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How To Deal With Self Esteem Issues After Breast Cancer

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For many women with breast cancer, the two biggest concerns are: "Will I survive?" and "What toll will the treatment take on my body?" Women also wonder what toll breast cancer treatments will take on their physical appearance and sex appeal. Dr. Mary Jane Massie, Attending Psychiatrist at Memorial Sloan-Kettering Cancer Center, offers some advice regarding self-esteem issues that often arise during breast cancer treatment.

I'm Lisa Birnbach. For many women with breast cancer, the two biggest concerns are, will I survive? And what kind of toll will treatment take on my body? Or simply put, will I ever feel attractive again?

Joining me to provide some advice on self-esteem issues is Dr. Mary Jane Massie, the psychiatrist who specializes in breast cancer issues at Memorial Sloane-Kettering in New York.

What is the key to accepting your body post breast cancer? Will a woman ever feel sexy again?

Oh, women do feel sexy again. We have a whole group of physicians right now who specialize in sexual issues related to cancer treatments. Gynecologists are increasingly interested in this issue, informed about this issue.

So we have lots of people who are happy to talk through with women their worries about changes in their body, their worries about their sexual performance or functioning.

These issues are pretty well known. And women have opportunities to learn how other women have adjusted and how they can make very useful adaptations with sometimes medication, sometimes thinking through their clothing, that let them live pretty much the lives they were living before.

Now, in terms of a positive outlook, it's sometimes hard to maintain a positive outlook when you're sick. Giving into a sort of crummy day, I feel lousy cancer day-- can that hurt your progress? Can that hurt your healing?

You know, most women ask about that. There's a lot of misunderstanding about mood, bad mood, low mood, and survival in cancer. And what we do know about that is that if we are so discouraged that we can't be compliant with treatment recommendations, that may affect our outcome. But low mood in itself is not going to change our cancer survival.

People often ask, did stress give me cancer? And what we can reassure people is that we do not have evidence that sad mood, low mood, or stress is what causes cancer.

Well, I think it's good that you said that. Because so many women I know who've been through it believe that the stress of their lives caused it.

All of us have stress in our lives. Stress is stress. Stress is not good. And the management of stress is important. So I think for women who are being treated for breast cancer, sometimes people ask for help with, how do my best manage stress in general? But that's a different issue then stress causing cancer. And for the latter, we have no evidence.

Right. Now some people feel, OK, I have this horrible breast cancer. I'm going to get through it. And then I'm going to do what the doctor I choose recommends. And I have my six weeks of radiation. And then I'm done. Or then I go into Moxifen. And then five years from now, I'm done. And then I'm done. And cancer has ended its reign of terror in my life. But that's not exactly true, is it?

No. Unfortunately, it isn't true. What is true is that women who have been treated for cancer will have periodic checkups, periodic testing. And oncologists will tell women what we understand about the appropriate schedule for testing for the rest of their lives.

So indeed, having to return to see the cancer expert, returning to the cancer center, returning to the doctor's office, for most women is a reminder of what I really have been through and how potentially very serious this could have been.

It's very common for women to have insomnia, difficulty sleeping, the night before their followup visits. It's very common for women to become anxious prior to followup visits and while they're waiting for the results of diagnostic tests that their doctor may have ordered. So I think it's good to know those kinds of mood changes and anxiety. Those are expected reactions.

What has been very helpful for a lot of women is to have a chance to speak with other women who have gone through this process. So when a woman has a chance to see a beautiful, competent, productive woman who says, I know exactly what you went through. Look at me. That type of role modeling is very important for women.

Thank you so much, Dr. Massie.

For more information, please go to Susan G. Komen for the Cure at www.komen.org, or call the Komen for the Cure helpline 1-800-IM AWARE. I'm Lisa Birnbach.

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