Self-management - Breast cancer in women

Breast cancer can affect your daily life in different ways. It can depend on what stage it's at and the treatment you're receiving.

How women cope with their diagnosis and treatment varies from person to person. But there are several forms of support if you need it. Not all of them work for everybody, but one or more of them should help.

You could:

• talk to your friends and family – they can be a powerful support system
• communicate with other people in the same situation
• find out as much as possible about your condition
• avoid doing too much or overexerting yourself
• make time for yourself
• liaise with your breast care nurse and discuss such issues

Recovery and follow-up

Recovery

Most women with breast cancer have an operation as part of their treatment. Getting back to normal after surgery can take some time. It's important to take things slowly and give yourself time to recover.

During this time, avoid lifting things and doing heavy housework. You may also be told not to drive.

Some other treatments, particularly radiotherapy and chemotherapy, can make you very tired.

You may need to take a break from some of your normal activities for a while. Don't be afraid to ask for practical help from family and friends.

Follow-up

After your treatment has finished, you'll be invited for regular check-ups.

If you've had early breast cancer, your healthcare team will agree a care plan with you after your treatment has finished.

This plan contains the details of your follow-up. You'll be informed of the plan, which will also be sent to your GP.

During the check-up, your doctor will examine you and you will be offered a mammogram every year for the first 5 years after your treatment.

Long-term complications

Although it's rare, your treatment for breast cancer may cause new problems, such as:

• pain and stiffness may occur in your arms and shoulders after surgery. The skin in these areas may be tight
• a build-up of excess lymph fluid that causes swelling (lymphoedema). This may occur if surgery or radiotherapy damages the lymphatic drainage system in the armpit

Talk to your healthcare team if you experience these or any other long-term effects of treatment.

Your body and breasts after treatment

Dealing with changes to your body

A diagnosis of breast cancer may change how you think about your body. All women react differently to the changes that happen as a result of breast cancer treatment.

Some women react positively, but others find it more difficult to cope. It's important to give yourself time to come to terms with any changes to your body.

Early menopause

Most cases of breast cancer occur in women over 50 who have experienced the menopause. Some younger women have to cope with an early menopause brought on by cancer treatment.

Symptoms can include:

• hot flushes
• vaginal dryness
• loss of sexual desire

Talk to your healthcare team about any symptoms you have and they'll be able to help.

Prosthesis

An external breast prosthesis is an artificial breast. It can be worn inside your bra to replace the volume of the breast that's been removed.

After a mastectomy, you'll be given a lightweight foam breast to wear until the area affected by surgery or radiotherapy has healed.

After it's healed, you'll be offered a silicone prosthesis. Prostheses come in many different shapes and sizes, and you should be able to find one that suits you.

Reconstruction

If you didn't have breast reconstruction carried out when you had a mastectomy, you may be able to have one later. This is called a delayed reconstruction.

There are 2 main methods of breast reconstruction:

• reconstruction using your own tissue
• reconstruction using an implant

The type that's most suitable for you will depend on many factors. These will include the treatment you've had, any ongoing treatment, the size of your breasts and your general health. Talk to your surgeon about which reconstruction is suitable for you.

Relationships and sex

Relationships with friends and family

It's not always easy to talk about cancer, either for you or your family and friends. You may sense that some people feel awkward around you or avoid you.

Being open about how you feel and what your family and friends can do to help may put them at ease. However, don't be afraid to tell them that you need some time to yourself if that's what you need.

Your sex life

Breast cancer and its treatment can affect your sex life. It's common for women to lose interest in sex after breast cancer treatment.

Your treatment may leave you feeling very tired. You may feel shocked, confused or depressed about being diagnosed with cancer.

You may be upset by the changes to your body, or grieve the loss of your breast(s) or, in some cases, fertility.

It's understandable that you may not feel like having sex while coping with all this. Try to share your feelings with your partner.

If you have problems with sex that aren't getting better with time, speak to a counsellor or sex therapist.

Talk to other people

Your GP, nurse or cancer specialist may be able to answer any questions you have about your cancer or treatment.

You may find it helpful to talk to a trained counsellor or psychologist, or someone at a specialist helpline. Your GP surgery will have information on these.

Some people find it helpful to talk to other people who have breast cancer. This could be at a local support group or on an internet chatroom.

There is a lot of help available if you need it. Just ask.