Breast cancer remains the leading cause of cancer-related death among Jamaican women and although rare, men can get breast cancer too.

A breast cancer diagnosis can be devastating, and navigating potential treatment options can be stressful and overwhelming. The impact of the disease is not only physiological and physical, but an emotional and psychological experience.

In fact, there are many aspects of breast cancer that can cause immense stress and emotional issues. Treatment with a mastectomy is one of them.

After making the difficult decision to undergo a mastectomy, it's completely normal for women to feel a flood of emotions. Many are concerned about whether they're making the right decision and experience anxiety over their future without one or both of their breasts, though it is understood that the surgery is a life-saver.

Following mastectomy, women face an entirely new set of challenges. Aside from the side effects that come along with healing from surgery, they're adjusting to changes in appearance, how clothing fits, and many other unexpected changes. For many survivors, this can be the most difficult part of the diagnosis, often leading to depression and grief.

Grief is the emotional suffering you feel when something you have a bond with all your life is taken away. But how on earth do you grieve for a body part? This part of your body that is also seen as central to your intimate anatomy? There's no funeral service, no eulogies, no publicly acknowledged period of mourning, no closure. You go to sleep in surgery with two breasts and wake up with one, or both, absent. There might be a new breast in place if you've opted for reconstruction but the breasts you knew, got used to, appreciated for all it could do are gone. The cancer has hopefully gone too, but still, it's a hard way to say goodbye. The overwhelming feelings are emotionally and psychologically challenging.

Some women struggle with their identity as a woman after mastectomy. You may feel differently about your body or feel a sense of loss over your femininity or sexuality, loss of positive self-image. You feel less attractive and feminine, especially in the eyes of their intimate partners. It may take time to process your feelings about the effects of your mastectomy. Along similar lines, some women also experience negative effects on their sex life due to fears about their partner's perception of their body. In these cases, it's important to give yourself as much time as you need to heal.

Many women also find comfort in talking with therapists and support groups in Jamaica like Reach to Recovery and Cornwall Regional Hospital Cancer Support Group that are doing an excellent job in supporting breast cancer survivors and their families about life after a mastectomy.

Dr Cathi-Ann Williams, NCD Risk Factor Programme Development Officer, Non- Communicable Disease and Injury Prevention Unit at Ministry of Health and Wellness, strongly recommends that women talk with their doctor if they experience signs of depression that persist for more than few weeks. These include feeling constantly sad and tired; finding little or no enjoyment in activities you used to enjoy; having trouble concentrating; feeling hopeless or worthless; having trouble sleeping; having thoughts about dying or wanting to die.

Dr Williams added, “Depression is treatable and treating it can help you recover mentally and physically”.

Other ways you may cope with the emotional impact of a mastectomy include having open discussions with your partner about your feelings as this will also help you adjust to life after a mastectomy. You may also work with your partner to resolve sexual concerns as losing your breast to cancer can lower your libido and change how you feel about your body. You can enhance your relationship if you make decisions about your post-surgery sex life together.

Moreover, do not forget the hobbies and activities you loved before your diagnosis. Immersing yourself in things you enjoy can help you feel more positive, confident, and strong. Learn more about breast health at ncdip.moh.gov.jm