From Pam Stephan,
Your Guide to Breast Cancer.
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About.com Health's Disease and Condition content is reviewed by V.K. Gadi, MD

A diagnosis of breast cancer is a great shock. Women report that they fear breast cancer more than heart disease, even though they have a better chance of surviving breast cancer, and dying of stroke or heart failure. Breast cancer has been with us since the early Egyptians, and fear of this disease as well as the treatments for it, seems to be inherent in women all across the world.

Normal Emotions and Breast Cancer

Here are some normal emotions that you may experience at diagnosis and during treatment.

• Fear, shock
• Denial
• Anger
• Depression
• Sadness
• Anxiety
• Stress
• Guilt
• Loneliness, alienation
• Hope

Physical Responses to Strong Emotions
As you begin to deal with diagnosis and treatment, your body will be reacting to emotions as well as surgery and drugs. Your physical responses to the overall stress may be:

• Fear – trouble sleeping, headaches, body aches
• Anger – change in blood pressure
• Depression – fatigue, crying, feeling moody
• Stress – pain, irritability, tension

Unresolved or Unexpressed Emotions May Lead to Other Problems

You are not alone with your diagnosis – or your emotions. Expressing your feelings can give you quite a bit of relief, helping you move forward in your journey. Not all of us are freely expressive, but there are safe and creative outlets for your feelings. Letting out your emotions will help you get support and heal more quickly. Your bottled-up emotions may lead to:

• Loneliness, withdrawal from others
• Frustration
• Hopelessness
• Feeling out of control

Emotional Concerns and Breast Cancer

When you’ve accepted your diagnosis, you may be facing other emotional concerns. The loss of a breast, or part of a breast, has an impact that goes beyond the physical fact. If aggressive treatment is required, it might have long-term impact on your health. It is normal to be concerned about:

• Fear of recurrence
• Loss of attractiveness
• Difficulty with sexual function
• Loss of fertility

Coping With and Surviving Breast Cancer

You can improve your emotional health and reduce your physical symptoms with good coping strategies. A study published in the Journal of Psychosocial Oncology reports that women who get help with pain and emotional distress have lower levels of anxiety, fatigue and depression. Here are some ways to cope with your emotions:

• Communicate with family and friends
• Maintain intimacy (if you have a partner)
• Visit with a counselor or spiritual director
• Join a support group
• Express your needs and ask for help
• Report your symptoms to your healthcare team
• Keep a log of medical visits, save test results, keep receipts
• Educate yourself about your cancer and treatments
• Exercise
• Make plans for a crisis

Getting Help for Emotions Is Not a Sign of Weakness

You may feel under pressure to “be strong” or “act brave” when you least feel that way. Perhaps you don’t easily share your feelings with others. You may be in a position of responsibility and trust, and feel like you must contain your fears and hide your disease or the effects of treatment. Sharing these feelings and struggles may make you feel vulnerable. A study published in the Journal of Personality shows that women with breast cancer who do express their anger, fear, sadness, and affection in a group setting live longer than women who suppress these emotions. Here are some ways to express your emotions and boost your emotional and physical health:

• Make time to talk to family members
• Communicate with friends and coworkers
• Attend a support group, or join an online support list
• Find a good therapist and commit to regular visits

Take-Home Message
Your feelings about breast cancer and its affect on your body, family, relationships, finances, and mortality are valid and normal. Expressing your emotions and needs will help boost your mental and physical health. Letting it out lets you live longer!

_{Sources:
Journal of the American Geriatric Society. Effect of depression on diagnosis, treatment, and survival of older women with breast cancer. Published January 2004.}

Journal of Psychosocial Oncology. Examining the influence of coping with pain on depression, anxiety, and fatigue among women with breast cancer. Published 2005.

National Institute of Health. Women's Fear of Heart Disease Has Almost Doubled in Three Years, But Breast Cancer Remains Most Feared Disease. Published 2005.

National Cancer Institute. Support for People with Cancer - Taking Time. Published 2005.

California Breast Cancer Research Program. Does Change in Emotional Expression Mediate Cancer Survival? Final Report Published 1999.