Ask CancerCare

A. Ductal carcinoma in situ (DCIS) is an early noninvasive form of breast cancer wherein abnormal cells multiply and form a growth within a milk duct of the breast. The term "noninvasive" means that the abnormal cells have not spread out of the milk duct into other parts of the breast. DCIS is normally identified during mammogram screenings and confirmed by biopsy. If left untreated, it is more likely to develop into invasive breast cancer so it is important to seek medical care.

As for your family's reaction, during times of crisis such as health emergencies it is not unusual for friends, family members and loved ones to react in unexpected ways. Based on what you have shared, it sounds like your family's response was experienced as unsympathetic and hurtful. Often times, loved ones think that they should only "be positive" or always look on the bright side. This can leave the patient feeling unsupported and unable to express his/her true feelings. I'm not sure if you've shared your feelings with your family, but sometimes people do not know what to say or do and need a little guidance.

Support groups can be an important part of overcoming your feelings of disappointment. Groups are a place where you find the support you need and feel heard and understood. Make sure to find a group that is a good fit for you; some organizations offer groups for women who've been diagnosed with DCIS or early stage breast cancer, including SHARE: Self-Help for Women with Breast or Ovarian Cancer.

I encourage you to be attentive to your emotional needs during this time. You may want to explore individual counseling to work through your feelings of disappointment and stress. Benefits of counseling include feeling less isolated and verbalizing your feelings without fear of reprisal or judgment. To learn more about counseling, please read our Counseling Frequently Asked Questions.

A. The phase following active cancer treatment can be one of mixed emotions. On the one hand, it is a time of hope and relief, but it can also be a time of fear and anxiety. Fear of recurrence is not at all uncommon for cancer survivors and you are not alone. Take control of those things you can influence. Everyone has their own way of coping, but here are a few practical suggestions:

• Take better care of yourself by making healthier choices which may include increasing physical activity and adjusting your diet. Some people find it helpful to engage in activities such as yoga, meditation, or other relaxation techniques.
• Seek out support. Speaking with others in a support group can help relieve anxiety.
• Explore spiritual connections. "Strengthening the Spirit" , a CancerCare fact sheet, talks about the role spirituality may have in helping you cope.
• Stay active in your follow-up care by asking specific questions about the likelihood of recurrence with your doctor and what you can do to minimize recurrence.

CancerCare's fact sheet, "Doctor Can We Talk?" , offers practical suggestions on how to organize thoughts and questions to guide you through a conversation with your provider. Questions to ask your doctor about recurrence include:

• Can the type of cancer I have return?
• What is the likelihood that my cancer may return?
• Are there any steps I can take to keep it from returning?
• How can I know if it's back? Are there things I should I look for?

You may also find the following two resources helpful:

• CancerCare's Education Workshop, Nurturing the Spirit with Love Meaning and Hope
• The National Coalition for Cancer Survivorship (NCCS) offers a Cancer Survival Toolbox which includes resources for survivors

And finally, expressing your feelings to a counselor one-on-one in a nurturing environment can also be helpful. The process of openly dealing with emotions helps many people feel less anxious.

A. The decision to seek counseling is always very personal and the motivation to seek help may differ at various points throughout a cancer diagnosis. As a post-treatment cancer survivor, you are probably grappling with concerns that are very different than those you had at the time of your initial diagnosis. The post-treatment phase may be a time to reevaluate purpose, direction and priorities in one's life. We also know that many cancer survivors have fears of recurrence and other anxieties that friends, family members and co-workers may not fully understand. Engaging with a professional counselor can help.

CancerCare offers a number of ways for cancer survivors to obtain support from professional oncology social workers including individual counseling and telephone and online support groups. Individual counseling can help you manage anxieties and concerns you might have. A support group provides a safe place for people coping with similar circumstances to share and learn from each other. Many people find the opportunity to relate to others in this way enormously helpful and powerful. The American Cancer Society can help you locate a face-to-face support group in your area.

Others resources that might be helpful to you include Telephone Education Workshops from The Seventh Annual Cancer Survivorship Series:

• Living With, Through and Beyond Cancer, Part I: Managing the Stress of Survivorship
• Living With, Through and Beyond Cancer, Part II: The Importance of Nutrition and Physical Activity

Keep in mind that taking care of yourself emotionally is equally as important as looking after your physical needs. CancerCare's social workers can help you determine what support services might be helpful. Call 1-800-813-HOPE (4673) or email info@cancercare.org.