I just found out I have breast cancer. What should my very first steps be – emotionally, medically, and practically?
Emotionally, have the big picture in mind at all times: That it is a disease that for the large part is treatable and curable.
Medically, consult and follow the recommendations given by your surgeon or oncologist. Avoid delaying the treatment.
Practically, stay healthy. Keep your body in the best shape to undergo treatment, be it surgery or chemotherapy. This means stopping alcohol consumption and smoking. Eat and rest well and try not to fall ill. Wear a mask especially in crowded places.
How do I make sense of the diagnosis and understand what it means for me personally – things like the stage, type, and urgency?
Stage and type gives us an idea of how advanced the disease is and what the future prognosis is like. The later the stage, the more advanced the disease. There are also certain cancer types, such as triple negative breast cancers, that are known to be more aggressive. In general, once breast cancer is diagnosed, it is best not to unnecessarily delay treatment.
What should I know about treatment options and how do I begin deciding between them?
Very often, the first line of treatment is between surgery or chemotherapy. This will depend on a few factors like cancer type, tumour size, and lymph node involvement.
The choice of surgery depends on many factors. Generally, it is between a lumpectomy or a mastectomy. A lumpectomy removes the tumour with a clear margin of normal tissue around it, leaving the rest of the breast behind. A mastectomy aims to remove all of the breast tissue. This can be paired with a reconstruction done at the same surgery.
So which surgery is best? We look at the size of the tumour relative to the volume of the breast, the number of tumours, as well as their location in the same breast, involvement of the overlying skin and the underlying chest wall. There is also the consideration of radiotherapy post-surgery, whether a patient has a genetic mutation related to the breast cancer, lifestyle factors, and patient preferences.
Every woman and every tumour is different, so do take the time to listen carefully to what your doctor has to say and take some time to consider what surgery you would be most comfortable with.
How can patients cope mentally and emotionally in the early days?
Remember very importantly that breast cancer very often is no longer a death sentence and does not always mean losing your breast.
It is normal to fear, question, and to feel lost and overwhelmed. Allow yourself the time and space, tears and tissues, to acknowledge and process these thoughts and feelings alongside making the medical decisions. If you are able to share these with confidantes, it will be a helpful part of the journey. And then, pick yourself up and carry on with treatment.
During the decision making consultations, it is always helpful to have another trusted person who can help remember what is discussed during the consultations and see another point of view. This can be a spouse, family member, or close friend. Even silent support means volumes.
(Related: Staying fit, wherever you are)
What kind of support network should I try to build and where can I find it?
Personal networks are important – spouse, siblings, besties, friends.
Look to other women who have been through a similar diagnosis, especially those who have undergone the same type of treatment and are in the same stage of life. They would be the ones who understand best what you are going through. These can be found through fellow patients and many support networks, such as the Breast Cancer Foundation and the Singapore Cancer Society.
Also look out for support for the spouse and caregivers. This is important and often overlooked. Professional help in the form of trained counsellors or psychologists are especially helpful when the situation becomes overwhelming.
What does life look like after treatment ends? How should I prepare for the long-term journey ahead?
Life looks precious! It may not necessarily return to what it was before treatment, but many times for the better. The silver lining is that it is often a wake-up call. Many patients tell of how there is often a shift of priorities to the things that truly matter in life: Family, health, better diet, and exercise.
Medically, there will be regular long-term surveillance every few months, in the form of consultations with the doctor, blood tests, and breast imaging. There will always be the niggling fear and stress of a recurrence, but your doctor will be vigilant, and so will you, in your regular self-checks and body awareness. That aside – live well. And when you are ready, reach out to another newly diagnosed patient, because you would be in the best position to be that support.
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