Am I going to make it?
We all ask this question, even if only in our minds. The difficult truth, of course, is that no one can give you a guarantee -- not your surgeon, not your oncologist. But you have far better odds than you may think. Most women with breast cancer in the U.S. survive more than five years, the yardstick used by most doctors.
Do a lot of research! Go on the Internet or to the local library. Take notes! You'll feel more in control if you're informed. And it'll help you ask the right questions to get the answers you need from your doctors. Some doctors may not offer to show you your pathology report showing the type of cancer you have and possibly information on how far it has spread. Ask for it! Some doctors may not offer you all the treatment choices. Others may lay out every possible choice, then say the decision is up to you. Either way, you'll feel more confident if you've done your own research.
Also, talk to other survivors. Go on the Internet and visit message boards for breast cancer survivors. Just post the question: Anyone out there who was diagnosed 10 or even 20 years ago? You'll be amazed by all the women who answer you. They can offer you the hope and courage you need now.
How am I going to look after treatment?
The answer depends on what you do.
If you have a mastectomy that is covered by your health insurance, your insurance is required to cover full reconstructive surgery as well. You can even have the plastic surgeon waiting to walk into the operating room the moment your breast surgeon walks out. But you'll have to ask for this; don't expect your doctor or insurer to suggest it! Plastic surgeons can rebuild real looking breasts with implants or with tissue from your own body (like fat and muscle). They can even rebuild the nipple.
If you have a lumpectomy, you may have a small dimple in your breast -- or a large divot -- it all depends on how much tissue the surgeon removes.
Many women choose no reconstruction. Yes, you'll have a flat chest, but for some women that's no big deal.
There's no right choice here. The important thing is that you do what feels right for you. You can have some good-looking breasts reconstructed. Or you can fit a pad into your bra whenever you feel like it.
Losing your hair may bother you nearly as much as losing your breast! There's just something about seeing clumps of hair falling onto your shoulder that makes it seem like you're really sick. You can also expect to lose eyelashes and brows, nose hair, and pubic hair. Most women cut their hair very short before beginning chemo, so the hair loss isn't so dramatic. Several women on WebMD even shaved our heads, and it felt great. You'll have enough to cry over during these early months of diagnosis without crying about your hair. Once again, there's no right choice -- except to be true to yourself. If your hair is important to you, splurge and buy a terrific wig. If it's not, have fun trying out some stylish turban wraps. And even if you haven't worn much makeup since high school, play around a little! Call the American Cancer Society and sign up for their "Look Good Feel Better" program. They'll hook you up with a volunteer cosmetologist who can teach you how to draw on eyebrows, apply makeup, and wrap turbans.
One last point: Don't be surprised if you gain 10 or 20 pounds during treatment. Most doctors warn you about losing weight because of nausea. But some medications cause you to gain weight, and so do many of the foods that settle your stomach -- mashed potatoes, crackers, etc. Never go on a diet during treatment without talking to your doctor.
Remember, pamper yourself in every way possible. Eat what you want to eat, within reason. Buy what you want to buy to make yourself look good in your eyes. It's important to know yourself, and to give yourself what you need.
What do I tell my kids?
Most women in WebMD's breast cancer community just sat our children down and told them we had breast cancer. We told them we would probably have an operation and chemotherapy, and that we would be sick for awhile, but we were pretty sure we would get better. What you say, of course, depends on how old your children are. But, keep in mind, your children will feel hurt if you exclude them from this part of your life. They want to help. And they'll probably feel a little safer if they're involved.
One woman, a single mother, let her children come to chemotherapy with her, and asked the kids to hold her hands because they felt cold. (Her hands weren't really cold but the kids felt so good about helping!) Most moms expect the kids to help out around the house bit more, or run some errands. Your kids will probably surprise you with their maturity. But they also need to maintain some normalcy in their own lives. It helps if they know the new chores are temporary, and if you arrange for friends to help drive so they don't have to miss practices or rehearsals.
What can I do to lessen my anxiety?
Talk! Chat online! And take anti-anxiety medication if it helps! Find support, perhaps through a formal support group, or counseling, or through your church.
Waiting is one of the worst ordeals you will go through on this journey. Talk with friends, especially other women with breast cancer. Your friends from "before" love you, but they don't really understand. Talking with other survivors can help ward off the worry monster when you're waiting for critical test results. Remember, chat rooms and message boards throughout the Internet never close. The web works 24 hours a day, 7 days a week, and so does the telephone.
Sometimes, talk isn't enough. You shouldn't feel surprised if you feel anxious or depressed; you have good cause. And you shouldn't hesitate to take medication to help you cope. Talk to your doctor first, of course. Some women take an anti-anxiety pill only on the days they go in for test results or a CAT scan. Some take an antidepressant every day. Other women get the "medicine" they need just talking online. Whatever works for you, do it. But don't let anxiety or depression drag you down.
How do I deal with my job?
The Americans with Disabilities Act protects people with cancer from discrimination or layoffs if their company receives any federal funding. Most private employers follow those guidelines. Also, you'll want to check into your options for disability pay, use of sick leave, Social Security benefits, and the Family Medical Leave Act. (See Earning a Living.)
So the main question you need to answer is, what do you want to do about work?
One woman had never liked her job, and her husband was well-employed. After she got her diagnosis, she simply walked into work and quit. Other women liked their jobs and kept working throughout treatment. Still others took a year off despite the financial strain, and then returned to work. Again, spend time getting to know yourself so you'll know what's right for you.
When you tell your boss, be generous with yourself. Overestimate the time off you may need. Ask for a temporary part-time schedule. You can always come roaring back early if you feel good.
There's always some initial awkwardness with co-workers. It helps if your boss or a friendly co-worker tells the others so you don't have to retell your story 100 times! Even so, people are going to want to know how you feel, and you're going to have to deal with that.
Most women on the WebMD message boards who returned to work found that they needed to break the ice so everyone could feel comfortable. Some went back joking. One older woman even asked the younger women, "You want to see?" and off they would troop to the bathroom. Don't forget that every woman fears breast cancer and is curious. Others simply said, "I'm back and I feel OK most days, but please, don't ask me every day. I want to talk about something other than breast cancer."
You might want to use one close co-worker as your town crier. Find someone you're comfortable talking with, fill her (or him) in on the details you want passed along.
What should I expect of my friends?
Some friends are going to feel awkward; others will want to call you every day. You'll need to set the tone: "I want to talk about anything but breast cancer today!" or, "I need someone to cry with."
Many women find that they want to talk about breast cancer with other women who have breast cancer. They create two circles of friends -- fellow survivors, and friends from before. Your best friends love you, but they probably can't understand exactly what you're going through. So let them help in other ways.
Your co-workers may want to donate sick days to you or take up a collection. Your pals may want to bring dinner or drive your kids to soccer practice. Accept their help! You might feel awkward. You probably don't want to impose. But it's important to recognize that people who care about you need to try to help. Let them do something.
How do I deal with insensitive comments?
You'd better brace yourself. No matter how wonderful your friends, family and co-workers are, some of them are bound to say things that drive you crazy!
Imagine a dozen people a day saying, "You look good!" when they see you. (Funny how no one says that if you aren't sick.)
Imagine being asked over and over, "How do you feel?"
And then, of course, there's the relative or friend who may say earnestly, "How long do you have?"
Don't scoff. Many women with breast cancer have heard those lines.
You deal with them in any way that feels right to you. Make a wisecrack. Or, simply say, "You wouldn't believe how insensitive that sounds." Don't worry about being polite. Remember, the insensitive lout probably also cares about you. So use the awkward moment to educate him or her. We'll all thank you for it.