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The short answer on identity after breast cancer
There is no correct word for who you are after breast cancer. In one study of people a few years past diagnosis, most said "survivor" fit them, nearly as many chose "a person who has had cancer," and many used more than one label at once. Some words seemed to sit alongside better well-being and some alongside worse, but the research cannot say the word itself is the cause. The label that fits is the one that feels true to you, and it is allowed to change.
What to know about identity after breast cancer
- Most people hold more than one identity. "Survivor" and "person who has had cancer" were each chosen by about four in five.
- "Survivor" is not for everyone. Some avoid it because it sounds like the danger has passed.
- Feeling like a victim tends to fade. It was the only label that weakened as time passed after treatment.
- You get to decide. No study found a label you are supposed to use.
Why does breast cancer change how you see yourself?
Because it rarely stays in its box. In a 2000 review in the journal Cancer Practice, researcher Brad Zebrack argued that cancer is not a single event with a clean ending. It changes the roles people play at work and at home, and with them the way they see themselves in the world. He described recovery as partly a process of rebuilding identity, folding the experience into a sense of self that may be new or renewed.
Zebrack opens his paper with words from someone years past treatment, who described cancer as one patch in a larger life: "My life is a quilt, and one of those patches is cancer." That is one way the experience can settle. It is not a deadline for when it has to.
What do people actually call themselves after cancer?
A 2009 study in the Journal of General Internal Medicine asked 167 adults, aged 18 to 55 and diagnosed one to three years earlier, how well four labels described them. Nearly half had had breast cancer. Here is how many said each label fit them at least somewhat:
- Survivor: 83 percent
- Person who has had cancer: 81 percent
- Patient: 58 percent
- Victim: 18 percent
The labels were barely linked to one another, which means many people carried several at the same time. A woman could feel like a survivor at a fundraising walk and like a patient in the scan waiting room on the same day.
Why do some women avoid the word "survivor"?
The word has a history. The National Coalition for Cancer Survivorship chose it deliberately in 1986, to promote empowerment for people with cancer. In its official meaning, a survivor is anyone living after a cancer diagnosis, for however long that is.
In everyday speech, though, a survivor is someone the danger has passed. The study's authors note that for people facing years of hormone therapy or a real fear of recurrence, that can feel untrue. They point to an earlier study of men after prostate cancer in which, given only one choice, more than half picked "someone who has had cancer" over "survivor."
Babette follows the same instinct. We don't call our readers survivors or warriors by default. We use the words you use.
Does the word you choose affect how you feel?
The words were linked to different experiences, but the study cannot show that a label changes anyone's well-being.
People who identified more strongly as survivors reported more positive feelings and fewer negative ones. They also reported more growth since their cancer, and were more likely to talk openly about it and take part in fundraising events. People who identified as victims reported more negative feelings, more unwanted thoughts about cancer and less satisfaction with life. Feeling like a patient, or like a person who has had cancer, made no difference to well-being either way.
All of this was measured at a single moment, so the arrow could run in either direction. Feeling well may make "survivor" fit more easily, rather than the reverse. The study's authors also note that their participants were mostly white and well-off, and that fewer than half of the people invited took part.
What does it mean if you feel like a victim of cancer?
It does not mean you are coping wrong. In the study, people who felt like victims worried more about cancer coming back, and some were using alcohol or drugs to cope. Victim was also the only identity that faded as time passed after treatment ended.
The same group was also more likely to belong to cancer organizations and to press public officials for change. Anger at what happened can turn into action, and that counts for something.
How do you find the words that fit you?
None of this comes from a study. It is what the research suggests is worth trying:
- Try a few words on. Say "I had breast cancer" and "I'm a survivor" out loud, and notice which one you flinch at.
- Let it depend on the room. The word you use at work does not have to be the one you use with friends.
- Tell people your preference. Many people say "survivor" because they think it is the kind word. You can ask them to use yours.
- Expect it to change. The word that fits in year one may not fit in year five.
For help with what to say to the people around you, see How Do I Help a Friend With Breast Cancer?, and send it to them.
When to tell your care team how you are doing
- Thoughts about cancer keep intruding and won't let you rest
- You are leaning on alcohol or other substances to get through
- Low mood or worry has lasted more than two weeks
Many cancer centers have counselors and psycho-oncology teams who work only with people who have had cancer. If you are in crisis in the U.S., call or text 988.
Questions to ask yourself about who you are after breast cancer
- When someone calls me a survivor, how do I actually feel?
- Which parts of my life feel most changed, and which feel like they are still mine?
- What would I like the people closest to me to call this part of my life?
- Has the word I would choose changed since I was diagnosed?
Sources: Crystal L. Park, Ianita Zlateva and Thomas O. Blank, Self-identity After Cancer: "Survivor", "Victim", "Patient", and "Person with Cancer", Journal of General Internal Medicine (2009); Brad Zebrack, Cancer Survivor Identity and Quality of Life, Cancer Practice (2000). This article is general information, written in Babette's own words, and is not a substitute for advice from your care team.
