Mental health
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Breast cancer is a serious challenge that turns a person's life upside down. It disrupts their natural rhythm and feeds the fear of death. It changes daily routines, priorities, future plans, the way of thinking, and how one interacts with others. During treatment, many women stop working, isolate themselves at home, avoid meeting even friends, and only leave the house to visit the hospital.

The diagnosis can involve different therapies for each person, but the common experience is a long treatment process, physical pain, stress, uncertainty, and fatigue.

When treatment ends, the time comes to return to active life – going back to work, resuming social contacts, and taking on family responsibilities. This sounds both so desirable and so frightening. Our personal expectations and those of society are to return to a normal way of life, but often, the long period of focusing on the illness has created many barriers: "I want to, but I can't," "I should, but I don't know how," "Is it even worth trying?"

After the relief of finishing treatment, a prolonged transition often follows in the search for a new normal. You might be asking yourself, "It's great that I'm going back to the old normal, but am I ‘normal’ like before?" The shift in perspective on life and the search for a new normal is a journey that takes time, and this time is different for everyone.

Treatment has ended, and you are probably physically ready to return to active life, but mentally, there may be barriers that make this seem difficult or even impossible. Unlike the body, which starts to recover and strengthen, the mind has had to be "strong," and now it begins to "relax." Often, the emotional impact of the diagnosis and treatment continues for years after the therapies end.

In the following sections, we will look at the internal resistances that prevent us from returning to the desired previous rhythm and how to overcome them. We will discuss how different responsibilities and expectations can feed our anxiety and explore ways to manage it.

EMOTIONS ON THE THRESHOLD OF THE "KINGDOM OF THE HEALTHY"

Susan Sontag once said, “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”

What happens to a person who is now returning from the kingdom of the sick?

You hear that the illness is gone. Everyone around you is happy and seems to return to their normal lives, but inside you, there remains a constant anxiety, wondering if you will be able to move forward and if the illness will come back again.

The natural reaction after finishing treatment is to be filled with mixed emotions. There is relief that the illness is gone and that you can return to your previous rhythm, but at the same time, anxiety about the unknown increases.

Until now, your body has been weak, requiring care, while your mind had to be "strong and resilient" to endure what you've been through. Now, as your body strengthens, your mind allows all the emotions it had held back, such as fear, anxiety, and sadness, to surface.

The strong concern here is whether the future will be filled with uncertainty and worry, demanding constant attention to your health, or whether it will be a fulfilling life filled with confidence, joy, and plans for the future.

After completing active treatment, it is normal to feel a range of emotions, from relief and happiness to fear and depression.

It is completely normal to feel the following after the end of treatment:

Relief that the treatment is successfully completed;
Hope for the future;
Happiness about returning to your usual daily routine;
Loneliness because people may not understand what you've been through and are still going through;
Fear that cancer might return;
Anxiety before check-ups or test results;
Uncertainty about the future;
Pressure from family and friends who expect you to be the same as before;
Worries about the side effects of treatment;
Concerns about family finances and returning to work;
Lack of confidence due to changes in your body and decreased sexual desire;
Increased emotional sensitivity – for example, you might start reacting overly emotionally, even when someone simply asks, "How are you?";
Anger – you might feel angry about what you’ve been through and how it has affected your life.

Acknowledging how you feel can help you overcome your emotions. It is important to balance your positive expectations for long-term remission with the reality that you still fear the illness.

Try to manage stress in these moments by:

Accepting that it’s normal to have many strong emotions;
Trying to analyze where they come from, why now, and what they are trying to tell you;
Allowing yourself to talk freely about your emotions, sharing your fears and hopes with close friends and family. Studies show that patients who openly express their fears and emotions related to the illness tend to adapt more quickly and effectively to the new situation and continue their lives fully.
Seeking psychological support from a specialist.

Cancer will always be in your mind, but your most important task is not to let it control you. Key to a successful return to the "kingdom of the healthy" are your attitudes and beliefs, as well as the understanding and support of your loved ones.

EXITING THE "PATIENT ROLE"

From the moment of diagnosis to remission, you have been in the "patient role." This role is directly connected to survival: accepting the diagnosis, following the treatment plan, overcoming the side effects of therapy, and so on. With the completion of treatment, you will need to leave behind your role as a patient and the hospital routines that have been a part of your daily life. From now on, you have a new task: to gradually distance yourself from the patient role so that you can recover socially and emotionally.

Exiting the "patient role" is a process, and it is possible that you will continue to feel uncertain, anxious, and even a desire to remain in this role, finding it difficult to meet the expectations of your loved ones.

After active treatment ends, the mandatory hospital visits and medical check-ups decrease. This might create feelings of insecurity or abandonment. Previously, you had the medical team available almost daily to answer your concerns. Now, months might pass without visiting the hospital, but those same concerns remain and weigh on your mind. To cope with this, try to take charge of your health care again. Talk to your oncologist about the follow-up care plan, the various routine exams and tests you will need over time, the potential side effects of therapies, and how to manage them. Being well-informed will allow you to feel in control and help you be less dependent on your past diagnosis.

In turn, this sense of insecurity might provoke a need for constant reassurance that the cancer has not returned. You may feel the urge to continually check various indicators or undergo numerous tests that have not been prescribed by your medical team. This can fixate your thoughts solely on the risks and dangers that might occur, thereby increasing your anxiety. It’s important, and enough, to follow your follow-up care plan and trust your doctors, just as you did during treatment. This will allow you to focus on things beyond the illness and return to a new normal.

It is possible that, for a long time, every visit to the doctor or every test you undergo will pull you back into the "patient role" because they will bring back memories and fears. In such moments, it is helpful to "acknowledge" the emotion and give it the right to exist ("It's normal to be afraid; I went through a lot of painful things..."), but not to let it control you ("I'm going to the doctor to hear good news. I will worry afterward if there’s a reason to.").

It’s very likely that your family, friends, and colleagues will try to speed up the process of you leaving the patient role. The pressure they may put on you comes from their own desire to distance themselves from everything related to the illness and to have everything return to normal as quickly as possible. It’s important to listen to your own feelings and give yourself time. You can talk to your loved ones, share how they make you feel, and explain how they can support you by respecting your pace.

No one wants to get sick, so the "patient role" is not a voluntarily chosen one but rather imposed by the onset of the illness. However, how you choose to emotionally relate to it is entirely up to you. In psychology, there is an exercise where a patient is shown a white sheet of paper with a dot on it. The question is, "What do you see?" You would probably spontaneously answer "a dot," and you wouldn’t be wrong, but you would have missed the entire sheet. When we fixate on just one thing in our life, like the illness, we miss everything else and, most importantly, the opportunity to live life fully.

"REASSURING" MESSAGES

The messages we send to ourselves or hear from others during and after treatment are meant to reassure us, but they often have the opposite effect. Here are some of them and how to counteract them:

"Forget about it, it's over!" Forgetting something that has happened to you is like accepting that a part of your life didn't exist. Denial prevents us from processing the fear, which continues to smolder in our subconscious, acting as a barrier to moving forward. It's important not to forget but to accept that the illness, like everything else you've experienced, is a part of your life, but it is now in the past. All that matters is the present, so our advice is to try to live without the shadow of the past, making room for the future.

"Everything will be just like before!" Some things may happen as they did before, but you are no longer your "old self." You've gained new experiences, new knowledge, and new insights. Allow yourself to change the old patterns and to be who you are, as you feel and experience life in this moment.

"Be strong!" This phrase accompanies anyone going through a difficult time. The message it carries places a heavy burden on the person receiving it: you don't have the right to be weak. You have to be tough. But why do you have to? This is the expectation of others, not your own. Perhaps at this moment, you need to be weak—to express or even cry out your fears. Only you can decide when and how you want to be.

"Don't think about it, what will be, will be; It's not a big deal, it happens to many people." This type of message directly downplays your emotions, worries, and experiences. It suggests that what is happening to you is not important and that you don't have the right to talk about it. It may not even be expressed in words; it could be enough for the person you're sharing with to go silent or start crying. The feeling of being forbidden to express your emotions is unfortunately part of the suffering. That's why it's important to explain to your loved ones and friends what in their behavior or words upsets you or makes you feel insecure, and what kind of reaction you need from them.

"Well, at least it's this; it could have been worse." Fantasizing about how things could be worse only fuels your fears. During the treatment period and afterward, it's difficult to control what happens to you, and anxious thoughts can take over as "the boss." There's a saying that things could always be worse, but they could also be better. So, your task is to focus on what you can do to feel good more often.

"Don't worry, everything will be fine!" There’s a story about a surgeon who begins an operation and says, "Don't worry, Ivan!" The patient nervously replies that his name isn't Ivan. The doctor responds that he knows and that he was talking to himself. The message "don't worry" is often directed at the person saying it. Most likely, the person telling you this is feeling insecure at the moment, not realizing that if you could be calm, you wouldn't need to share your worries. In such a situation, you can turn and say, "I'm not calm; I'm sad, and I need you to listen and understand me."

MANAGING THE "EMOTIONAL TORNADO"

Remission can be just as frightening as the diagnosis itself. During treatment, you have a goal, direction, and the care of a medical team. When you enter remission, you suddenly realize that the goal has been achieved, but the fears haven't disappeared.

After treatment ends, there follows a long period of adaptation, filled with many different emotions. What are they, and how can we deal with them?

Fear

Receiving an oncological diagnosis understandably intensifies all our fears, especially the fear of death. Most likely, after hearing the words "you have cancer," you were faced with a whole array of fears—fear of death, fear of the unknown, fear of pain, fear of how your loved ones would handle your diagnosis, and more.

After treatment ends, it's normal for some fears to subside, but new ones may arise—fear of recurrence, fear of any new pain, fear of how you will continue your life, and so on.

Experiencing fear is completely normal; accept that it is part of your emotions, and there's no need to blame yourself for feeling it. Your task here is to not let fear control your life.

Coping with Fear:

Face Your Fears: The natural reaction when experiencing fear is to "hide" and wait for it to go away on its own. Instead, try to confront your fears. Start exploring them: Ask yourself, where does this fear come from? What is it connected to? What triggers it? What’s the worst that could happen? Is there anything you can do about it? When you face your fear and analyze it, you may discover that it’s not as terrifying as you thought.
Distract Your Mind: When you feel that fear is taking over, try to distract your thoughts by engaging in some activity. For example, take a short walk around the neighborhood, make yourself a cup of tea, take a shower, or do something else to divert your attention from the fear.
Set "Office Hours" for Scary Thoughts: Fear has a way of consuming you and making you feel like there’s nothing else in your life. Trying to avoid scary thoughts might even intensify them and make them more persistent. Try managing your thoughts like you manage your daily schedule. Don’t wait for scary thoughts to invade your mind; instead, set "office hours" for them. Choose a short period during the day to "talk" with your fears, like a boss with an employee. Once the time is up, you can say to yourself, "The workday is over! Now I’m going to focus on something else." If scary thoughts intrude at other times, remind yourself that you’ve set "office hours" for them. This way, whenever they start creeping in, you’ll be able to control them—"You’re off duty now!"
Learn to Manage Panic: Prolonged stress and fear can lead to severe anxiety, which might escalate into a panic attack. Typical symptoms include a rapid heartbeat, sweaty palms, and shortness of breath, making it feel impossible to catch your breath. It's important to know that these symptoms are a normal physiological reaction to fear. If you experience this for the first time, you might think it's life-threatening. Many people mistake panic attack symptoms for serious conditions like a heart attack, but panic attacks are not life-threatening. They usually pass within a few minutes, but in some cases, they can last longer. Here are a few techniques you can use in such moments:some text
- Place your hand on your stomach and start breathing slowly and deeply. Focus on your inhalation and exhalation.
- Close your eyes and imagine a favorite or peaceful place, trying to feel it with all your senses—how it looks, how it smells, what you hear, what you feel.
- Begin repeating short positive phrases to yourself, either silently or aloud, to change your negative inner voice. For example: "I am calm and in control," "This feeling is passing," or "I am safe. I am feeling better now."

You can find more practices like these online. Panic attacks are scary, but with the right preparation and practice, you can learn to manage them more effectively and quickly.

Focus on the Positive: Staying in the negative feeds fears—whether real or not. This puts you in self-destruct mode. Try to keep your attention more often on the positive aspects of your life, on what brings you peace, joy, satisfaction, and a smile. This will help you switch to self-healing mode.‍
Seek Professional Help: You can always seek specialized help from a psychologist or psychotherapist.

Anxiety and Stress

After treatment ends, it’s normal to feel anxious or stressed. Anxiety is an emotion characterized by a vague, free-floating fear directed towards the future. Anxiety and stress can make you feel nervous, worried, tense, and irritable. It's important to know that prolonged anxiety and stress can lead to depression.

In some cases, anxiety can become so overwhelming that it leads to panic attacks, causing additional fear and worry. When you’re experiencing anxiety, you might feel like you’re reliving unpleasant moments from the past repeatedly, feel detached from reality, or experience emotional numbness.

Physical signs of anxiety and stress can include changes in appetite, nausea, acid reflux, diarrhea, sleep disturbances, muscle weakness, chest tightness, a rapid heartbeat, and difficulty concentrating. If you remain in these states for too long, you may start to perceive future fears as real and present dangers.

There are various ways to reduce anxiety and stress. Here are some of them:

Engage in enjoyable activities: Hobbies, sports, reading novels, or other interests can distract you from negative thoughts.
Learn relaxation techniques: Practice relaxation, positive visualization, and meditation techniques. Use them individually or together to reduce stress and tension, relaxing both your mind and body.
Organize your time: Prioritize your tasks by importance. If you don’t have time to do everything, focus on the most important tasks on your list. You can always break down large tasks into smaller ones. For example, don’t clean the entire house at once; do it room by room on different days. Seek help with tasks you can’t handle on your own.‍
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Focus on things you can control: Stress can stem from something you can’t change or control, even with the best plan in place. An example of this is city traffic. People who are flexible and adapt easily experience less stress. The only aspect of a problem you can control is your reaction to it. By managing your reaction, you can conserve energy for more important things.

Sadness and Depression

Sadness arises from feelings of discouragement, leading to a sense of helplessness, despair, and pessimism. On the one hand, you may wish for everything to return to normal as quickly as possible, but at the same time, you might feel powerless and lack the desire to move forward. Dreams, plans, and the future may seem uncertain. Everyone has episodes of sadness, and it’s normal to allow yourself to feel it, but it’s important not to dwell in this feeling for too long.

Coping with Sadness:

Redirect your attention: Focus on activities and pleasant experiences that can dilute the intensity of sadness, such as taking walks, listening to music, or engaging in sports.
Practice deep breathing and relaxation exercises: These can help you relax.‍
Seek support: Join support groups or consult with a psychologist.

Prolonged or intense periods of sadness and the accompanying emotions can lead to depression. Depression is common among cancer patients and their loved ones. Depression can be mild and temporary, with periods of sadness, or it can be more severe and long-lasting. The more severe type is known as clinical depression. It hinders daily functioning and requires action.

Signs and symptoms that might indicate you need professional help include:

Feeling sad every day and finding no meaning in anything.
Losing interest and pleasure in activities, hobbies, or social interactions that used to bring you joy.
Experiencing sudden changes in weight—either weight loss without dieting or weight gain.
Poor sleep quality—insomnia, difficulty falling asleep, interrupted sleep, or constant fatigue and a desire to sleep.
Feeling guilty, helpless, and hopeless.
Difficulty concentrating and making decisions.
Mood swings ranging from depressive thoughts to states of euphoria, happiness, and energy, or long-term dwelling on dark thoughts.
Frequent thoughts of death or suicide.

In addition to working with a psychotherapist, some people with these symptoms may need to consult a psychiatrist who can prescribe medication to help overcome this condition.

Guilt

Guilt arises from the feeling that you haven’t done your best for yourself or others. It’s an emotion that attempts to repair the damage we believe we’ve caused. Guilt can lead people to replay "what if" and "if only" scenarios in their minds, trying to figure out how they could have done things differently. During or after treatment, guilt may manifest as “punishing thoughts” like: “I caused my cancer,” “I’m responsible for my loved ones’ suffering,” or “I feel guilty that my treatment was successful while others weren’t so fortunate.” Guilt can make you feel inferior and create a perception that you are not a good person.

Coping with Guilt:

Accept that the past cannot be changed.
Remind yourself that no one is perfect.
Learn to forgive yourself and grow from your mistakes.
Join a support group. This will allow you to connect with other women in the same situation who have experienced similar feelings. Specialists in these groups can help you discover your inner resources and develop coping mechanisms.

Loneliness and Isolation

Loneliness and isolation are common feelings among those who have survived cancer. The diagnosis can make people feel misunderstood, different, and pitied. You may develop the belief that only you truly understand what you’re going through, and that talking about it isn’t necessary because it would burden others or because no one else truly understands. These feelings can persist even after treatment ends. If you stay in a state of loneliness and isolation for too long, it can lead to ongoing emotions like sadness and guilt, which could result in depression.

Feeding the Feeling of Loneliness:

In the remission stage, others expect you to be well, active, sociable, and smiling, but often you may not be able to meet these expectations or even share how you truly feel. Prolonged periods of inadequate communication with others and withdrawing into yourself can lead to isolation and a sense of loneliness.
Your rhythm differs from that of others, which can make you feel weak, guilty, and unwell, leading you to retreat into your personal world where you feel familiar, protected, and in control.
Loneliness is fueled by the feeling that you will never be the same again.
Loneliness also arises when there is a lack of intimacy in your relationship with your partner.

Coping with Loneliness and Isolation:

Recognize that it’s normal for your “self” (the idea you have of yourself) to change. After treatment, you inevitably live with some changes in your body that affect how you perceive yourself. It’s important to acknowledge and accept these changes so that they don’t become a reason for self-isolation.
Communicating with people who have gone through a cancer diagnosis can give you a different perspective and support your recovery process.
You can also participate in organized support groups to share your experience with others like you, and work together with the psychotherapist who moderates the group. New friendships often form in such groups.

Joy

Joy is a fundamental emotion related to how we perceive the world; it reflects our attitude toward it. Joy fills the body with a sense of vitality and lightness, makes the world seem more colorful, makes future plans feel easily achievable, and brings a smile to your face. Joy gives energy and is the fuel we need to keep moving forward.

But what is joy doing among emotions that are difficult to manage? Isn’t joy exactly what you’ve been fighting to feel from the moment of diagnosis until now? Feelings and sensations like joy, happiness, and calm are highly desirable but often feel “forbidden.” They are often accompanied by messages like “Too good to be true.” You might feel an "inner prohibition" to feel joy, fearing that after a brief moment of happiness, a wave of negative emotions will overwhelm you, or that by experiencing joy, you might somehow invite something bad to happen.

Allow Yourself to Feel Joy:

Become a seeker of joy. Remind yourself what joy is. How do you carry it within you? What kind of joy are you seeking? What does it look like? Where can you find it?
Allow yourself to feel joy without believing that it magically brings bad events. Both good and bad things simply happen. Whether you are happy or sad does not determine this process. On the contrary, the ability to experience joy helps you navigate difficulties more easily.

Anger

Many patients living with cancer experience anger. This emotion often arises when the diagnosis is first given, but it can also persist after treatment has ended. Anger may be triggered by the challenges you've faced, the way cancer has changed your life, or the reactions of family members and friends. Anger is a natural emotional response to reality, so you should not feel guilty about feeling angry. Anger itself is not bad, but it needs to be expressed in a healthy way, as it can sometimes cause harm to those around you and to yourself, potentially leading to depression and other issues. When expressed constructively, anger can expand our comfort zone and make us more confident.

Coping with Anger:

Consider what other feelings might be hiding behind your anger. Some people find it easier to express anger than to face other emotions like fear or sadness.
Channel your anger physically. The need to shout and hit is common in anger. Do this in a safe way—use a pillow, punch it, or shout into it to muffle the sound.
Seek professional help from a psychologist to uncover the underlying causes of your anger and develop strategies to manage it effectively.

Envy

Envy is a socially oriented form of anger that everyone experiences at some point. It’s the desire to have what others possess. In Bulgarian culture, this emotion is often associated with shame: "How can you be envious? You're such a good person!" We are ingrained with the idea that we should hide this emotion, which only amplifies the suffering it causes.

Envy may be an emotional response to your personal fears, to the feeling that your diagnosis has taken a lot from you and could take even more.

Coping with Envy:

Recognize that envy often arises unexpectedly from seemingly harmless situations. Thoughts may flash through your mind that sound harsh or bitter, followed by feelings of guilt. Try to break this vicious cycle by understanding that these thoughts signal a desire for change. You don't want the other person to be worse off; they simply remind you that you don't feel as well as you'd like. You can change this by doing things that make you feel more feminine (a new hairstyle, makeup, a smile) or more energized (exercise, massage, a walk), and so on.

Body Image and Self-Esteem

Every woman has her own concerns about how her body looks. After the diagnosis and treatment, these concerns are likely to intensify. Even now, when you are in remission, cancer has probably left some visible reminders of what you have been through, with the most noticeable being the scars from surgeries. You may also have gained or lost weight as a side effect of the medications. All of this can lead to disappointment with your body.

To feel good about your body after these changes:

Move from denial ("I refuse to accept that I look like this") to acceptance ("This is my body, and despite everything it has been through, it is still beautiful").
Use the "I love my body" technique. Sit comfortably, close your eyes, and imagine moving from your toes up to your head, telling each part of your body, "I love you."
Try an experiment when you are home alone: stand in front of a mirror without covering your scars. As you look at yourself, repeat aloud, "I accept you." This may be difficult to say and may bring up a lot of emotions, but it will help you accept yourself and reduce the intensity of the negative feelings you may have.
Accept that the physical illness has left its marks, but your femininity is still there and can be expressed.
Take care of your body—exercise, eat moderately, and take advantage of cosmetic and aesthetic procedures (for example, if your eyebrows haven't grown back as before and it bothers you, there are now many options to restore their appearance permanently).
Talk to your partner about how they perceive your body, and you may find that they have no problem with the changes in your body.
If you cannot manage on your own, you can always seek help from a psychologist or psychotherapist.

Remember, the way others perceive you is a reflection of how you perceive yourself.

Family Relationships

Breast cancer is a serious challenge that has undoubtedly affected you emotionally and psychologically, but it has also greatly impacted your entire family. It has affected your partner, your child or children, your parents, and other close relatives. Their concerns have been centered around whether you would survive, how you would respond to treatment, how you would cope with the side effects, and whether there would be any lasting consequences. The usual rhythm of life for everyone has suddenly changed.

Your transition into remission brings relief and hope to your loved ones, signaling a return to the old routine for everyone. The focus is now entirely shifted toward the positive, idealizing a future without cancer. These expectations can quickly crumble because the fear of death or the return of the illness still lingers. This is also the transition to accepting that for everyone, there will now be a "new normal," filled with hope but also with anxiety.

Communication within the family is one of the challenges both during and after therapy. Often, the topic of the illness becomes taboo. Avoiding it creates an illusion that nothing has happened, but this only generates tension in relationships.

There comes a time, however, when the emotions that were carefully avoided during the illness begin to surface and demand to be addressed. You may find yourself wondering whether to share these feelings with your partner or keep them to yourself.

To restore intimacy and ensure that communication within the family is fruitful, it is essential to share and speak openly about your experiences, concerns, and fears.

The Emotions of the Caregiver

Your loved ones, especially those who took on the role of "caregiver," experience emotions similar to yours because, in their own way, they too go through the oncology process. To avoid worrying you during treatment, your loved ones likely put their own feelings, concerns, pains, and joys on the back burner. Now that you are in remission, both you and they may find these emotions surfacing. You can encourage your loved ones to share their feelings.

Strong emotions such as fear, anxiety, guilt, sadness, anger, envy, and shame are part of the transition to a new normal for your loved ones as well. They, like you, may experience moments of intense emotions—ranging from despair to excitement.

Don’t judge yourself because they feel this way. Talk about your emotions, and find different ways to reduce their intensity (shared hobbies, dancing, sports).

During the dynamic times of care, medical appointments, and therapy, your loved ones likely had to play the roles of nurse, psychologist, and social worker. Even after your treatment has ended, it’s normal for some of their "caregiver" habits to persist. This isn’t because they want to remind you that you are a vulnerable patient, but because they still feel, out of habit or fear, that you haven’t fully recovered. Share with them how you would like them to help and in what ways, rather than having them do things for you.

You might be surrounded by "controlling" loved ones who, out of fear that something might happen to you, make decisions on your behalf, thinking they know better what you need. Let them know that you are once again in control of your life and no longer need as much help.

Messages Your Loved Ones Should Hear:

Duties at home, family, and work bring back a sense of normalcy.
I take care of myself. I am resuming my previous hobbies, sports, and social activities.
My well-being depends on me, not on others.

Relationship with Your Partner

With the cancer diagnosis, your relationship with your partner has likely been filled with strong emotions, a different rhythm, and countless unspoken expectations and fears. During the treatment phase, your relationship has already undergone changes, and now, without anyone asking if you have the strength for it, new challenges arise—such as sexual problems, fertility issues, physical limitations, fear of returning to work, financial worries, and more.

If you had problems in your relationship before the diagnosis or during treatment, they are likely still there, "waiting." Typically, the illness acts as a catalyst in the relationship, revealing what’s present and prompting a reevaluation of many aspects of life and personal relationships. Some may decide they no longer want to be in a relationship where they feel unhappy. Others may feel they need the security the relationship provides, even if they don’t feel entirely happy. Still, others may find that the experience has brought them closer to their partner.

Dealing with Communication Difficulties with Your Partner: Couples often struggle to talk about the things that weigh on them. Good communication isn’t easy and doesn’t always happen naturally. It requires time, practice, and effort:

Listen Actively: This means trying to understand what your partner wants to share, rather than thinking about what you should say next. For example, share what you understood from their words to get feedback on their perspective.
Don’t Assume: No matter how well you know someone, you’re not a mind reader. You don’t know what thoughts or feelings they’re harboring. Share what you think, instead of making assumptions. For example, "When you look at your phone while I’m talking, I feel like I’m not important to you."
Avoid "You" Statements: "You said this. You did that." This often comes across as an accusation. Use "I" statements to express your feelings. For example, "I felt really bad when..."
Avoid Criticism, Sarcasm, and Insults.
Avoid Generalizations: "You always..." Focus on the specific situation and what’s making you feel uncomfortable.
Calm Yourself: If you get angry or upset during the conversation, find a way to calm down by taking deep breaths or asking to take a break to avoid confrontation.
Stick to the Topic: Don’t bring up old arguments or stray from the subject of the conversation.
Don’t Expect to Solve Everything in One Conversation: Be prepared to have this kind of conversation again in the future.‍
Consider Talking to a Third Party: It might be helpful for both of you to talk to a third party, such as a psychologist or another neutral person you trust, to help navigate this challenging period.

If you weren’t in a relationship before your diagnosis and are now seeking a partner, it’s a good idea to be prepared for the possibility that you will need to tell them about your cancer, which might be difficult for you. When you feel the time is right to discuss this with a new partner, they may react in different ways. It’s possible they may be initially shocked and need time to adjust to this news. They may have their own fears and concerns about cancer and what it means for them. It’s also possible that your new partner will respond positively to what you’ve been through and understand that it’s now a part of who you are.

Sexuality

Sexual changes are one of the least discussed challenges during and after treatment. In fact, a significant percentage of survivors experience some form of sexual dysfunction, which directly impacts their quality of life and relationships with their partner. A lack of knowledge on this topic and the shame that patients often feel about discussing it are some of the reasons why these issues remain unresolved.

Intimate relationships may suffer for various reasons: some are physiological, related to the illness and its treatment, while others are emotional, linked to body image perceptions after therapies.

A loss of sexual desire is common among women, as they may experience vaginal atrophy and dryness as a side effect of treatment, causing pain during intercourse.

While oncological therapy can sometimes cause sexual changes and difficulties, these problems are often rooted in emotional issues. Unfortunately, concerns about appearance and the scars left by surgery don’t simply disappear when treatment ends. These changes can significantly affect self-esteem and create anxiety about resuming sexual activity. Anxiety and depression can also contribute to a decrease in sexual desire.

In any case, it’s important to talk about and seek solutions to these problems:

Consult with Your Gynecologist: Discuss the physiological discomfort and how it can be managed.
Seek Help from a Sexologist: A specialist can help you overcome psychological barriers.
Talk Openly with Your Partner: Even if it feels strange or difficult, communicate with your partner. They can’t know exactly what you’re going through, but once you explain your concerns, what doesn’t work for you, and what gives you pleasure, they’ll be better able to meet your expectations.
Address Concerns About Body Image: You might avoid sexual contact because you worry your partner doesn’t accept your body. Share your concerns—you may find that your partner is not bothered by what worries you. You can always choose to wear attractive lingerie or a nightgown that covers certain parts of your body, or go to bed before your partner so you don’t have to undress in front of them.
Explore New Erogenous Zones Together: For many women, the breasts are a particularly erogenous zone. If breast stimulation was an important part of your sexual life, the loss of a breast may significantly impact your pleasure during intercourse. Your partner might also feel a sense of loss if touching and looking at your breasts brought them pleasure. Together, you can explore other erogenous zones. Discovering new ways to share erotic moments can add excitement to your sexual life as a couple.

Relationships with Children

Until now, you’ve likely worried not only about your illness but also about its potential impact on your child(ren)’s life and your inability to fully participate in their development. Your natural instinct as a parent is to protect them and do what’s best for them, yet they’ve had to see you sick, weak, and different.

Your illness has probably changed their daily routine as well. There may have been times when they took on the role of "caregiver," noticing the physical and emotional changes in you, which might have caused them to feel sadness or guilt.

Now, after treatment, it’s completely normal for your children to continue feeling anxious and worried, just like everyone else in the family. The need to adapt to a new dynamic with old habits—taking your child to school or daycare, weekend trips, park outings—along with creating new habits, such as time for regular check-ups or personal time for yourself, can also be challenging for the children and may require time.

It’s important for your child to be aware of the changes that are about to happen, regardless of their age. Your child will witness yet another process of adaptation, this time to a new normal, and might feel overwhelmed because they don’t know what is expected of them.

Children are incredibly intuitive; they sense changes in emotions at home and in their parents' behavior. Talk to them about what remission means. They need to receive accurate information and help to process it in their own way. It’s important not only to provide them with information but also to show them your love and reassure them of your readiness to handle the current situation.

If you believe your child is having difficulty adjusting to the new dynamic, don’t hesitate to seek help from a child psychologist.

Social Environment

After experiencing an illness like cancer, it’s likely that your social environment and interactions with others have changed significantly. Cancer may have altered the dynamics within your social circle, leading to changes in behavior from those around you, causing confusion and doubt as you wonder why they act this way. You might find yourself facing social stigma, which means dealing with stereotypes that society often attaches to those who have survived such an illness.

Your disappointment may stem from the gap between your expectations of how someone would react and their actual behavior. Common perceptions often associate cancer survivors with vulnerability, guilt, incapacity, and shame, which can affect how you relate to certain individuals. This may happen without you even realizing it, as these feelings are deeply embedded in our culture. For example, to avoid uncomfortable situations, you might feel the urge to isolate yourself in some way from the surrounding world. This deceptive feeling arises from societal cultural norms, which tend to label those who are different from the majority. In many cases, the stigma surrounding cancer is not intentional but rather a response to cultural, rather than individual, issues.

One strategy for dealing with these stereotypes is to talk openly about the illness without taboos. During this period of your life, you need supportive and encouraging people around you, but that doesn’t mean there won’t be others—those who distance themselves from the illness and, by extension, from you. Keep in mind that everyone has their own reasons, often rooted in personal experiences or fears, that you may not be aware of. They may prefer to keep their distance to protect themselves from the pain associated with illness. This is also a way of avoiding the unsettling realization that cancer can happen to anyone and that no one is immune. Even though cancer is a well-known disease in society, many people are afraid or uncomfortable talking about it. The reasons for this discomfort lie in ignorance: we don’t know how to deal with the pain that accompanies illness, and we don’t know exactly how to offer help and support to someone in need. Understanding the motives behind others' reactions is key to building stable relationships and continuing your journey without carrying feelings of disappointment, misunderstanding, or abandonment.

You may also witness many positive reactions from people you didn’t expect to be so supportive, and you might even expand your circle of friends. Additionally, you could form new friendships with others who have gone through a similar experience, sharing common values. The mutual understanding that comes from a shared experience makes it easier to express emotions without fear of being judged or hurting someone. These relationships can be very positive, both for coping with the illness and for returning to normal life after treatment. However, be cautious of the "contagion effect," where you might internalize others' emotions as your own. Everyone goes through their own process.

To build a comfortable environment and strengthen friendships, it’s important to consider the changes in your value system and priorities that may occur as a result of your cancer experience. These changes will bring about new habits or reactions. It’s a good idea to talk to your friends about your "new normal." This way, you can continue to feel comfortable in your social environment, and the newly established life dynamics won’t be an obstacle for anyone.

Hobbies, Interests, Self-Improvement

As you work to restore your life’s rhythm and adjust to the aftereffects of the illness, it’s time to re-engage with or develop habits that bring you joy, energize you, and help you continue living life to the fullest.

After therapy, one possible reaction is a strong desire to do countless things, to "conquer the world." There are various reasons for this response. During the illness, you likely observed the world from a more passive position than you were accustomed to. You may have stopped working, traveling, seeing friends, or studying. Now, as you recover, you feel the need to prove to yourself that you can. The feeling of being given a second chance might spark a strong desire to actively engage in life, to try to do everything at once to make up for lost time. The pain and fear of death may have led you to reassess life and view it from a different perspective. Perhaps you’ve set new personal challenges for yourself. But don’t forget that your health remains your top priority.

Sports, hobbies, social events, travel, and meeting with friends will help you return to an active life. Gradually, the illness will take on a less significant role in your life, and you’ll have plenty of evidence that you can do more and are getting better at it each day.

Back to Work and Your Emotions

During treatment, many women stop working. Sometimes, they make this decision themselves, while other times they are forced to halt their careers due to their physical condition. Perhaps you were one of these women, and now that treatment is over, it’s time to return to work. While this may be something you eagerly anticipate from an economic, social, and emotional perspective, it can also be a challenge. The fast-paced work environment, which you may have become unaccustomed to, the redistribution of roles within the family, and the attitudes of colleagues are all factors that could make this transition difficult.

We have developed practical resources to help you through this transition, which you can find [here], but for now, let’s talk about the different emotions that may arise, which are completely normal:

Fear of Rejection: Throughout your treatment, your self-esteem may have taken a hit. You might feel apprehensive about how you’ll be perceived due to changes in your body. Most likely, others don’t even notice the changes, and these concerns exist only in your self-perception.
Doubt in Your Own Abilities: Naturally, your long stay at home and shifted focus have distanced you from the work rhythm and habits. You may be doubting whether you’ll be able to handle your work responsibilities as before. It’s normal to worry and to feel like you’ve lost some confidence. Women returning to work after maternity leave often go through similar emotions, even without having faced your ordeal. Remember, your illness does not define your professional skills. Reflect on the tough moments during treatment that you overcame and remind yourself of how strong you are. It’s completely normal to need time to get back into the specifics of your job and to regain your confidence—give yourself that time.
Confusion About Your Career Path: The illness likely caused you to rethink many aspects of your life, and your career path might be one of them. You may feel confused—should you return to your old job, look for a new one, or even change your career direction entirely? Give yourself time and pay special attention to understanding what makes you unhappy and what brings you joy at work. Consider what your previous job/profession offers and what a change might bring. You can always seek help from a career counselor.
Relationships with Colleagues: You may be worried about how your colleagues will react, what your relationships with them will be like, and how you’ll talk about your illness. You might receive a variety of reactions—from unhealthy curiosity, through full acceptance and empathy, to indifference and avoidance. Keep in mind that others’ reactions are heavily influenced by your previous relationships, their subjective understanding of the illness (a conversation about cancer might remind them of their own experience or fears).
The topic of your illness might not be pleasant for you either. It’s up to you how much, if any, of your experience you share. You can plan ahead about how much, what, and with whom you’ll discuss, and prepare phrases to close off the conversation, such as, "That period is behind me, and I don’t want to revisit those emotions," or "We’ve talked enough about the illness, let’s talk about something pleasant."
You might also encounter excessive care from colleagues, which could make you feel inadequate. Talk to your management and team about how you’re feeling and what workload you’re ready to take on.
No matter how well you know your colleagues, you probably can’t predict everyone’s reactions. You’ll only find out when you return to work, but running through anxious scenarios in your head beforehand can only lead to more stress.‍
Pressure from Family: Your family and closest friends have been by your side during treatment, lived through the fear of losing you, and may now, in their continued effort to protect you, want you to stay home a bit longer. Alternatively, in their desire to distance you from the illness, they might push you to return to work before you’re ready. It’s important to listen to your own rhythm and desires. Talk to your loved ones about the decision you’ve made, and discuss the new distribution of roles in the family according to your abilities.

Our professional success is often a key part of our identity and one of the things that give us a sense of purpose. Therefore, returning to work can help you distance yourself from the memories of your illness, regain your self-confidence, and give you new positive experiences.

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Accepting that treatment is over and that you’re back to normal life is just as challenging as accepting that you were ill. Now that you know what it’s like to be sick, you understand the value of being healthy. Continue living your life, enjoy your roles as a partner, mother, daughter, and worker. Embrace yourself as a healthy person who is moving forward, has the right to be happy, to travel, to take care of yourself and others. The fear may still visit you, but you now know how to welcome it without letting it control your life.