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Talking about these feelings, either with family or friends or a support group, is important, Ashton says. Another good strategy may be to do a short course of acceptance and commitment

therapy (ACT). This type of therapy focuses on teaching mindfulness skills, helping women to focus on the present moment whenever anxiety over the future threatens to railroad them. The

_Cancer_ journal study found, for instance, that breast cancer survivors who received ACT therapy for six weeks reported less anxiety and depression and a better quality of life six months

after treatment than a control group. You can find a therapist experienced in ACT on the Association for Behavioral and Cognitive Therapies website. You may also feel more empowered as a

survivor if you and your oncologist have come up with a strong follow-up-care plan, Dev says. This will include a schedule for screening tests, a list of possible late or long-term side

effects from treatment (and when to contact your oncologist), and lifestyle modification suggestions. Dev also recommends journaling, as a way of processing your emotions and handling

stress. One small University of Kansas study found that women with early-stage breast cancer who wrote daily about their feelings (including dark thoughts like fear of dying) for three

months after finishing treatment reported one-third fewer symptoms and doctor appointments than those who simply journaled about the facts of their treatment experience. BODY IMAGE ISSUES

Breast cancer treatments can knock out more than just disease. Indeed, struggling with body image is one of the biggest challenges for survivors. “It's not just losing your breasts —

it's struggling with other issues such as hair loss, weight gain from chemotherapy, and fatigue and joint pain from taking medications to prevent recurrence, like tamoxifen,” says Lisa

Lurie, 59, cofounder of breast cancer shopping website Cancer Be Glammed, who was diagnosed with breast cancer 12 years ago. Support groups can be particularly helpful in dealing with this

issue, too. When researchers had over 131 breast cancer survivors who grappled with poor body image and/or problems with sexual functioning participate in eight weekly 90-minute group

therapy sessions, they found that, a year later, the women reported significantly fewer concerns about how they looked and better body image than a control group. Communication is also key,

Ashton adds. “It doesn't always have to be about jumping back into sex. Women need to realize that it's fine to ease back into a romantic relationship with just physical contact

and spending time together,” she says. While drugs like tamoxifen can reduce the risk of breast cancer recurring by up to 50 percent, they can also lead to loss of libido and other symptoms

that can affect your sex drive, such as hot flashes. If you notice this, it's important to talk with your doctor; there are things that she can suggest that may help, like vaginal

moisturizers and lubricants, or even a low-dose vaginal estrogen cream. LACK OF SUPPORT “The notion that breast cancer is the ‘good’ cancer drives me crazy,” says blogger Nancy Stordahl,

author of _Cancer Was Not a Gift & It Didn't Make Me a Better Person._ “Many think it's a year or so out of your life and then you're done. Not so. People don't

realize the scars are deep and long-lasting — the emotional ones as well as the physical ones.” Even more frustrating, she adds, is the belief by some that if a survivor simply adopts a

healthy lifestyle, there's no chance of cancer recurring. “People sometimes think if a person's cancer recurs, it's somehow her fault,” Stordahl says. “Not true. It's

mostly about biology and chance." If you feel like your family and friends aren't providing the support you need, Ashton advises simply sitting down and talking with them. “People

who are close to you are usually truly well meaning, but when they hear you voice something that upsets you, their tendency is usually to try to fix it, because they want to make you feel

better,” she explains. “They don't realize that sometimes a survivor just wants to be heard.” If you can name your specific emotion — anger or sadness or even guilt — and say that you

just need to vent, chances are that both you and your loved ones will feel better. Or you could do what Fisher did, which was to go to a jeweler and have him make a necklace engraved with

the words, “One tough b----.” (She recently launched a jewelry line with the exact same name.) Fisher wears it today backward, so no one can see the message. “I consider it a sort of

talisman that I can use to give me the strength to power through,” she says. “Whenever I get nervous or anxious, I grab on to it and remember that I'll be OK."