Survivorship: Psychosocial Factors and Breast Cancer

bc-survivorship-mtp-pinkOne in eight women in the U.S. will be diagnosed with breast cancer in her lifetime, and more than 40,000 women and 440 men in the U.S. will die from the disease this year.

It is no surprise that, when faced with this news, women possibly experience shock, fear, sadness, disbelief or other feelings of psychosocial distress. Many women are able to adjust to and manage the disease, survivorship and their “new normal.” Some women will experience times of persistent psychosocial distress and would benefit from interventions. Intervention is important because distress can interfere with a woman’s ability to cope with cancer treatment and can extend along the continuum from common feelings of vulnerability fear, and sadness, to true depression, anxiety, panic and feeling isolated.

Coping with a Breast Cancer Diagnosis

  • Learn about breast cancer at your own pace. Get information about clinical trials, treatment options and side effects. Doctors can make suggestions, but decisions should be made together.
  • Seek professional help if you need help managing your issues with breast cancer and how to cope with your feelings.
  • Talk to your doctor honestly about your breast cancer journey.
  • Be patient. Coping with breast cancer requires time, acceptance, a fighting spirit and support.
  • Lean on your network of family and friends. They can help:
  • Lend support from diagnosis through treatment and beyond
  • With day-to-day tasks
  • Gather information for you about breast cancer

Coping with Fear of Recurrence

It is normal to have thoughts and concerns about breast cancer coming back breast. Fears of recurrence often peak right after treatment, but they can happen at an time. You can take control of your fears and learn effective triggers and coping strategies to keep these fears from consuming you. Some of these strategies include:

  • Get and stay informed. Learn about your cancer and risk of recurrence, continue your follow-up-care plan and take care of yourself.
  • Remove any blame. Never blame yourself for your cancer diagnosis. Cancer does not choose to punish people and it doesn’t discriminate. Cancer can happen to anyone.
  • Talk to your doctor and begin an appropriate exercise program. It can improve your mood and make you feel healthy, confident and strong.
  • Find ways to relax like yoga, meditation, prayer, etc.
  • Acknowledge your feelings. Talk to family, friends or other survivors. Journal, craft, or find creative ways to give voice to your emotions.
  • Focus on the positive. Find ways to stay hopeful and use your energy to stay as healthy as possible.
  • Control what you can. Empower yourself by taking an active role in your healthcare team.

Learn more about breast cancer recurrence and maintaining quality of life:

Survivorship: Intimacy


Being diagnosed with breast cancer can take a physical toll on your body, not to mention your intimate and sexual health. Breast cancer and treatment for breast cancer can sometimes make it difficult to be sexual and intimate with another person, and that is okay and natural.


A woman’s breasts symbolize so many things, including motherhood, sexuality and being a woman. For some women, breasts now represent cancer. Most women, and their partners, will need to take time to grieve the loss of (or changes in) their breast(s).

Joining a support group may help you cope with the changes in your body and self-image. Remind yourself that healing takes time and at some point, you will become more comfortable with your new normal.

Accepting yourself as you are is all part of the process.

How to Talk with Your Partner

While there is no such thing as a perfect time to talk, certain times are better than others. Choose a moment when you are alone and relaxed. When you feel comfortable, give yourself and your partner permission to talk about your feelings, both good and bad. Above all else, be honest.

Your biggest fears. You may not feel pretty or worry that your partner finds you less attractive. You may be afraid your partner will reject or leave you due to your breast cancer.

Your partner’s fears. Your partner may be afraid of physically hurting you during sex. He/she may be confused or unsure of the best way to show support and affection and is waiting on you for cues on when to resume an intimate and/or sexual relationship.

Birth control. Treatments such as radiation or chemotherapy and tamoxifen can cause birth defects, so it is import to talk to your partner about birth control. After treatment, do not assume that you can no longer become pregnant.

Your “new” sex life. Breast cancer may change what you like to do and how you like to be touched during sex. You may not even want to have sex for a while, so it is important to talk to your partner about how you are feeling.

Other Things You Can Do

Get romantic. Bring romance back by planning a candlelight dinner, taking a bubble bath or other romantic gestures. Take the time to nurture your sexuality.

Go slow. Kissing and touching can provide pleasure and help with intimacy. Do not rush into something until you feel comfortable with it.

Get comfortable. Sex may be painful because of changes in your body, due to breast cancer treatment.

Try using water-based lubricants just before sex. To help with vaginal dryness, try an estrogen-free vaginal moisturizer. These products are available over the counter without a prescription. Since they do not contain estrogen, they’re safe for breast cancer survivors. If vaginal dryness is still a problem, contact your doctor.

Try something different. Change your sexual routine- try new things and have fun!

Get some advice. Consider seeking advice from a marriage counselor, sex therapist or joining a support group. You can go with your partner or by yourself.

Make sure to share this information with your partner. Getting the intimacy you need should not be your responsibility alone.

Learn more:

Breast Cancer Survivorship: Family/Co-Survivor Support

bc-survivorship-mtp-pinkIt doesn’t take time-consuming and heroic gestures to be a good co-survivor. Sometimes being there and listening is all that matters. Here are just a few ideas of what co-survivors can do to help a breast cancer survivor:

  • Run errands
  • Send a “Thinking of You” card
  • Take her/him to an appointment
  • Create an online calendar to organize meal deliveries, rides and other tasks
  • Bring together family, friends and coworkers to help support and care for your loved one through a caring social network and planner. CaringBridge provides sites where friends and family can stay connected and updated on someone’s health event and leave messages of hope and encouragement. The planner also gives you the power to set a community of support in motion by organizing meals, tasks and other helpful activities.

Advice for the Caregiver

Communicate: Keep communication between you and your loved one open and honest. Understand that he/she will often worry just as much about you as you do about him/her.

Understand: Learn more about the experiences of others diagnosed with breast cancer.

Talk Medicalese: Learn to better communicate with your loved one’s health care team. This can be a big help when you accompany your loved one to appointments.

Talking to Your Children About Your Diagnosis

Each child and each family is unique, and helping children cope with a loved one’s diagnosis can present many challenges.

However you decide to tell your children, be as open and honest as possible no matter how hard it may seem. You decide how much you want to say. Remember that children, just like adults, will fill in wherever you leave gaps. And because children may not know as much as adults, it is more likely that what they fill the gaps with will be wrong.

Encourage your children to talk to you and to ask questions. Giving honest, realistic answers to their questions will help lessen their fears. If you are going to be gone for a few days, if you are getting sick from the treatment or if you are losing your hair or a breast, let your children know why this is happening. Explain anything that changes their daily routine.

It is a good idea to let your children’s teachers know what you are going through — especially for younger children. The teachers may be able to help the children cope if they spend most of the day at school.

Finally, just as your children depend on you, you can depend on them too. They can be, and probably want to be, a source of support for you. They will want to listen to you, hug you, kiss you and spend time with you. Let them.

Learn more:

Breast Cancer Survivorship: Support Community

bc-survivorship-mtp-pinkA breast cancer diagnosis can be confusing, overwhelming and scary. Make sure that you build and search for a support community to support you in your journey. The support of others who care about you and your well-being can give you the strength to cope and retain a sense of control during this challenging time.

At Komen, we believe anyone who has been diagnosed with breast cancer is a survivor, from diagnosis through treatment and beyond. The National Cancer Institute’s Office of Cancer Survivorship also defines breast cancer survivor in this way.

Getting the Support You Need

There are three main types of support: informational, emotional and practical. You may need different kinds of support at different times and from different people.

Informational Support provides you with information about breast cancer. This might include finding facts about your type of breast cancer or gathering information about your treatment options.

Emotional Support looks after your emotional well-being. Emotional supporters listen to you, give you the chance to express your feelings and just be there when you need a friend.

Practical Support helps you with specific tasks. This might include rides to appointments, help with cooking or cleaning or going to the doctor with you to take notes. It may also mean seeking out any short-term financial assistance available.

The Komen breast care helpline- 1-877-GO KOMEN (1-877-465-6636) provides breast health and breast cancer information to anyone with questions or concerns about breast cancer.

Building your Support Community

Write down the names of people (co-survivors) who might support you in different ways. Your list may include your partner, children, other family members, friends, support group members, co-workers, clergy, neighbors or even health care providers. Look outside your existing network of support people, too. Have you met someone who has experienced breast cancer that you could reach out to?

Write down what kind of support you would like most from each person on your list. For instance, you may want your doctor to give you informational support, your best friend to give you practical support, your sister to give you emotional support, and your partner to give you all three types of support.

Tell each person exactly what he or she can do to help you and be specific. They can help with laundry, the bills, cleaning, etc. Sometimes all it takes is asking.

Have a “back-up” support person. Although it is true that you are the one who has breast cancer, the special people in your life have also been affected by your illness. Sometimes co-survivors will need to deal with their own feelings before they can support you.

Benefits of Co-Survivor Support

  • Reduced anxiety and psychological distress
  • Reduced depression and feelings of pain
  • Improved mood and/or self-image
  • Improved ability to cope
  • Improved feelings of control

Support groups are also an important resource for breast cancer survivors. They are designed to increase the support network of the people in the group.  Your doctor can also tell you how to find a local support group.

Learn more:

Breast Cancer Survivorship: Complementary & Integrative Therapies


Many people use complementary therapies during or after their breast cancer care. Some use complementary therapies to improve quality of life and relieve side effects of treatment or the breast cancer itself. Complementary therapies are used along with (not instead of) standard medical care.

When combined with standard treatments (such as surgery and chemotherapy), complementary therapies may be called integrative therapies.  Complementary therapies should not be used to treat the breast cancer itself.

Types of Complementary & Integrative Therapies

Natural products use herbs, vitamins, minerals or microorganisms (such as the bacteria found in yogurt). Examples include black cohosh and probiotics.

Mind and body practices are techniques given or taught by a trained practitioner or teacher.

Examples include:

  • Acupressure and acupuncture
  • Aromatherapy
  • Art therapy and music therapy
  • Chiropractic medicine and massage
  • Guided imagery
  • Meditation and prayer
  • Qi gong
  • Reflexology
  • Reiki

Whole medical systems use many types of therapies. Examples include: Ayurveda, homeopathic medicine and traditional Chinese medicine.

Is Complementary Therapy Right for You?

STEP 1: Talk With Your Doctor

If you are thinking about using a complementary therapy, don’t decide alone. Your doctor can help make sure the therapy is safe for you to use during your treatment.

STEP 2: Only use a complementary therapy along with standard treatment.

Standard cancer treatments have proven benefits. It is not safe to replace them with complementary therapies. It may be fine to use complementary therapies along with standard medical treatments if approved by your doctor.

STEP 3: Understand what you are doing (or taking).

When considering a complementary therapy, learn all you can about it. Research its safety and effectiveness. Discuss what you have learned with your doctor.

STEP 4: Beware of wild claims

No complementary therapy has been proven to cure cancer. If this claim is made, it’s not true. Find out what research has been done. Your doctor can be a good source of this information.

STEP 5: Natural does not mean safe

While the idea of natural products seems like a good idea, natural does not mean safe. Think about poison ivy, poisonous mushrooms and rattlesnakes. High-dose vitamins can also be unsafe.

STEP 6: Choose trusted brands

With dietary supplements, what’s on the label may not be what’s inside the bottle. Look for the “USP verified” stamp on the label (USP is the U.S. Pharmacopeial Convention). Choose supplements from well-known makers to increase the likelihood the:

  • Supplement listed on the label is what is inside the bottle
  • Dose and potency are listed correctly
  • Supplement is free of harmful contents like pesticides and heavy metals (such as lead, arsenic or mercury)

STEP 7: Choose certified complementary therapy practitioners.

Being certified means a practitioner passed the licensing requirements for his or her field. Visiting a certified, licensed practitioner isn’t a guarantee you’ll get good, safe care, but it’s a good start.

Questions to Ask Your Doctor about Complementary Therapies

  • How do you feel about complementary therapies?
  • Have you ever referred someone to a complementary therapy practitioner?
  • What’s the best way to find a licensed complementary therapy practitioner?
  • I am using these complementary therapies (name therapies). Should I stop using them during and/or after my breast cancer treatment?
  • Should I let you know before I start a new complementary therapy? Which therapies should I not use?
  • Is this complementary therapy (name therapy) safe? Is there research showing it is safe?
  • Are there any side effects with this complementary therapy (name therapy)? If yes, what are they and what should I report to you?

Learn more:

Dine Out to Fight Breast Cancer During Dine Out for the Cure® in Mid-Missouri on October 6


Fight breast cancer while dining out for breakfast, lunch and/or dinner during the Susan G. Komen Missouri Dine Out for the Cure® on Thursday, Oct. 6, in mid-Missouri. Participating restaurants will donate a portion of their proceeds to Komen Missouri.

Pizza Tree (909 Cherry Street in Columbia) will donate 30 percent of proceeds from Dine Out day (lunch and dinner) to Komen Missouri.

Kaldi’s Coffee Roasting Company (29 S. 9th, Columbia) and Nourish Café & Market (1201 E. Broadway, Columbia) will each donate 15 percent of proceeds during breakfast. Coley’s American Bistro (15 S. 6th Street, Columbia) will donate 15 percent of proceeds from dinner.

In Moberly, Santa Fe Mexican Restaurant (520 E. US Hwy. 24, 65270) will donate 15% of proceeds from lunch to Komen Missouri.

Seventy-five percent of the net funds raised through Dine Out for the Cure stays in the community to fund breast cancer screening, breast health education and patient navigation and support services for underserved and uninsured individuals. The remaining 25 percent funds global breast cancer research.

Komen Missouri encourages Dine Out participants to “tweet and eat” by following @KomenMissouri on Twitter and Instagram and using the official event hashtag #KomenMidMODine.

Visit for Dine Out details. Visit to learn more about Susan G. Komen Missouri and its year-round mission to save lives and end breast cancer forever.

Understanding Breast Cancer Risk Factors: Exercise

bc-risk-mtp-pinkLet’s get moving and be physically active! Exercise can help with weight control. For postmenopausal women, being lean lowers the risk of breast cancer. And physical activity may lower estrogen levels in all women, which can also protect against breast cancer. Physical activity may also boost the body’s immune system so that it can help kill or slow the growth of cancer cells.

Activity equal to walking 30 minutes a day may lower risk by about 3 percent.

For breast cancer survivors, activity equal to a 30-minute brisk walk several times a week leads to lower recurrence rates and death from breast cancer.

Being active is good for your health, but it can be hard to find time to exercise. Do whatever activities you enjoy most (for example, dancing or gardening) that get you moving.

Learn more:


Understanding Breast Cancer Risk Factors: Alcohol Use

No one should drink a lot of alcohol. Drinking more than one drink per day (for women) and more than two drinks per day (for men) has no health benefits and many serious health risks, including breast cancer. Many studies show that drinking alcohol increases the risk of breast cancer.  A pooled analysis of data from 53 studies found for each alcoholic drink consumed per day, the relative risk of breast cancer increased by about seven percent.

Research shows that women who had two to three alcoholic drinks per day had a 20 percent higher risk of breast cancer compared to women who didn’t drink alcohol.

Estrogen levels are higher in women who drink alcohol than in non-drinkers, which may increase the risk of breast cancer.

Drinking alcohol can reduce blood levels of the vitamin folic acid. Folic acid plays a role in copying and repairing DNA.  Low levels of folic acid may make it more likely that errors occur when cells divide, which can cause cells to become cancerous. Such errors can lead cells down a pathway to become cancer.

However, drinking in moderation has some health benefits like lowering the risks of heart disease, high blood pressure and death. It is important to note that drinking excessive alcohol has no health benefits, only health risks.

Learn more:

Understanding Breast Cancer: Questions to Ask Your Doctor

No one knows more about your body than you do – not your partner, not your parents, not even your doctor. So when you talk with a health care provider about your health, remember that you have valuable information to share. You know about changes in your body and about any problems you may be having. Share that information. Open and honest communication between you and your doctor is one of the best ways to make sure you get the care you deserve.

To get the most out of each doctor’s visit, try following these guidelines:

  1. Be prepared. It is often helpful to gather information about your health concerns — from the library (books and medical journals), trusted Internet sites, etc. The more you know, the more comfortable you will be talking to your doctor.
  1. Organize your questions ahead of time. You should be able to talk openly and honestly with your doctor about breast health and breast cancer to make sure all of your questions are answered. To help you get started, Susan G. Komen® has a series of 17 Questions to Ask the Doctor topic cards on a variety of breast cancer issues. Each card contains important questions to discuss with your doctor. Space is provided for you to jot down the answers. Also, be sure to bring a voice recorder to capture your conversation so you can refer back to your doctor’s responses. These questions will help your doctor understand and address your specific concerns. You can download and print these cards to take to your next doctor’s appointment at
  1. Tell your story. When your doctor comes in, ask if you can take a few minutes to briefly explain your situation and concerns. Be as specific as you can. Then, give the doctor your list of questions and ask them.
  1. Give feedback. If your doctor’s responses were helpful, say so. This kind of feedback will encourage your doctor to talk with you, listen to you and continue to help you. Doctors are just like anyone else; they want to do their job well. That means doing whatever they can to help you stay healthy or to get better. Remember, although doctors may know a great deal about breast health and breast cancer, they may not truly understand or be aware of all that you are going through. You can help your doctor help you by sharing your feelings and concerns.

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Understanding Breast Cancer Risk Factors: Menopausal Hormone Use

bc-risk-mtp-pinkIn the past, many women used menopausal hormone therapy (MHT), also known as hormone replacement therapy, to relieve hot flashes and other symptoms of menopause. But studies show that use of estrogen plus progestin increases the risk of both developing and dying from breast cancer. Although MHT is approved for the short-term relief of menopausal symptoms, the U.S. Food and Drug Administration (FDA) recommends women use only the lowest dose that eases symptoms for the shortest time needed.

When women take these hormones (estrogen plus progestin), their risk of having an abnormal mammogram increases within the first year of use and their risk of breast cancer increases within the first five years of use. The risk of breast cancer goes up slightly each year a woman takes estrogen plus progestin. One large study found women who use estrogen plus progestin for five or more years (and are still taking it) more than double their breast cancer risk.

When women stop taking MHT, the risk of breast cancer starts to decline. After about 5 to 10 years, the risk returns to that of a woman who has never used MHT.

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