Breast Cancer Counselling & Psychological Support

A breast cancer diagnosis affects far more than the body. The emotional impact — the fear, the uncertainty, the grief, the disruption to identity and relationships — is real and significant, and it deserves as much attention as the clinical treatment itself.

Research consistently shows that psychological wellbeing during and after cancer treatment influences quality of life, treatment adherence, and long-term recovery. Yet many patients feel reluctant to seek support, believing they should simply "get on with it" or that their distress is not serious enough to warrant help. Neither is true. Psychological support is not a sign of weakness — it is a recognised and important component of comprehensive breast cancer care.

At Breast & Surgical Oncology at The Poche Centre, we take the emotional dimensions of a breast cancer diagnosis and its treatment seriously. Every patient has access to a range of psychological and practical support services, from their first appointment through treatment and into life beyond cancer.

Why Psychological Support Matters

Living with a breast cancer diagnosis is rarely straightforward. The experience is different for every person, but common emotional responses include anxiety and fear — about the diagnosis, treatment, and the future — as well as depression, grief, anger, difficulty sleeping, loss of confidence, concerns about body image, relationship strain, and fear of recurrence that persists long after treatment ends.

For some patients, these feelings are manageable with the support of family and friends. For others, they become overwhelming and interfere with daily functioning, relationships, and the ability to engage with treatment. And many patients fall somewhere in between — managing reasonably well on the surface, but quietly struggling beneath it.

Psychological support is not only for those in crisis. It is available at any stage of the journey and for any level of need — from a single conversation with a breast care nurse to a structured course of psychological therapy. The right support, at the right time, makes a meaningful difference.

The Breast Care Nurse — Your First Point of Contact

Our breast care nurses are specialist oncology nurses with dedicated training in the practical and emotional support of patients with breast cancer. They are an integral part of the team and are involved in your care from the time of diagnosis through treatment and follow-up.

Your breast care nurse is your most accessible source of support within the practice. She is available by phone, in person during hospital admissions, and at outpatient appointments. She can help you with a wide range of needs including understanding your diagnosis and treatment plan, preparing for surgery and other procedures, managing treatment side effects, navigating practical challenges — workplace concerns, financial pressures, family communication — and connecting you with the additional services that are most appropriate for your situation.

Nurse-led support may take the form of telephone conversations, face-to-face appointments at the clinic or hospital, or written and digital resources tailored to your circumstances. If your needs are more complex or you are experiencing significant psychological distress, your breast care nurse will facilitate a referral to our psychology service.

The Kay Van Norton Centre for Wellbeing

A/Prof Kylie Snook was one of the founding clinicians of the Kay Van Norton Centre for Wellbeing at The Mater Hospital — a dedicated wellbeing facility for cancer patients receiving treatment at the hospital. The centre provides access to a range of complementary and psychological support services alongside the medical care patients receive, in a calm, purpose-designed environment.

Services available through the centre include psychological counselling, relaxation and mindfulness programs, and complementary therapies that support overall wellbeing during treatment. Your breast care nurse can provide information on accessing services through the Kay Van Norton Centre if you are receiving care at The Mater Hospital.

Clinical Psychology — For Patients Who Need More

When distress is significant, persistent, or interfering meaningfully with daily life and treatment, a referral to a clinical psychologist with specialist experience in oncology is recommended. Psychological therapy for cancer patients is evidence-based and effective, and should not be considered a last resort — accessing it early, when distress is first recognised, produces better outcomes than waiting until a patient is in crisis.

Our network includes clinical psychologists with specialist expertise in cancer-related psychological concerns. Therapy typically involves a series of individual one-on-one sessions and may draw on approaches such as cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), or mindfulness-based stress reduction — all of which have strong evidence bases in the context of cancer care.

A GP Mental Health Care Plan — arranged by your GP — allows eligible patients to access a Medicare rebate for up to ten psychology sessions per calendar year, significantly reducing the out-of-pocket cost. Your breast care nurse or specialist can help you navigate this process if needed.

Support at Every Stage of the Journey

Breast cancer is not a single moment — it is a journey with distinct phases, each of which can bring its own emotional challenges. Support needs change over time, and it is important to know that help is available at every stage.

At diagnosis — the period immediately after receiving a breast cancer diagnosis is often described as one of the most shocking and destabilising experiences patients face. Feelings of disbelief, fear, and acute anxiety are extremely common. This is a time when support from a breast care nurse or counsellor can make an enormous difference in helping patients absorb information, manage immediate distress, and prepare for what comes next.

During treatment — surgery, chemotherapy, radiotherapy, and hormonal therapy each carry their own physical and psychological demands. Body image changes, fatigue, cognitive effects ("chemobrain"), menopausal symptoms, and the relentlessness of treatment schedules all contribute to emotional strain. Many patients also experience relationship difficulties as the demands of cancer treatment change family dynamics and roles.

After treatment — the end of active treatment is often expected to bring relief, but many patients find it a surprisingly difficult transition. The structure and close monitoring of treatment ends, and patients are often left to navigate a new "normal" with ongoing fears about recurrence, lasting physical side effects, changes in identity, and the challenge of re-engaging with life. Fear of recurrence is one of the most common and persistent concerns for breast cancer survivors and is a well-recognised focus of psychological support.

Living with metastatic disease — for patients with metastatic (stage IV) breast cancer, psychological support is a fundamental and ongoing component of care. Managing life with an incurable illness — including its practical, existential, and relationship dimensions — requires sustained, compassionate, and expert support.

Group Programs and Peer Support

Many patients find that connecting with others who have had similar experiences is among the most meaningful forms of support available. The shared understanding between people who have been through breast cancer is something that no clinician, however skilled, can fully replicate.

Group programs — face-to-face programs focused on coping skills, stress management, relaxation, and mindfulness are available through our hospital networks (private and public). These structured programs provide both skills training and the opportunity to meet and support others in similar situations. Your breast care nurse can provide information on currently available programs.

Breast Cancer Network Australia (BCNA) — BCNA is Australia's peak breast cancer consumer organisation and offers extensive peer support resources, including the My Journey app (a personalised online resource for newly diagnosed patients), the Helpline (1800 500 258), the Pink Lady newsletter, and a network of trained volunteer breast cancer survivors who can be matched with newly diagnosed patients for peer support conversations. Visiting bcna.org.au is a worthwhile first step for every newly diagnosed patient.

Cancer Council NSW — the Cancer Council runs a range of support programs and services, including the 13 11 20 telephone support line staffed by oncology nurses, face-to-face counselling through Cancer Council centres, the Canteen program for young adults, and financial assistance services. Visit cancercouncil.com.au for information.

Online support communities — there are several active and moderated online communities where breast cancer patients and survivors connect, share experiences, and offer mutual support. BCNA's online network is one of the most well-regarded.

Supporting Those Who Care for You

A breast cancer diagnosis affects everyone close to the patient — partners, parents, children, and close friends. Carers and family members often experience their own significant distress, sometimes at a level equal to or exceeding that of the patient, while simultaneously trying to be a source of strength and support.

Psychological support for carers and family members is available and important. Your breast care nurse can provide information on carer-specific resources, and clinical psychology services can be accessed by partners or family members who are struggling. Children may benefit from specialist support — child psychologists and school counsellors can be valuable resources, particularly during periods of intensive treatment.

What Counselling and Support Can Help With

Breast cancer counselling and psychological support can help with a wide range of concerns, including anxiety about diagnosis, treatment, and the future, depression and low mood, sleep difficulties, adjustment to body image changes after surgery or treatment, relationship and communication difficulties, sexual health concerns related to treatment effects, managing menopausal symptoms and their emotional impact, workplace and financial concerns, fear of recurrence, the transition from active treatment to survivorship, existential concerns and uncertainty about the future, and end-of-life planning and support for advanced disease.

If something is troubling you — whether it is on this list or not — please raise it with your breast care nurse or specialist. There is no concern that is too small, and there is no issue that is not worth addressing.

Ask for Support — It Is Always Available

One of the most consistent findings in cancer psychology research is that patients who receive psychological support do better — across a wide range of measures including quality of life, treatment tolerance, and even some biological markers of recovery. There is no medal for managing alone, and there is no point in the journey at which asking for help is anything other than the right thing to do.

If you are struggling — at any stage of your breast cancer journey — please speak with your breast care nurse, your specialist, or your GP. Support is available, accessible, and waiting for you.