• The emotional and psychological effects of cancer can linger even in survivors

  • The Breast Cancer Book is a manual designed to support people through all stages of their cancer experience

  • We have therapists who specialise in working with serious illness and cancer – find them here

Finally, breast cancer and treatment are behind you and you’re a member of the cancer survivor’s club. You may feel a wonderful sense of relief and closure. At the same time, you may feel sad and maybe anxious that you’ll no longer have the frequent interactions and constant monitoring of your healthcare team, particularly if you’ve built a strong bond with them.

Adjusting to life after breast cancer can take time, and although the crisis that you’ve lived with for so many months may be over, you might feel lost in the abrupt transition from patient to non-patient. You may need several months to fully regain a healthy level of energy and sense of well-being, especially if you’re still dealing with treatment side effects.

As you get back to life without breast cancer, you’ll gradually have more and more days when it doesn’t occupy most of your thoughts. Give yourself credit for getting through your diagnosis and treatment. Be vigilant about your health, and take good care of yourself. Above all, enjoy life.

Life won’t necessarily be exactly as it was before, however, because the experience will likely have changed your perspective. Breast cancer survivors sometimes find that they are more resilient than they knew, and they may even experience meaningful personal growth from having undergone their unwanted experience with breast cancer.

Despite the hardships, breast cancer can be a life-changing gift that forces you to look at life in a different way. You have the power to determine what that change will be.

It may involve holding on to things that are familiar or opening yourself to new ideas; you may reassess your priorities and make positive changes in your life. Breast cancer may have shown you an inner strength that you didn’t know you had and a newfound self-confidence and motivation to make the most of every day. This is the “new normal” that survivors often describe.

Some survivors also talk about “post-traumatic growth syndrome,” which describes this personal growth during or after the challenge of cancer.

In 1985, Dr. Fitzhugh Mullen wrote “The Seasons of Survival,” an article about the phases of his own journey through cancer. Although the model he described has changed over time, it still describes that for most cancer survivors today, diagnosis and primary treatment often comprise a relatively short period of time that is followed by many years of living cancer free.

The seasons of survival for most breast cancer survivors include:

• Acute survivorship is the time of diagnosis and treatment that may include surgery, radiation, chemotherapy or hormonal therapy

• Extended survivorship is a period of surveillance and observation with planned visits to your breast cancer team after initial treatment. This is often referred to as a five-year period

• Permanent survivorship describes the years when women typically think less about their diagnosis and when breast cancer becomes part of their past medical history. Most women in this phase typically do not report ongoing symptoms related to their treatment, but some report what are known as “late and long-term side effects,” and some may develop a second cancer

• Chronic survivorship describes the experience of women who live with breast cancer as a chronic disease that is being treated with the hormone therapies, chemotherapy, or targeted therapies described in this book

Overcoming uncertainty about the future 

Whether you’re a “glass half full” or a “glass half empty” type of person, you may feel anxious and uncertain about breast cancer returning. As you move into your life beyond breast cancer, certain things may trigger unease. You may worry that every follow-up scan and test may find a new tumour.

Media stories about breast cancer, the anniversary of your diagnosis, or hearing about someone else who has been diagnosed may also make you feel vulnerable, while every headache, cough, or ache that develops may seem ominous.

It’s important to understand the signs of recurrence so that you can alert your physician as soon as possible if any of them occur. Remember that many of these symptoms can be caused by other conditions as well. Although recurrence is always a possibility, most survivors never need breast cancer treatment again.

Moving forward

Identifying these emotional triggers and talking about them can help you pre-emptively address them and minimise the effect they have on your life.

Share your fears with your family. Talk in person or online with members of your support group, who can give you the benefit of their experience. Discuss your worries with your healthcare team, and be honest about what you don’t understand or what you fear. Just having the conversation can make a positive difference, but they can’t help you if you’re not vocal about issues that concern you.

Having a Survivorship Care Plan that clearly describes your follow-up monitoring and care can help you feel less vulnerable, enabling you to focus on the present and avoid worrying about things that may never happen.

Living with hope is empowering. Living with fear and uncertainty compromises your physical wellbeing and your ability to enjoy life and to make plans for the future. Realise that you’ve done everything that can be done to beat your breast cancer, so that you can now focus on living your life and enjoying each day.

If you can’t seem to shake your fear that breast cancer will return, speak to a therapist about cognitive behavioural therapy, which can help reduce your anxiety and replace negative thought patterns with positive ones.

The Breast Cancer Book: A Trusted Guide for You and Your Loved Ones by Kenneth D. Miller & Melissa Camp with Kathy Steligo 

Further reading

After my cancer diagnosis, therapy helped me feel less alone

The psychological impact of a cancer diagnosis

My womb cancer experience: what I want others to know

My 100km bike ride to celebrate my life-saving lung transplant