The Impact of a Breast Cancer Diagnosis
©Nancy Davis Ph.D. (2009; 2013)
Although breast cancer is the most frequently diagnosed cancer in U.S. women, with over 212,000 invasive cases expected each year, it is only the second leading cause of cancer deaths. Lung cancer claims the lives of over 70,000 women each year; while 39,800 deaths are projected annually from breast cancer. Heart disease, not cancer, is the leading cause of death in U.S. women, causing between 350,000 – 500,000 deaths a year. Despite this rather substantial disparity between the number of deaths from heart disease and breast cancer, it is reported that “significantly more women fear breast cancer over heart disease” (Morales, 2003)
Some professionals who work with heart disease patients have asserted that this fear is misguided, and it simply based on a lack of information. It is, however, more likely not a lack of information, but information related to these women from their relatives or friends who have lived with breast cancer and its treatment which makes them more fearful of this disease.
Mortality: When a suspicious spot in her breast becomes the basis for additional tests to determine if she has breast cancer, a woman’s sense of her own mortality begins to emerge. If the tests reveal malignant cells, her life view is even further altered. Although most people recognize and accept, at least on an intellectual level, that death is part of the natural cycle of life, when one is advised they have a potentially fatal disease, it suddenly becomes a jarring reality.
Decision making: She begins to face the first of many life-altering choices, beginning with the decisions about which doctors will treat her. Breast cancer treatment typically involves a number of physicians: a primary care doctor, possibly a gynecologist, surgeons, radiologists and chemotherapy specialists (hematologists). These doctors often have offices in different locations. Multiple and time consuming appointments often become a regular part of her life.
Some women respond to a diagnosis of breast cancer by searching for as much information as possible. In doing this, she may become very educated as to the treatments with the most favorable outcomes and other valuable information about the treatments. However, she also is likely to learn of the sometimes frightening side effects of these treatments, as well what are often rather cold and clinical prognosis for woman diagnosed with each type and stage of breast cancer. Other women may respond by refusing to research anything, leaving the choice of doctors and treatments to relatives, trusted friends or largely to their physicians.
Her doctors may ask her to choose among a number of treatments depending on the type of breast cancer she has and the stage of the cancer. For example, she may be asked to choose between having a complete mastectomy or removing the cancer cells and tissue around the suspicious or cancerous area. If she chooses a mastectomy, she will be asked to decide if her breast should be rebuilt, with the alternative being a flat, scarred area on her chest. She may even have to decide if she wants to have both of her breasts removed to reduce the possibility that cancer will appear at a later time in the breast which is cancer free. She is often given the option of chemotherapy, radiation, surgery or a combination of these treatments. If she chooses chemotherapy, her doctors may review a number of chemotherapy protocols and ask that she decide which of these she wants. “My doctor gave me four different chemotherapy protocols and told me to choose. I had only a very short time period to decide. Even when I reviewed the available information on each treatment, I was aware that those that were the most potent had the greatest side effects and that the choice I made might determine if I lived or died.”
She is also aware that she may be choosing treatments which will leave her exhausted and alter her immune functioning, thus making her venerable to pathogens (bacteria, viruses and fungus). Some treatments may cause her to lose her hair and can lead her to feel as if she has been poisoned. She may find herself suddenly moving from a life of low or medium level of stress to one in which the decisions she is forced to make can be life altering and even lethal.