The sudden shock of a breast cancer diagnosis can shatter your confidence and sense of identity, and make you feel like you’ve lost your former self. Fear and the feeling of being betrayed by your own body can be intense, especially for younger women enjoying their career, getting married and having kids.

A breast cancer diagnosis is also the start of a sprint—“a short, aggressive period of treatments and care to ensure the best long-term outcome,” says breast medical oncologist Shari Goldfarb, M.D., of Memorial Sloan Kettering Cancer Center in New York. She is the director of their Young Women With Breast Cancer Program. “Medical teams are working fast to stop the cancer, minimize treatment side effects and prevent further changes in the body.”

But the early breast cancer journey isn’t just about treatments, medicine or mastectomies (removal of the breast). It brings with it a host of physical and emotional changes that can impact every part of life.

Body Image and Intimacy

Treatments like chemotherapy and radiation hit your body hard. From hair loss and skin changes to extreme fatigue, nausea, weight loss, vaginal dryness, menstrual irregularities and more, the physical changes are real. It’s normal to not look or feel like yourself. And it can seriously shake your confidence and desire for intimacy and sex.

Goldfarb encourages her patients to go slow and explore new ways to be intimate. “Simple, small moments make all the difference. When you’re weak and too tired, just touching, kissing or a cuddle on the couch is meaningful.” The goal is to communicate and figure out what works for both of you.

And don’t be afraid to talk to your oncology team, insists Goldfarb, because early diagnosis and treatment are about your whole person, not just the cancer. Your doctor can offer solutions like special vaginal lubricants and medications to help balance hormonal impacts for you to feel more stable and confident.

Relationship Support

Breast cancer can put a huge strain on relationships—including with your partner, kids, family and friends, as well as at work. Loved ones may struggle with how best to help you, and you might feel totally alone because they don’t understand what you’re going through.

“Many say their partners think they should bounce back to normal after breast cancer treatment,” notes Valentina Ogaryan, Ph.D., psychologist and clinical director at UCLA Simms/Mann Center for Integrative Oncology. She stresses that going back to the old you is rarely possible, which is why it’s important to let your partner, family and friends know that your breast cancer journey is ongoing and fluid.

While some relationships struggle, others become tighter than ever. It’s still smart, though, to find support outside your close circle. Dr. Ogaryan advises seeing a therapist or joining a breast cancer support group where others really get what you’re going through. “It’s normal to be conflicted and not talk about things, so it’s important to feel what you feel and talk to others who truly understand without judgment.”

Redefining Your New You

Going through breast cancer changes you. It’s not about trying to be the old you again but rather embracing the new you with purpose. Dr. Ogaryan says your values might shift, and that’s okay.

“You have to give yourself permission to explore these changes without needing all the answers right away, and embrace the importance of this period as a time of reflection. Living through diagnosis may symbolize resilience for some, while others have a strong desire to distance themselves from their cancer experience.”

Both perspectives, she says, are completely valid. The most important thing is to remember your whole self. You are not your cancer, and it’s not all that you are.

Tame Your Scanxiety

That intense fear and worry that builds up before getting medical scans or test results has a name in the cancer world: scanxiety. It can show up as irritability, insomnia, agitation, muscle tightness and a general sense of dread. UCLA clinical psychologist Dr. Valentina Ogaryan and Natalie Schnaitmann, L.C.S.W., of City of Hope National Cancer Center, both in Los Angeles, offer these tips for coping.

• Shift your mindset. Schedule a tune-up session with a therapist or psychologist to help fight your fear and get ahead of it.
• Plan distractions and rewards. Before your scan, go to a concert, or treat yourself to a shopping trip or special restaurant with friends. Then have a reward already scheduled for afterward, like a luxurious spa day or a massage. That way you bookend the experience with positive ones.
• Name your anxiety out loud. Acknowledge to partners, friends and family that it’ll be a tough week. “A common saying in psychotherapy is ‘Let’s name it to tame it!’ ” says Ogaryan. “And it helps.”