stress can also cause fatigue.
Treatment-related fatigue feels very different from regular tiredness. It can come on quickly and not be related to recent activity. Even after a good night’s sleep, you may drag.
Radiation treatment may cause changes in the shape, texture, and size of your breast, or in the skin. Your radiation oncologist and oncology nurses can offer treatments to help soothe skin irritation and prevent certain complications. Treating these side effects early may help you feel better physically and, in turn, emotionally.
Chemotherapy is given to kill cancer cells that are growing or dividing quickly. Both chemotherapy itself and some medicines taken with it can affect your emotions. Some people feel moody or sad. Steroids, often given with chemotherapies to prevent allergic reactions, can make you feel jumpy, overly energetic, annoyed, angry, or anxious and unable to sleep.
Other side effects of chemotherapy indirectly affect mood. Like other breast cancer treatments, chemotherapy can cause or worsen fatigue. Some women report chemobrain, problems with thinking, short-term memory, and concentration. Being forgetful can cause frustration, anger, and embarrassment. Keep lists of things you want to remember, or put sticky notes with reminders in places you can’t miss. Your cell phone can be used to keep a to-do list or alert you to upcoming appointments.
Chemotherapy also can cause nausea, vomiting, and lack of appetite, and may affect the way foods taste. Not eating well can affect your mood. Nausea can often be prevented, so talk to your healthcare team if your experience it.
It's common to gain or lose weight during chemotherapy treatment. Try not to be hard on yourself about these changes. It may surprise you to discover that you are gaining instead of losing weight. Chemotherapy may cause hormonal changes that make it difficult for you to keep off weight. Even if you take in the same number or fewer calories than usual, the treatment could still make you gain weight.
Some, but not all, chemotherapy medicines can cause hair loss or thinning. This can be distressing for many reasons. You may feel that you look ill for the first time, that your cancer is now public and not private. You may feel less attractive or feminine.
Your breast cancer treatment may include other medicines that could affect your mood. If the cancer is HER2-positive, you will most likely take HER2-targeting treatments. Issues with appetite, sleep, fatigue, changes in weight, and other side effects may impact your emotions.
Hormone receptor-positive cancers, or those that test positive for the estrogen or progesterone receptor, or both, are often treated with hormonal therapies. Depending on the type, hormonal therapy may block estrogen receptors, reduce the amount of estrogen made, or lessen the number of hormone receptors.
Because estrogen plays an important role in how you feel physically and emotionally, hormonal treatments can affect your mood. Many of the effects of hormonal treatments are reversible, but some are not.