(LifeWire) - When Karen Eggers was diagnosed with breast cancer, she needed her friends to rally around her for support. What she expected and what she got proved quite different, though. Some longtime confidants went MIA, while once-peripheral acquaintances became her strongest allies.
Eggers, now age 45 and a breast cancer survivor of seven years, had two steep learning curves she had to endure: the reams of medical information from which she had to make sense (expected) and as she underwent treatment that included a mastectomy, chemotherapy and breast reconstruction surgery, experiencing changes in her social support network (unexpected).
"You do have people who can't be there, and others that really surprise you," says Eggers, who owns a real estate firm. "The ones who don't step up, you have to let go. At the time, it flabbergasted me."
Her experience is not uncommon. Women who are first diagnosed with breast cancer -- which happens to about 240,000 American women each year -- usually face responses from friends that range from complete avoidance to extreme concern. At this especially vulnerable time, the breast cancer patient may feel abandoned or strongly supported, or both.
In fact, new breast cancer patients often experience a drop in social and emotional support during the first year after diagnosis, according to a May 2007 study in the journal Psycho-Oncology, evaluating the role of friends, family and healthcare providers.
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It's important to understand that unsupportive reactions reflect the other person's issues and feelings, experts advise. Friends or acquaintances may be tongue-tied, fearful, uncomfortable or unaware of how much support you need, especially if you look just fine. Rarely, though, do they intend to hurt you.
"I encourage cutting people a little slack," says Mary Jane Massie, MD, a psychiatrist specializing in breast cancer counseling at New York City's Memorial Sloan-Kettering Cancer Center. "We do take it personally when a friend lets us down and wonder about the relationship, but we realize that if someone cannot extend a hand, there is a reason why. You may never know what a person's issues are."
"Many people don't know what to say and others are facing their own fears of mortality," agrees Debbie Saslow, PhD, director of breast and gynecologic cancer for the American Cancer Society. "Other people draw closer. Often, there is an outpouring of support."
That support may end up being as crucial for breast cancer patients' physical recovery as their emotional stamina. Researchers examining social ties and survival after breast cancer diagnosis reported in the March 2006 issue of Journal of Clinical Oncology that the most socially isolated of more than 2,800 women participants were twice as likely to die of breast cancer, compared with the most socially integrated women.
"Social-emotional support, often provided by a confidant, may reduce stress and . . . might improve [protection] against cancer recurrence," the lead author of the study, Candyce H. Kroenke, a researcher at Boston's Brigham and Women's Hospital, wrote. "Investigators have suggested that social-emotional support may be more critical than instrumental [medical] support for breast cancer survival."
Eggers says that, at the very least, the support of close friends added to her quality of life and helped her feel more normal as she went through breast cancer treatment.
"I had a friend who had also been on chemo, and he was my cheerleader," she says. "I think we depend on friendship. Some people don't have it to give, and you can't give what you don't have. But I had so many other people who were there."
When faced with a lack of support, how can breast cancer patients address their concerns? Possible strategies include:
Ask for help. As Eggers notes, many well-wishers write in cards, "Please let me know what I can do." Well, let them. Think of specific tasks or favors you need, such as babysitting, housecleaning or running errands. Both of you will feel better with concrete means of support.
Share an article or book. Sometimes a subtle push comes in the form of informational material about breast cancer and the kind of support it requires. You'll get your point across without bashing them with it.
Assign a spokesperson. Patients often need advocates -- spouses, siblings or grown children -- to help them navigate the medical issues involved in breast cancer treatment. These individuals can also become your social advocates, updating friends and other family members on the status of your treatment and explaining what kind of support is needed.
Sources:
Arora, N.K., L.J. Finney Rutten, D.H. Gustafson, R. Moser, and R.P. Hawkins. "Perceived Helpfulness and Impact of Social Support Provided by Family, Friends and Health Care Providers to Women Newly Diagnosed with Breast Cancer." Psycho-Oncology. 16:5(2006): 474-86. (subscription).
Eggers, Karen. Telephone interview, 2 Jul. 2008.
Kroenke, C.H., L.D. Kubzansky, E.S. Schernhammer, M.D. Holmes, D. Michelle, and I. Kawachi. "Social Networks, Social Support, and Survival after Breast Cancer Diagnosis." Journal of Clinical Oncology. 24:7(2006): 1105-11.
Massie, Mary Jane, M.D. Telephone interview, 14 Jul. 2008.
Saslow, Debbie, Ph.D. Telephone interview, 3 Jul. 2008.
"Talking to Other Relatives and Friends." breastcancer.org. 25 Jul. 2008. 29 Jul. 2008.
