How Breast Cancer Affects Young WomenJuly 2, 2013 • Contributed by Norma Lee, MA, MD, Cancer Topic Expert Contributor
“You can’t cross the sea merely by standing and staring at the water.” —Rabindranath Tagore
“Cassidy,” 29, had a mastectomy and axillary lymph node dissection for stage III breast cancer six months ago. She finished chemotherapy a couple of months later and will soon be done with radiation therapy. Ever since her diagnosis, she feels like her life has been a whirlwind of medical appointments, medications, and side effects. The day before her diagnosis, life was normal. The words “You have breast cancer” transported her to a foreign place: Cancerland, where nothing is familiar and nothing makes sense.
Cassidy feels completely overwhelmed and exhausted. She tries not to let it show, though, because she feels everyone around her has supported her as much as they can and she shouldn’t ask for anything else. In fact, people have as much as told her that they expect her to be back to normal as soon as her radiation treatments are finished. Part of her thinks this is an unrealistic expectation, but part of her wonders if maybe there’s something really wrong with her because she is so far from feeling “normal.”
Cassidy has tried to talk to her husband, “Dave,” about how she is doing, but Dave doesn’t listen. Instead, Dave tries to come up with solutions for how to solve the problems. This is typical. Men are fixers. They want to make things better for their wives/partners. Not being able to do so makes them feel frustrated, angry, and inadequate. So, Dave tries to show he cares by offering solutions. Cassidy sees this as not listening to her feelings, meaning Dave doesn’t think her feelings are valid. Cassidy talks about her feelings more to try to be heard, and Dave offers more solutions that Cassidy doesn’t use. As neither person feels heard or appreciated, they begin to pull away from each other.
In addition, though Dave hasn’t verbalized it, he has thought about what it would be like if Cassidy died of breast cancer. This is terrifying to him, and causes him to distance himself from her somewhat, thinking it will protect him in some way. Dave hasn’t tried to make love to Cassidy since her surgery because he is worried about physically hurting her and is a little “freaked out” about her chest after the mastectomy. The last thing he wants to do is hurt Cassidy’s feelings, so he hasn’t shared this with her. He thinks he would get used to the scar just fine, but Cassidy never lets him see it. He doesn’t think Cassidy ever looks at it, either.
Cassidy’s view of herself has changed significantly since her mastectomy and treatment. Being on tamoxifen (an estrogen-blocking agent) has put her into menopause. She has hot flashes, mood swings, and vaginal dryness, which are all associated with low estrogen levels. Her libido is gone, and she can’t imagine how her husband could find her attractive anymore. She thinks her chest looks hideous. She assumes her sex life with Dave must be over. On one hand, she’s so exhausted and uninterested right now that she’s kind of glad he’s not initiating anything, but she’s hoping it’s not always going to be like this. Will she ever feel feminine and/or desirable again?
What Cassidy and Dave need to know is that everything they are feeling is absolutely normal. Breast cancer affects a young woman’s sense of herself in all areas of her life: her body image, self-image, and sexual identity. It impacts her role as a mother, spouse/partner, and as a woman, both in personal (i.e., dating) and work situations. It affects her career by having to take time off for treatment, and if she doesn’t have excellent health insurance, it affects her life by impacting her income while she is off work and by the significant cost of cancer care. Additionally, cancer affects the entire family, not just the person with the diagnosis.
Young women have more distress with all of the above issues and with living with uncertainty than older women. It is crucial that they find a way to communicate with their spouses/partners so they can move forward from the trauma and disruption that breast cancer has created in their lives. Some of my previous blog posts have addressed how to communicate with your spouse/partner, as well as cancer and sexuality. If you are unable to work things out on your own, you may want to consider seeing a therapist. Breast cancer will change your life in some ways, but it doesn’t have to change your life in all ways.
© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Norma Lee, MA, MD, LMFT, therapist in Bellevue, Washington
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.
melodyJuly 2nd, 2013 at 1:12 PM
It is the uncertainty that a cancer diagnosis brings into your life that can be so unsettling.
Everything else in life becomes defined as “before” cancer and “after” cancer.
There never feels like there is any kind of peace and normalcy because when you are young and are told that you have cancer everything seems so temporary.
You have not yet had the chance to live with permanence like an older person has and therefore you wonder if that is even going to be something that is achieveable for you.
THOMJuly 2nd, 2013 at 1:48 PM
So often I hear of people making a disease/disorder the way of life.While there is definitely a disruption and some disorders more serious – letting it affect all areas of life is ALLOWING it to get to you!
Fight it and its effects,be a fighter – and you shall win!
JuliaJuly 2nd, 2013 at 9:16 PM
It must be so hard going through so many things at the same time.Cancer in itself is a large threat but the added negatives make it an even more daunting challenge.Support and counseling could help if you ask me.
Josephine YoungJuly 3rd, 2013 at 4:22 AM
it helps is these situations when you have a whole lot of support
leighJuly 4th, 2013 at 6:10 AM
Let me begin by saying that I have never experienced this so I can only speak for how I think that it would impact me. But my first thoughts are that if I could survive having breast cancer then I think that I would just be happy to be alive instead of focusing on what it has taken away from me. I would hope thanm I am able to instead focus on that which has not been taken from me, which would be my life and family.
LNJuly 5th, 2013 at 10:26 AM
It is very easy to tell a cancer patient “you need to let it go, focus on the positive, appreciate what you have that illness cannot take away.” However, it is extremely difficult for some to let go of their old life, their life before cancer, especially for a young patient who has been blindsided by their diagnosis (no family history, generally good health, etc). It is important for them and their support/loved ones to acknowledge the fear and uncertainty. Don’t push them to try to get past it or suppress it. It is definitely a process, one that takes a lot of time and patience, before they can get to that place mentally where they have let things go and can move forward. The truth is, cancer completely invades your life at diagnosis, and it is the rest of your life. It will always be there like a shadow at your heels. Little by little, you have to fight to keep it from taking over your life. It doesn’t happen in a day, a month, or maybe not even a year. It is a strength that is slowly built up until that shadow is much smaller than you.
The best way to support your loved one is to listen, listen, listen, just like it says above. It is great to encourage and remind the person that they need to stay strong and don’t let it overwhelm them, but it is absolutely ok if you find that you don’t know what to say to them anymore. They are not looking for “the answer” from you, just love and support.
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