• Life following treatment for breast cancer can present new and unexpected challenges, including physical side effects that can linger.
• Rates of depression and anxiety are higher among people who survived breast cancer than in the general population.
• Many people find that they have to make significant lifestyle changes following breast cancer treatment, including adjusting their diets or quitting smoking.

The overall five-year survival rate for all stages of breast cancer in the U.S. is now at 90 percent. Moreover, 75 percent of individuals with HER2-positive breast cancer live for at least 10 years. In 2019, there were 3.8 million breast cancer survivors living in the United States. If you’re among them, there’s a lot to celebrate, but there may also be challenges ahead.

Enduring a cancer diagnosis and subsequent treatment can be emotionally and physically draining. Some people anticipate that once they’ve successfully finishing cancer treatment, their lives will resume as normal. However, many find that lingering physical and emotional side effects create new issues and concerns that they might not have anticipated.

For this reason, it is good to be prepared for what your new normal might look like following treatment and to know what options are available to help improve your quality of life.

Long-Term Physical Side Effects

The combination of screening, chemotherapy, targeted therapy, radiation therapy, and surgery has significantly increased breast cancer survivorship rates over the past decade. However, this treatment combination can also cause both long-term and delayed side effects that can lead to health issues down the road.

According to Johns Hopkins Medicine, these side effects may include:

• Problems with memory and thinking, sometimes referred to as “chemo brain”
• Pain and numbness
• Problems with bone health (osteoporosis and bone loss)
• Infertility
• Difficulties with sex
• Blood clots
• Fatigue
• Headaches
• Cataracts
• Heart problems

MyBCTeam members often talk about the side effects they face due to breast cancer treatment. “Chemo brain is real! Be kind and patient with yourself,” one member wrote. Another said, “Fatigue is a daily battle.”

Learn some techniques for managing fatigue that comes with breast cancer.

If you no longer see an oncologist regularly, it is important to establish a good relationship with a primary care doctor who can help you identify, treat, and manage any medical issues that develop as a result of cancer treatment.

Emotional Side Effects

For many people, breast cancer treatment also takes an emotional toll. One study found that breast cancer survivors in the United Kingdom faced significantly higher depression and anxiety rates at three years following diagnosis compared to those who didn’t have cancer.

Anxiety and Depression

The sooner you recognize anxiety and depression symptoms after finishing breast cancer treatment, the more quickly you can get the necessary help to improve your quality of life and promote healing.

Anxiety produces constant feelings of fear, nervousness, and worry. Living on the edge with anxiety can alter the way you live your day-to-day life. Facing metastatic breast cancer can provoke anxiety related to concerns about the future. It’s important to acknowledge those feelings and to seek help from friends, family, your health care team, and a support network.

“I have been dealing with metastatic breast cancer for three years and three months,” one MyBCTeam member wrote. “I live in the moment and do not think much about the future (advice from my therapist).”

Common causes of anxiety among people with cancer include:

• Fear of cancer recurrence
• Uncertainty about the future
• Fear of death
• Lack of support
• Relationship changes

Breast cancer survivors are also at a high risk of depression. Depression is a mood disorder that is different from normal sadness and anxiety, and symptoms typically last longer than two weeks. Common symptoms of depression include:

• Loss of interest in activities you typically enjoy
• Appetite changes
• Too much or too little sleep
• Poor concentration
• Feelings of hopelessness and worthlessness

The good news is that anxiety and depression symptoms are treatable, usually through talk therapy, medication, or a combination of both. As one MyBCTeam member shared, “I have found a therapist and so far, so good.”

If you’re experiencing symptoms of depression or anxiety, reach out to your health care team or a mental health professional. Help is available, and you are not alone.

Learn techniques for reducing the stress that can come with metastatic breast cancer.

Survivor’s Guilt

People who recover from an illness or accident that others have died from can lead to what is known as survivor’s guilt. This is a common emotional challenge for many people living with breast cancer.

Coping with survivor’s guilt can be a long process. Experts have suggested that feelings of guilt can be a way to shield us from feeling powerless or helpless, as guilt is something we feel we can control.

Identifying feelings of guilt is the first step to emotional healing. Actions you can take to help diffuse negative emotions include:

• Finding a support group, either locally or online
• Giving back to your community or volunteering for a cancer organization
• Talking with your friends and family about how you are feeling
• Allowing yourself the time to grieve
• Finding a stress reliever
• Seeking help from a mental health professional

“Does anyone suffer from survivor’s guilt?” one member of MyBCTeam wrote. Another replied, “I felt like that for a long while. I had a friend who was battling cancer at the same time as me but she wasn’t as lucky. The ‘big C’ got into her bones and she died a few months ago.”

Body Image

The side effects from breast cancer treatment can also lead to both temporary and permanent changes in your appearance. These changes can cause negative perceptions of how you see yourself.

Whether it’s losing your hair or undergoing a full mastectomy, physical changes can have a large impact on how you feel about yourself. They can also raise insecurities about relationships and sexuality. “I really find swimming is helpful,” said one member of MyBCTeam. “I feel OK in the water, but I’m self-conscious in the dressing and shower room. I really need privacy.”

Talking with your health care team, friends, and family members, as well as other cancer survivors, can help empower you to feel confident and improve your self-esteem.

Lifestyle Changes

After their initial breast cancer diagnosis and treatment, many people realize that they’ll have to make significant changes to their lifestyle to remain emotionally and physically healthy.

Studies have shown a link between certain lifestyle factors and breast cancer mortality rates, including:

• Weight management — Weight gain can increase rates of recurrence.
• Exercise — Regular physical activity can reduce mortality by around 40 percent. Health care professionals recommend at least 150 minutes of physical activity per week.
• Diet — Saturated fat is linked to increases in mortality.
• Smoking — Those who quit smoking have higher survival rates.

Lifestyle changes are highly individual, and what works for one person may not work for another. Choosing positive changes that work for you is the best way to combat the emotional and physical side effects that you may encounter following breast cancer treatment.

Learn more about healthy lifestyle changes and metastatic breast cancer.

While healthy lifestyle changes are important, keep in mind that having some things stay the same may also be important. If you have favorite hobbies, for instance, you may benefit from keeping them as part of your routine. A MyBCTeam member shared, “I find that if I force myself to do just one thing that brings me a part of who I was, then at least some normalcy will follow.”

You’re Not Alone

MyBCTeam is the social network for people with breast cancer, survivors, and their loved ones. More than 56,000 members with experience in breast cancer gather to ask questions, give advice, and share their experiences with others who understand.

Are you a breast cancer survivor? What challenges and successes have you faced? Share your experience in the comments below or on MyBCTeam.