Living a full life, road to recovery

Bavina Sookdeo

As a breast oncologist and reconstructive surgeon, Dr Rajen Rampaul has seen the dreams – marriage, motherhood and career advancement – of many young women come crashing down when they’re given a breast-cancer diagnosis. Those dreams collide with surgery, chemotherapy and fear of recurrence.

But he says life after breast cancer can be full, meaningful, and hopeful – once the right support, knowledge and mindset are in place.

“Young women face unique challenges compared to older women,” Rampaul said. “The first that comes to mind is fertility and the ability to have children – and then the anxiety of whether they’ll have the joy of seeing those children grow up, graduate, get married and even have grandchildren.”

He pointed out that older women may have already raised their families, and while they would have concerns of their own, younger survivors often grapple with uncertainty about the future and the emotional toll of a diagnosis that threatens not just their health, but also identity and long-term plans.

Burden of treatment in daily life

Cancer treatment is physically and emotionally taxing.

“Side effects such as fatigue, scarring and loss of fertility have a profound effect on a young woman’s ability to resume her daily life,” Rampaul said.

He explained that unlike women in their sixties, younger women – those in their thirties, forties and even fifties – are often at the peak of their careers and child-rearing responsibilities. Their daily routines tend to be far more demanding.

Treatments like chemotherapy can cause significant side effects, including fatigue, difficulty eating, hair loss and even substantial weight gain due to steroids, all of which can hinder their ability to function effectively day to day.

Rebuilding confidence

Rampaul believes breast reconstruction plays a powerful role in helping survivors move forward.

“It has an important part in helping survivors regain confidence and reintegrate into society,” he said. “There are ample studies that demonstrate improvements in quality of life and in outlook toward work and personal relationships.”

Psychological support

As medical director at Pink Hibiscus Breast Health Specialists, he emphasised that psychological support is a crucial component of survivorship, saying all patient pathways should incorporate it to help individuals better process and cope with a difficult diagnosis.

At the Pink Hibiscus Breast Centre, such support is provided in various ways, including through a clinical psychologist. In the past, the centre has also offered group-based assistance through initiatives such as the Think Pink support group.

While he was head of the St James Breast Clinic, Rampaul collaborated with Dr Arianne Sheppard to establish the first breast-cancer support group in the public healthcare system.

Women who accessed these services found the groups extremely valuable, he said, as they provided a vital space to share their experiences and discuss the challenges they faced.

Returning to a full life

Can survivors return to normal activities?

Rampaul stressed, “Yes, women can and do return to their careers, studies and active lifestyles. “There really aren’t significant restrictions, and I encourage my patients to embrace life as fully as they would before they were diagnosed.”

But he noted some practical precautions.

“In patients who’ve had axillary surgery – surgery involving the lymph nodes under the arm – it’s important to wear gloves when gardening to prevent infection,” he advised. “They should also avoid overly invasive manicures that could disrupt the nail cuticle, as lymphatic supply to the arm may be affected.”

Body image and healing relationships

Rampaul advised young survivors to embrace life fully and to strive to return to the rhythm of their lives before diagnosis and treatment.

He said intimacy is best approached through open communication with one’s partner and by involving family members throughout the journey.

Acknowledging that maintaining healthy relationships after treatment can be challenging, he strongly encouraged patients to seek guidance from a clinical psychologist or counsellor. Neither patients nor their partners are often fully equipped to manage these emotional complexities on their own, he said.

He added, “Understanding that they can be cured and life can be wholesome again is very important in having this discussion and being able to share their fears and apprehensions.”

Thriving through lifestyle and self-care

Rampaul encourages patients to view lifestyle change in two key areas – what they put into their bodies and how they treat their bodies.

It’s important to achieve and maintain a healthy weight through diet and exercise rather than through weight-loss medications or surgery, especially for patients with oestrogen-positive breast cancer, who are at higher risk of relapse.

“There is scientific evidence to show that exercise alone can improve outcomes for breast cancer recurrence and can even reverse lymphoedema (swelling caused by fluid retention),” he said, adding that stress management is equally vital, as growing research highlights that certain foods can be either cancer-promoting or cancer-preventing.

He also said regular follow-up is essential.

“In my practice, I follow international guidelines, where patients are reviewed periodically during the first two years, and then annually thereafter. Follow-up includes blood tests and scans as necessary.”

As for women who are afraid of their children developing cancer in the future, Rampaul said this should be addressed through proper risk assessment. He emphasised that factors such as the child’s age and the family’s medical history play pivotal roles in guiding advice and determining any potential risk.

“It’s important to note that not everyone who has breast cancer will have children who are at risk.”

Embracing life itself

For those currently in treatment, Rampaul urged: “It is imperative that you communicate how you feel. Speak to your doctor, your counsellor, your loved ones.

“You will be surprised how many others share your worries – and how many have gone on to live strong, fulfilling lives.”

He believes healing begins with honesty and connection.

“Communication is the key. Having a platform to discuss fears allows patients to gain strength from positive feedback rather than keeping it to themselves.”

He also encouraged, “Embrace life itself. Work towards returning to the life you had before breast cancer. Understand that you can be cured, and life can be wholesome again.”