Knowing that you are at high risk for breast and ovarian cancer can be very emotionally challenging. Everyone will have a different experience after learning that they carry a BRCA mutation. Everyone will cope differently. Remember that the way you feel is OK and valid. Taking care of your emotional and mental health and having ways to cope with stress is part of taking care of your overall health. You will find strategies here that have helped women with a BRCA mutation cope with stress.

Melissa talks about the difference between
her and her sister’s worry

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What does living with high risk mean?

I thought it was going to get me. I was going to die…so I just didn’t deal with it well.

Melissa

Melissa and her sister each experienced their risk of cancer differently. Melissa was more scared about her risk. She was afraid of dying young from cancer, while her sister did not think about this possibility.

People differ in how they feel about risk. There are many people who live with some kind of risk. Some people may have a job with a higher rate of injury. Some people live in earthquake or tsunami zones. None of us can know for sure what will happen to us. However, having an increased risk of cancer may feel especially frightening. Unlike some forms of risk, it is not something over which you have any control.

Over time, most women with BRCA mutations learn how to accept and cope with their risk.


Tori and Natalie talk about coping with being a BRCA mutation carrier

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How do I cope with fear and stress?

I would say at the beginning I felt a little isolated, and maybe a little fearful, but I’m really starting to feel more empowered by it.

Tori

We all cope with stress and fear differently. Our coping abilities help us make difficult decisions and face frightening information.

Your levels of stress and fear will rise and fall over your life. They might rise while waiting for test results or making a decision whether to have surgery. Tori first felt alone after learning she was a BRCA mutation carrier. But, after taking her time and gathering more information, she eventually felt empowered by this knowledge. You might feel less worry after you have had a risk-reducing mastectomy or oophorectomy. After having both risk-reducing surgeries, Natalie felt relief, knowing she had done all she could. At the same time, she felt that learning she carried a BRCA mutation was a loss of innocence, a “knowledge you can never take away.”

One of the hard things about learning that I had the gene mutation was, I feel it’s a loss of innocence. You can never go back to a time before you knew. It’s a knowledge you can never take away.

Natalie

 

Melissa talks about coping with stress

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Coping with stress or painful feelings

There are many ways to cope with the stress and fear that come with knowing you carry a BRCA mutation. Some coping methods are effective and make you feel more in control of your life, while other methods can be harmful.

Unhealthy coping is:
  • denying that your BRCA mutation is an issue you have to deal with
  • constantly thinking and worrying about your BRCA mutation
  • not learning anything more about your BRCA mutation
  • not going to breast screening appointments because they are too stressful
  • not talking to anyone about your BRCA mutation or how you are feeling
  • using alcohol or drugs to escape stress or painful feelings
Healthy coping is:
  • focusing on specific decisions that you have to make
  • focusing on specific facts that you want to understand
  • not constantly thinking about your BRCA mutation
  • learning more about stress-reducing activities (see below)
  • discussing your feelings and concerns with someone you can trust (e.g., your partner, a counsellor, a member of the Willow Support Team)

There is no one best way to cope with stress and fear. What is helpful is having many different ways to cope with stressful situations. Trying not to think about your BRCA mutation all the time is a healthy coping strategy. But if avoidance is your only coping method it can have negative effects. You might avoid screening appointments or not know all your options when making a decision.


Everyone with a BRCA mutation can benefit by learning more coping skills to manage stress.

There are lots of different strategies to make living with risk less stressful for you.

Your toolkit to cope with stress can include:
  • guided imagery relaxation exercises (see audio below)
  • breathing exercises (see audio below)
  • progressive muscle relaxation training (see audio below)
  • meditation (mindfulness-based stress reduction) (learn what this is below)
  • yoga
  • exercise
  • talking with a friend
  • professional counselling

Guided imagery relaxation exercise

Mary Jane Esplen, PhD, RN, therapist, researcher

 

breathing exercise

Stephanie Phan, OT Reg (Ont.), Occupational Therapist, ELLICSR: Health, Wellness and Cancer Survivorship Centre.

 

 Progressive Muscular Relaxation

Stephanie Phan, OT Reg (Ont.), Occupational Therapist, ELLICSR: Health, Wellness and Cancer Survivorship Centre.

Meditation (Mindfulness-based stress reduction)

Mindfulness-based stress reduction (MBSR) is a learning program based on the principle of mindfulness. Mindfulness is an awareness of being in the moment, in a non-judgmental way. Mindfulness can help you manage the stress of living at high risk, as well as stress related to work, relationships, and other aspects of your day-to-day life.

You may wish to seek out a counsellor or program in your area that teaches MBSR. There also many web sites and books available to learn MBSR on your own.


What can I do if I am finding it hard to cope?

Coping with the fear and stress of carrying a BRCA mutation can be very difficult. There are likely other sources of stress in your life that can make it even harder to cope.

Some specific experiences can also play a role in how you understand your risk or deal with your genetic test results.

If you relate to some of the situations below and are feeling overwhelmed, it may be helpful to have some professional support to help you make decisions or cope with your situation.

I have taken care of a very ill parent or another close family member that struggled with breast or ovarian cancer

I have lost a close family member to breast or ovarian cancer

Breast or ovarian cancer is currently causing a significant disruption in my family life

I am worried that my test result will impact on my relationship with my partner (or future partner)

I am worried about talking to my children (young or adult) about their family history of breast or ovarian cancer, and what it means for them

My worries about breast or ovarian cancer affect my daily mood

I often worry about my risk of getting breast or ovarian cancer

I have had emotional problems in the past

I have had counselling with a counsellor and/or a mental health professional in the past

A professional counsellor can help you to explore your feelings, gain insight, and build your coping skills. You can ask your doctor or genetic counsellor for a referral to a mental health professional.

Who are mental health professionals?

  • Psychologists
  • Psychiatrists
  • Therapists or counsellors (sometimes therapists and counsellors are nurses or social workers)
  • Family physicians

Where can I connect with a counsellor?

  • Mental health centres
  • Psychosocial oncology programs at your local cancer centre or your genetics clinic
  • You can ask for a referral from your family doctor

Part of coping also involves taking steps to manage your risk

Learn more about managing your breast cancer risk
Learn more about managing your ovarian cancer risk
Learn more about managing men’s cancer risk


 

Lara talks about living with a BRCA mutation

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