Breast cancer survivor shares mental health journey after recovery

• Published: 10/9/2024

After more than a year of treatments, procedures and countless doctor visits, Maribel Marin Arellano celebrated a life-changing milestone in November 2023—being declared breast cancer-free. But as she closed one chapter of her battle, a new challenge emerged: facing the emotional toll of surviving breast cancer and rebuilding her life post-treatment.

“It felt like I was grieving my life before cancer,” said Arellano. “When I was sick, I was doing everything in my power to get better for my two kids. But once I was declared cancer-free, that’s when the depression really started.”

Arellano was diagnosed with a BRCA gene mutation, making life after her cancer treatments more challenging than she had anticipated.

The BRCA gene (BReast CAncer gene) mutation increases an individual’s risk of developing breast cancer by as much as 72% in their lifetime, compared to the general population’s 12%, according to the Breast Cancer Research Foundation. Women with the BRCA gene also face higher risks of ovarian cancer. Some women, like Arellano, opt for surgery to remove their breasts and ovaries to reduce these cancer risks. “Despite remission, this means survivors will need continuous monitoring and screening,” shared Bryana Anderson, APRN, FNP-C, AOCNP, an oncology advanced practice provider at Parkland.

Arellano’s anxiety manifested in constant worries about her cancer returning, making it difficult to focus on her daily life. She also struggled with motivation, feeling lost without the daily drive to ”fight” against something tangible like cancer. She was referred to Parkland’s Behavioral Health Clinic early on in her diagnosis. A decision, she says, is an ongoing help to her and her family.

“Talking to someone who isn’t a family member or close friend is so helpful because they can listen and help while still being neutral,” Arellano said. “Cancer doesn’t just affect you or your body, it affects your emotions, your plans, your relationships and your children.”

“Patients most of the time already feel like a burden. Having a space where they can talk about their worries without putting all the emotional burden on their family helps tremendously,” Carolina Peña, licensed professional counselor in Parkland’s Oncology Behavioral Health clinic explained. “It’s just having a space where they can freely discuss all of the tolls that cancer has on them.”

Peña said it’s common for patients to experience mental health struggles once they have completed treatment.

“We do cover and assist patients even when they are in survivorship because you have to adjust to a new normal, and now living with this ghost of cancer,” said Peña. “Sometimes there’s a lot of pressure and anxiety to be the person you used to be before cancer, both mentally and physically, but that doesn’t happen overnight. Those things could develop a lot of distress in patients.”

Arellano took part in Parkland’s group therapy sessions led by her mental health counselor, Peña. It was an opportunity they both agree was paramount in her mental healing during and after treatment.

“When the patients come together in these groups, they get this sense of community by being around others who they can relate to. They have all formed a very special bond,” Peña said. “Every group session is led by a mental health therapist so there is a lot of processing of emotions, thoughts and specific topics covered. It is very intense and profound work that we all do together.”

“Carolina helped me find the strength within me. I know that I am brave but sometimes you need that extra push to help you find it, the guidance from therapy is helping me do that,” Arellano shared.

The importance of breast cancer screen and early detection

“Cancer does not discriminate against age. The most powerful tool you have is to know your body, know when you experience something that is not normal for you, and then seek care,” said Aeisha Taylor, manager of Parkland’s Community Oriented Primary Care (COPC) Breast Imaging, Outreach and Education program.

Breast symptoms that warrant an immediate discussion with your healthcare provider include:

• New lump in the breast or armpit.
• Thickening or swelling of the breast.
• Dimpling of the breast skin.
• Redness or flaky skin in the nipple area or the breast.
• Pulling in of the nipple or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Change in the size or the shape of the breast not related to weight gain/loss or pregnancy.
• Targeted breast pain that is constant and not related to the menstrual cycle.
• A breast that is red and feels warm.

Parkland experts recommend annual mammograms for women aged 40 and older. For women under 40, mammograms may be recommended by your provider if you are having symptoms or abnormalities or have a family history of breast cancer.

“Mammograms might not keep cancer away, but they are important because they detect cancer early,” said Anderson.

Today, Arellano continues to manage her mental health with the help of counseling and a supportive community of survivors. She encourages other cancer survivors to reach out for help if they are struggling with similar issues.

Parkland Health Foundation leverages the power of philanthropy by raising funds to support access to early detection, diagnosis and treatment for breast cancer. To learn more and make a donation, visit https://parklandhealthfoundation.org/areas-of-need/cancer-care/.

For more information on Parkland’s oncology behavioral health services visit www.cancer.parklandhealth.org/cancer/oncology-behavioral-health.

For more information about Parkland services, visit www.parklandhealth.org.