This happens to a lot of people. You may have been going through so much during treatment that you could only focus on getting through your treatment.

Now you may find that you think about the potential of your own death, or the effect of your cancer on your family, friends, and career. You may also begin to re-evaluate your relationship with your spouse or partner. Unexpected issues may also cause concern -- for instance, as you become healthier and have fewer doctor visits, you will see your health care team less often. That can be a source of anxiety for some.

This is an ideal time to seek out emotional and social support. You need people you can turn to for strength and comfort. Support can come in many forms: family, friends, cancer support groups, church or spiritual groups, online support communities, or individual counselors.

Almost everyone who has been through cancer can benefit from getting some type of support. What's best for you depends on your situation and personality. Some people feel safe in peer-support groups or education groups. Others would rather talk in an informal setting, such as church. Others may feel more at ease talking one-on-one with a trusted friend or counselor. Whatever your source of strength or comfort, make sure you have a place to go with your concerns.

The cancer journey can feel very lonely. It is not necessary or realistic to go it all by yourself. And your friends and family may feel shut out if you decide not include them. Let them in -- and let in anyone else who you feel may help.

Body image: A woman's choice of treatment will likely be influenced by her age, the image she has of herself and her body, and her hopes and fears. For example, some women may select breast-conserving surgery with radiation therapy over a mastectomy for cosmetic and body image reasons. On the other hand, some women who choose mastectomy may want the affected area removed, regardless of the effect on their body image. They may be more concerned about the effects of radiation therapy than body image.

Other issues that women worry about include hair loss from chemotherapy and skin changes of the breast from radiation therapy. In addition to these body changes, women may also be dealing with concerns about the outcome of their treatment. These are all genuine concerns that affect how a woman makes decisions about her treatment, how she views herself, and how she feels about her treatment.

Sexuality: Concerns about sexuality are often very worrisome to a woman with breast cancer. Several factors may place a woman at higher risk for sexual problems after breast cancer. It is important to remember that some treatments for breast cancer, such as chemotherapy, can change a woman's hormone levels and may negatively affect sexual interest and/or response. A diagnosis of breast cancer when a woman is in her 20s or 30s is especially difficult because choosing a partner and childbearing are often very important during this period.

Relationship issues are also important because the diagnosis can be very distressing for the partner, as well as the patient. Partners are usually concerned about how to express their love physically and emotionally after treatment, especially surgery.

Suggestions that may help a woman adjust to changes in her body image include looking at and touching herself; seeking the support of others, preferably before surgery; involving her partner as soon as possible after surgery; and openly communicating feelings, needs, and wants created by her changed image.

Sexual impact of surgery and radiation: Because breast cancer is the most common cancer in women (excluding skin cancer), sexual problems have been linked to mastectomy more often than to any other cancer treatment. Losing a breast, or occasionally both breasts, can be traumatic.

The most common sexual side effects stem from damage to a woman's feelings of attractiveness. In our culture, we are taught to view breasts as a basic part of beauty and femininity. If her breast has been removed, a woman may be insecure about whether her partner will accept her and find her sexually pleasing.

The breasts and nipples are also sources of sexual pleasure for many women. Touching the breasts is a common part of foreplay in our culture. A few women can reach orgasm just from the stroking of their breasts. For many others, breast stimulation adds to sexual excitement.

Breast surgery or radiation to the breasts does not physically decrease a woman's sexual desire. Nor does it decrease her ability to have vaginal lubrication, normal genital feelings, or reach orgasm. Some good news from recent research is that within a year after their surgery, most women with early stage breast cancer have good emotional adjustment and sexual satisfaction. They report a quality of life similar to women who never had cancer.

Treatment for breast cancer can interfere with pleasure from breast caressing. After a mastectomy, the whole breast is gone. Some women still enjoy being stroked around the area of the healed scar. Others dislike being touched there and may no longer even enjoy being touched on the remaining breast and nipple.

Some women who have had a mastectomy feel self-conscious being the partner "on top" during sex. The area of the missing breast is more visible in that position.

A few women have chronic pain in their chests and shoulders after radical mastectomy. During intercourse, supporting these areas with pillows may help. Also, avoid positions where your weight rests on your chest or arms.

If surgery removed only the tumor (segmental mastectomy or lumpectomy) and was followed by radiation therapy, the breast may be scarred. It also may be a different shape or size. During radiation therapy, the skin may become red and swollen. The breast also may be a little tender. Breast and nipple feeling, however, should remain normal.

Sexual impact of breast reconstruction: Breast reconstruction restores the shape of the breast, but it cannot restore normal breast sensation. The nerve that supplies feeling to the nipple runs through the deep breast tissue, and it gets disconnected during surgery. In a reconstructed breast, the feeling of pleasure from touching the nipple is lost. A rebuilt nipple has much less feeling.

In time, the skin on the reconstructed breast will regain some sensitivity but probably will not give the same kind of pleasure as before mastectomy. Breast reconstruction often makes women more comfortable with their bodies, however, and helps them feel more attractive.

Effect on your partner: Breast cancer can be a growth experience for couples under certain circumstances. The relationship may be enhanced if the partner participates in decision making and accompanies the woman to surgery and other treatments.