Breast & Ovarian Cancer

The shock of the diagnosis. The uncertainty of treatment, results or mortality. The feeling of everything being out of our control.  

But first… 

What is Breast Cancer? 

A kind of cancer that begins as a growth of cells in the breast tissue. Abnormal breast cells grow out of control and form tumours.  

Breast cancer usually occurs in older women above 50 but can also affect men and younger women. In Singapore, breast cancer is the most commonly occurring cancer among women, accounting for 29.7% of all cancers diagnosed in females. 

What is Ovarian Cancer? 

It occurs when abnormal cells in ovaries or fallopian tubes grow and multiply out of control. It may originate from the ovary or more commonly from nearby structures such as fallopian tubes or the inner lining of the abdomen.  

Ovarian cancer usually occurs in older women above 60 who are in the menopausal stage but can also affect younger women. In Singapore, ovarian cancer was 4.4% of all cancers diagnosed in women from 2016-2020. It is the 5th most common cancer in Singaporean women. 

Mental Health Challenges 

Here are the moments that women may struggle the most in the cancer journey:  

6. Awaiting follow-up results  

  • Waiting for the outcomes of follow-up tests 

7. Survivorship phase (Life after diagnosis or treatment) 

  • Persistent guilt (about family, children, responsibilities) 

  • Fear of recurrence 

  • Diminished self-esteem 

  • Problems with social acceptance and body image 

  • Difficulty in re-entry into previous life 

  • Perceived and actual loss of employment and insurance discrimination 

  • Concerns about infertility 

8. Symptom recurrence 

9. Facing end of life 

As treatment goes on, distress heightens (with all the physical and social impacts too). It is then no surprise that these can culminate into anxiety, depression, PTSD, or other conditions. 

1. Before diagnosis  

  • Noticing a concerning symptom  

  • Anxiously awaiting test results 

2. Initial diagnosis  

  • Receiving the news of the diagnosis for the first time 

3. Anticipating treatment 

  • Waiting to learn about the recommended treatment plan  

4. Leaving the hospital  

5. Completion or adjustment of treatment  

  • Fear of finishing a treatment course   

  • Adapting to a change in the plan 


How to Cope, Psychologically 

Receiving a diagnosis is never easy. The shock and distress can be overwhelming, and we might not know how to cope with such complicated emotions and thoughts.  

Yet, how we feel, think and cope with the diagnosis and treatment can greatly affect our physical health, treatment progress, adherence and recovery. So let’s take time to prioritise ourselves – physically and mentally.

Here are some ways to cope better: 

1. Find your support pillars 

Lean on those trusted friends and family, they tend to be the reasons we keep going even in tough times. 

Many have also gone through the same journey, and we do not need to fight cancer alone. Consider the links below to find communities of like-minded individuals who may share the same struggles as you:  

How are you feeling? What emotions can you pinpoint exists? Was it fear, anxiety, shock, anger, regret, or hopelessness?  

What about your thoughts about this journey – from diagnosis to treatment? What do your thoughts tell you about… 

  • Cherished things and people 

  • Personal hopes and dreams 

3. Stay engaged, moment-to-moment 

We know we bring up mindfulness often, but bear with us. When time seems limited and more precious than ever, we often want to capture and “stay” in the moments we cherish the most.  

This speaks to a part of us that wants more presence, and connection to what is going on around us. To do so, we need pause, observe and engage.  

Here’s our guide to being more mindful (general tips are at the bottom of the article). 

4. Show kindness to yourself 

Your pain and suffering is valid. Your feelings are valid. The journey is not easy, and there is little that others can do to make it easier on us.  

 Yet, how do we respond to our pain and emotions? What our pain and emotions often need is soothing. Like a mother soothing a child in pain, aim to soothe the pain and emotions within you. Here are some ways to soothe and be kind to yourself: 

  • Cry it out 

  • Calming music or smells  

  • Visualise a place that is calming to you  

    • Sunsets, starry night sky, pet café, comforts of a bed or bath 

    • Focus on your 5 senses  

  • Repeat personal mantras  

    • “I can do this” 

    • “I got this” 

    • “Take it easy” 

    • “This will pass” 


People differ in how they cope with difficult emotions and painful situations. There is no “best” method here, so find ways that you are comfortable with and personalise your recovery journey in your own way.  

“It is during our darkest moments that we must focus to see the light.” – Aristotle 

Coping with Betrayal

When someone you love breaks your trust & heart

Betrayal can hurt as badly as a physical wound. Do you allow the hurt feelings to hold you captive or put them behind you? How do you move past the hurt and begin to heal?

What is betrayal?

Betrayal comes in many forms. Not limited to infidelity, betrayal can include breaking promises, lying or withholding information, not prioritising a relationship, or disclosing information that was shared in confidence. It can be experienced by anyone, and is not exclusive to any gender. 

Why does betrayal hurt so much?

Betrayal entails the violation of someone’s trust and confidence. When people enter a committed relationship, they agree to live by the core values of a relationship (e.g., trust, commitment, respect). When one partner breaks the bond of trust, it erodes the foundation of the relationship. It affects the betrayed partner’s self-esteem and makes them doubt their self-worth. It also leaves the betrayed partner feeling confused as they begin to doubt everything the betrayer has said and done. People who have been betrayed may find it difficult to trust people, which hinders them from forming meaningful relationships.

How do I cope with betrayal in a relationship?

Ψ Acknowledge the betrayal 

The betrayal might have come as a shock to you. It is often difficult to wrap our minds around how and why a trusted confidante would betrayed you. However, to heal, you need to recognise and accept that the betrayal has happened. This does not mean that you are fine with it but as a stepping stone, you need to acknowledge that the act took place. 

 

Ψ Name your emotions 

Anger, sadness, disgust, insecurity, and loneliness — You might experience a whirlwind of emotions in the aftermath of a betrayal. These are legitimate feelings of betrayal. Do not deny or suppress them. Label these feelings. You may even want to write them down. 



 Ψ Spend time apart 

Avoid the person physically and electronically, if possible. Taking time away will reduce the intensity of your negative emotions, placing you in a better position to rationally think and process what had happened. You should not feel pressured to make a decision in response to the betrayal.

An example of a thought journal to help you to better understand the links between your thoughts and feelings, and make sense of them

Ψ It’s ok to grieve

Allow yourself to grieve the relationship that you have lost. In some cases, you may also be grieving the future that you had imagined. During the recovery process, you may experience the five stages of grief: denial, anger, bargaining, depression and acceptance. Note that this is not a linear process. You may find it helpful to journal your thoughts and what you felt are your losses.

  

Ψ Resist the temptation to retaliate 

It is normal to feel the urge to get back at the person who betrayed you and make them suffer. Planning revenge will only delay your healing process, and prolong your pain. 

Ψ Talk to a confidante 

Emotional support from your loved ones will be crucial during this stressful time. Speak with someone whom you trust. If you are not comfortable, you need not share what happened. You can share your feelings and thoughts about the incident, or just seek companionship from your loved ones. It would be best to find someone who can stay neutral, and not add fuel to the fire. 

Ψ Reflect on the relationship  

Examine your relationship, and be realistic about it. Some issues might have existed in your relationship before the betrayal. Your relationship did not turn sour overnight. It would be a good time for you to figure out how much the relationship means to you to determine if you should salvage or end the relationship. After gaining insights into the problems, you could then think about how things need to change should you and your partner wish to continue the relationship. 

 

Ψ Have a conversation with the person 

When you feel ready, have a conversation with the person who betrayed you. Let the person know how their actions made you feel. To prevent the person from getting defensive, try to focus on the impact on you rather than what they did. One way would be to use the “I” statements which starts with “I”, e.g.., “I felt hurt and angry when you…”. 

Allow the person to share their side of the story too so that you can understand how the betrayal came about. Note if they are trying to defend their actions or genuinely seeking forgiveness. 

 

Ψ Try to forgive 

See if you can forgive the betrayer. Forgiveness does not mean condoning the action; it is deciding to move past the hurt and move on with your life. Forgiveness is for you, not for the other person. Feelings of resentment and bitterness from the lack of forgiveness will take a toll on your physical and emotional well-being. 

If you wish to continue the relationship, forgiveness will be crucial to bring the relationship forward. You could let the person know that you have decided to forgive them but explain that it will take time for you. 

 

Ψ Decide how to take the relationship forward 

You have to decide if you want to forgive the person and rebuild the relationship, or end it for good. You may also consider a temporary separation as an option. Some considerations underlying this decision include: 

  • Is the person a repeat offender? 

  • Was it unintentional? 

  • Does the person acknowledge the pain that they have inflicted on you? 

  • Is the person genuinely remorseful? 

  • Has the person accepted responsibility for their actions? 

 

Ψ Be kind to yourself 

You may feel somewhat responsible, and wonder what you might have done wrong. Do not blame yourself for the betrayal. The person has to take responsibility for their actions. 

Forgive yourself for saying and doing things on the spur-of-the-moment when you discovered the betrayal. 

Be patient with yourself. Recovering from the hurt is a tough journey. Do not rush yourself to move on. Engage in self-care activities such as eating well, getting enough sleep, and spending time doing things you enjoy. 

 

Ψ Seek professional help 

If you find yourself ruminating on the betrayal and hurt, or your behaviours have changed since the betrayal and they are impairing your daily life, seek guidance from a mental health professional. Professional help could also address the damage the betrayal has caused to your sense of identity, self-esteem, and sense of security. Seeking help is a sign of strength, not weakness.  

If you are dealing with romantic betrayal, you could speak with our marriage and family therapists (Ling Ling and Wendy) and our clinical psychologists who have experience working with couples who struggle with marriage and family difficulties (e.g., Yuka).  

Moving past from the hurt of a betrayal is a painful and difficult journey. Some days may be tougher than the rest where you just wish to wallow in self-pity and wound the betrayer back. These responses and acute negative emotions are normal. The key is to remain kind to yourself and lean on your loved ones throughout this recovery process.  

How to Cope with Guilt about Breaking Up

It is okay to feel.

The Emotional Complexity of Initiating a Breakup

It is commonly misunderstood that people who initiate a breakup will cope better than the person they break it off with. This is not always true. Initiators can experience complex emotions such as guilt on top of sadness upon the breakup. Experiencing guilt for initiating a breakup is common, even if the relationship ended off in amicable terms.

If you have just initiated or are thinking of initiating a breakup and are experiencing guilt, know that it is okay to feel. It is normal to feel this way after a relationship ends. Your emotions are valid but that does not mean that you did anything wrong, or that you deserve to feel this way. While guilt is an empathetic response and a feeling of being responsible for the effects of your actions on them, it can cause a lot of distress.

Here are some ways to cope with guilt about a breakup: “S.E.L.F-C.A.R.E”

S - Seek social support and help (to manage breakup guilt)


Express or disclose your feelings of guilt to a close family member or friend who you trust. Do not be afraid to let them know how they can best support you. It is okay to turn to others for support as you lose your main pillar of support. Be comfortable initiating outings with your close friends and surround yourself with people who care for you.

Going for therapy can help you cope with difficult emotions and address the guilt in a helpful and adaptive manner. If you would like to share and process your emotions with someone, you may consider speaking to our clinical psychologists, like Dr Annabelle and Stephanie, who have extensive experience with providing guidance on relationship difficulties, emotional dysregulation, and equipping clients with the coping skills needed to get through this difficult time. You do not have to go through this alone.

E - Engage in self-reflection (to understand your feelings of guilt)


Reflect on the reasons for your feelings of guilt. Are you feeling guilty about hurting your ex-partner or are you feeling guilty for not trying harder for the relationship? Or perhaps you are feeling guilty because of how your family and friends react to your breakup? Everyone has their own unique reasons and it is always beneficial to be aware of the reasons behind your emotions so that you can take active steps to understand the validity of these reasons.

There may also be times where you do not know you are feeling a certain way after a breakup. When that happens, take the time you need to figure this out yourself, with your loved ones or a clinical psychologist.

L - Look at your relationship objectively to overcome guilt


Guilt can cause you to second guess your decision on ending the relationship and forget about all the negative experiences or the reasons for the breakup. Remind yourself of your intention to leave the relationship.

Grab a piece of paper and pen, and list out the reasons. Refer to them as many times as you need. This can also serve to remind you that building and sustaining a healthy relationship is a shared responsibility; it is not one person’s sole responsibility that the relationship has come to an end.

F - Focus on putting your own needs first


Hurting isn’t a competition. It may be painful for your partner to experience losing you now, but his or her pain is not more important than yours. It is okay to put your own needs first and that does not make you a selfish person. If being in your current relationship is painful or does not serve your needs, you have every right to let it go.

C - Come to realise what breaking up is not

“The only thing worse than breaking up is not breaking up when you know you are supposed to.” - Adonis Lenzy

Breaking up is not a wrong thing to do. It is not disregarding your ex-partner’s feelings. It is not ruining your ex-partner’s life. Ending a relationship does not make you a horrible person.

A - Acknowledge that you are being honest when you end the relationship


You owe your partner honesty and respect; not unwavering commitment when you know you no longer can or will not. It takes a lot of courage to be honest about your feelings in a relationship. It is not an easy decision to make, even if it is the right thing to do. Acknowledge that this is the right thing to do, and this hard decision is the best for both of you, including your partner, in the long term. 

R - Release your responsibility to your ex-partner


When the relationship has ended, release your responsibility to them and focus on healing yourself. You are no longer his or her partner and thus, you are no longer liable for their care, and neither are they.

Ψ Recognize what you can control and what you cannot. What is within your control is your honesty and respect towards your ex-partner. How they respond and take care of themselves emotionally are, unfortunately, out of your control.

Ψ Establish healthy boundaries with your ex-partner. If your ex-partner is causing you distress about the breakup, even unintentionally, maintaining some physical and emotional distance may be necessary. Do not feel obligated to respond when your ex-partner reaches out to you. This is not easy, especially if he or she seems vulnerable or expresses feelings that mirror your own. Remind yourself that you both need time and space to work through those difficult emotions.

E - Engage in self-compassion during and after a breakup


Be kind to yourself.

Ψ Imagine a close friend experiencing the same thing as you, what would you say to that friend? Try using the same words for yourself. Write a letter to yourself.

Ψ Remember that your thoughts are not always accurate reflections of reality.  Notice your critic and remind yourself of the positive effects of ending the relationship.

Ψ Reframe negative self-talk. Changing negative thoughts to positive thoughts can be quite a jump, you can try working towards neutrality first by lowering the intensity of your language. For example, changing “I can’t stand this” to “this is challenging”, “I am an extremely horrible person” to “I am having a thought that I am a horrible person”.

Ψ Practice self-forgiveness. This can be done by expressing remorse and regret instead of shame, viewing the breakup as a learning experience and accepting yourself as an imperfect being, just like the rest of us.

Breakups are never easy, but when you’re dealing with feelings of guilt on top of heartbreak, moving on can feel impossible. If you’re struggling with breakup guilt, acknowledge your feelings, engage in self-reflection, and be kind to yourself — these are all important steps in overcoming guilt and moving on with your life.