Breast cancer: How your mind can help your body

According to the National Cancer Instituteopens in new window, an estimated 310,270 women and 2,790 men in the United States will learn that they have breast cancer in 2024. Because many of them have no family history of breast cancer or other known risk factors, the diagnosis often comes as a devastating surprise. The emotional turmoil that follows can affect a patient's physical health and psychological well-being.

This question-and-answer fact sheet explains how psychological treatment can help these patients boost their emotional resilience.

Receiving a diagnosis of breast cancer can be one of the most distressing events a person ever experiences. And those diagnosed may not know that psychologists can be a source of help.

Distress typically continues even after the initial shock of diagnosis has passed. As patients begin what is often a lengthy treatment process, they may find themselves faced with new problems. They may find their personal relationships in turmoil, for instance, as research shows that seriously ill women are 6 times more likelyopens in new window than seriously ill men to be abandoned by their partners (Glantz, M. J., et al., 2009). They may feel exhausted and be very worried about their symptoms, treatment, and mortality. They may face discrimination from employers or insurance companies.

Factors like these can lead to chronic stress, anxiety, and depression.

Feeling overwhelmed is a normal response to a breast cancer diagnosis.

But negative emotions can cause people to stop doing things that are good for them and start doing things that are especially worrisome for those with a serious disease.

Those diagnosed with breast cancer may start eating poorly, for instance, eating fewer meals, and choosing foods of lower nutritional value. They may cut back on exercise. They may have trouble getting a good night’s sleep. And they may withdraw from family and friends. At the same time, these patients may use alcohol, nicotine, caffeine, or other drugs to soothe themselves.

A breast cancer diagnosis can also lead to more severe problems. For some patients, for example, the news leads to depression, which can make it more difficult for them to adjust, make the most of treatment, and take advantage of whatever sources of social support are available. Some patients become so disheartened by their cancer diagnosis and treatment that they refuse to undergo surgery or simply stop going to radiation or chemotherapy appointments.

Depression can also decrease survival rates, research shows. According to one meta-analysis of 17 cohort studiesopens in new window, depression was associated with a 30% increased risk of all-cause mortality in breast cancer patients. It was also associated with a 29% increased risk of cancer-specific mortality and a 24% increased risk of breast cancer recurrence.

Licensed psychologists and other mental health professionals with experience in breast cancer treatment can help a great deal. Psychologists working closely with medical professionals in integrated health settings like hospitals or cancer centers play a key role. They focus on helping patients learn how to cope with the physical, emotional, and lifestyle changes associated with cancer as well as with medical treatments that can be painful and traumatic.

For some patients, the focus may be on how to explain their illness to their children or how to deal with a partner’s response to their diagnosis. For others, it may be on how to choose the right hospital or medical treatment. For still others, it may be on how to control stress, anxiety, or depression.

By teaching patients problem-solving strategies in a supportive environment, psychologists help those diagnosed work through their grief, fear, and other emotions. For many people, this life-threatening crisis eventually results in life-enhancing personal growth.

Breast cancer patients themselves aren’t the only ones who can benefit from psychological treatment. Partners may also suffer. In a cohort study of over 3 million peopleopens in new window, spouses of patients with cancer had increased risk of psychiatric disorders and were 14% more likely to seek treatment than spouses of people without cancer (Hu, K., et al., 2023).

Psychologists can help spouses manage the challenge of offering both emotional and practical support while dealing with their own feelings. Children, parents, and friends involved in caretaking can also benefit from psychological interventions.

The need for psychological treatment may not end when medical treatment does. In fact, emotional recovery may take longer than physical recovery and is sometimes less predictable. Although societal pressure to get everything back to normal is intense, breast cancer survivors need time to create a new self-image that incorporates both the experience and any physical changes. Psychologists can help patients do that and learn to cope with such issues as fears about recurrence and impatience with life’s more mundane problems.

Absolutely. Cancer diagnosis and treatment create significant stress, affecting individuals’ quality of life. Stress can worsen symptoms and potentially impact tumor growth and spreadopens in new window (Antoni, M. L., et al., 2023). Psychologists have developed stress management interventions that are useful for dealing with the nausea and vomiting that often accompany chemotherapy, for example. For some patients, these side effects can be severe enough to make them reject further treatment efforts. Psychologists can teach relaxation exercises, meditation, self-hypnosis, imagery, or other skills that can effectively relieve nausea without the side effects of pharmaceutical approaches. These types of services are so vital that, as of 2015, cancer centers are required to screen patients for distress and refer them for psychosocial interventionsopens in new window to maintain their accreditation (Gudenkauf, L. M., & Ehlers, S. L., 2018).

Psychologists can also empower women to make informed choices in the face of conflicting advice and can help them communicate effectively with their health care providers. In short, psychologists can help patients become more fully engaged in their treatment. The result is an enhanced understanding of the disease and its treatment and a greater willingness to do what needs to be done to get well.

Earlier research indicated that psychological treatment may boost chances of survival for those with breast cancer. In one study, for instance, a decrease in depression symptomsopens in new window was associated with longer survival in patients with metastatic breast cancer (Giese-Davis, J., et al., 2010). Another study examined the impact of psychologist-led small group sessionsopens in new window that offered strategies for reducing stress, improving mood, changing health-related behaviors, and adhering to treatment and care (Andersen, B. L., et al., 2008). The breast cancer patients who participated in the groups had a 45% lower risk of their cancer coming back and a 56% lower risk of dying from breast cancer. The results were even more impressive when the researchers excluded patients who attended fewer than 20% of the sessions: The remaining participants’ risk of dying from breast cancer was 68% lower.

Replication of these results has been inconsistent in more recent research, particularly for metastatic breast cancer. However, one study focused on women with nonmetastatic breast cancer found that nondepressed women had longer overall survivalopens in new window than those with depressive symptoms (13.56 years vs. 11.45 years) (Antoni, M. H., et al., 2017).

Such findings underscore the importance of psychological interventions. Cognitive-behavioral therapy for cancer distressopens in new window is one of the most thoroughly researched treatments for managing cancer-related distress (Ehlers , S. L., et al., 2023). This therapy, which is specifically designed for cancer patients, teaches skills to challenge negative thoughts, improve behaviors, manage symptoms like insomnia, and enhance communication for better social support. Studies have shown that this type of therapy can reduce psychological distress and improve quality of life even more than a decade after diagnosisopens in new window (Stagl, J. M., et al., 2015).

A combination of individual and group treatment is often the most effective approach. Individual sessions with a licensed psychologist typically emphasize the understanding and modification of patterns of thinking and behavior.

Group psychological treatment with others who have breast cancer gives women a chance to give and receive emotional support and learn from the experiences of others. To be most effective, groups should be made up of women at similar stages of the disease and led by psychologists or other mental health professionals with experience in breast cancer treatment.

Whether aimed at individuals or groups, psychological interventions strive to help women adjust to their diagnoses, cope with treatment, and come to terms with the disease’s impact on their lives. These interventions offer psychologists an opportunity to help women better understand breast cancer and its treatment. Psychologists typically ask women open-ended questions about their assumptions, ideas for living life more fully, and other matters. Although negative thoughts and feelings are addressed, most psychological interventions focus on problem-solving as women meet each new challenge.

A breast cancer diagnosis can severely impair a woman’s psychological functioning, which in turn can jeopardize her physical health. But it doesn’t have to be that way. Women who seek help from licensed psychologists with experience in breast cancer treatment can use the mind-body connection to their advantage to enhance both mental and physical health.