For some breast-cancer survivors, the scariest day of their lives isn't when they get the diagnosis — it's when they finish treatment...

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SANTA ANA, Calif. — For some breast-cancer survivors, the scariest day of their lives isn’t when they get the diagnosis — it’s when they finish treatment.

“As long as they’re aggressively fighting it, they feel safer,” says Sandy Finestone, coordinator for breast-patient services at a hospital in Newport Beach, Calif.

“The treatment is all-consuming. It becomes your life, and then it stops.”

Earlier detection and improved treatments mean more women than ever are surviving breast cancer. But what happens to these warriors when they return from battle?

You’ve endured about six months of grueling chemotherapy and radiation treatments.

The doctor says the cancer is gone. The casserole brigade has slowed. Family and co-workers want the “old you” back.

While children and partners may want the survivors to rewind their clocks to pre-diagnosis, many women can’t.

“I wanted to get back to as normal a life as I had before,” says Julie Rolfe, 51, of Huntington Beach, Calif. “I found it wasn’t as normal as I wanted it to be. I wanted to do things I had always put off.”

For Rolfe, that meant a return to ski racing, a sport she neglected while raising a family. Some women will want the family to continue their extra chores. Others will insist on watching every sunset.

Whatever the response, it’s clear that cancer shifts priorities. Survivors don’t have to return to supermom and superwife mode, Finestone says.

Emotional effect

It’s important to recognize the positive effects that came out of treatment, says Finestone, a 23-year survivor. Maybe you became closer with your husband. Perhaps you made new friends.

“My self-confidence grew from going through treatment,” Rolfe says. “If I could get through that, I could get through anything.”

But some women find that, after treatment, their marriages fail. Friends can also back away. The fear of recurrence can be overwhelming for survivors, even as family members try not to think about it at all.

Remember that support groups don’t set time limits on attendance. Some women find comfort in talking with other survivors years after treatment ends.

Setting new life goals can also help offset the emotional impact, experts say. Make sure to carve out free time for cherished activities. It can even be therapeutic to volunteer at a hospital to help others experiencing the same thing.

Physical changes

The cancer treatment might be over, but the side effects aren’t.

About a third of survivors will endure debilitating fatigue even years after treatment ends. That’s because their immune systems continue to operate full-throttle even after treatment, UCLA researchers discovered earlier this year.

Chemotherapy and radiation can also lead to heart and lung problems. Radiation can make ribs brittle. Breast-reconstruction surgery typically takes abdominal fat and muscle. The muscle loss raises the risk of hernias.

“These are all nuisance factors that prevent you from going through a normal day without thinking about this disease,” says Lillie Shockney, two-time survivor and administrative director of the Johns Hopkins Avon Foundation Breast Center in Baltimore.

Sexuality redefined

For women who lose one or both breasts, perspective is key.

Instead of thinking of a mastectomy as the amputation of a valuable body part, a woman should think of the surgery as a transformation from victim to survivor, Shockney says.

“You don’t see that your breast is gone, you see that the cancer is gone,” says Shockney, who had a double mastectomy.

Couples must talk through their sexual issues, she adds. Discuss how important breasts are to intimacy. Find new erotic zones. And don’t define femininity by breasts.

“Most men, if you’re comfortable with it, can accept it easily,” said Tash Sogg, 83, a survivor from Santa Ana, Calif. “You’ve got to have a sense of humor.”

Ongoing care

Five years after surgery, more than a third of breast-cancer survivors aren’t getting annual mammograms, according to a study published by the American Cancer Society. Whether stymied by fear or complacency, survivors must continue to be diligent about their care.

Another challenge: The number of oncologists, or cancer specialists, is not increasing at the same rate as survivors. So after treatment, most women return to the primary care of their family practitioner or gynecologist. General practitioners must be aware of the special needs of the survivor, including how to do a clinical exam on a radiated or reconstructed breast.

For the survivor, her family, friends and doctors, nothing is the same. Hopefully, that’s a good thing.

Yvonne Lau, a one-year survivor from La Habra Heights, Calif., was inspired to start a Spanish-speaking support group for the American Cancer Society.

“My oncologist said to me, ‘This is just a chapter in the book, it’s not the whole story,’ ” Lau said. “That I’ve passed along. Spiritually, emotionally, physically, I had to be in a good place to get through.”

Orange County Register correspondent Courtney Perkes contributed to this report.