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Body Image After Breast Cancer: Reclaiming Identity, Intimacy, and Confidence

Long after surgery, chemotherapy, or radiation end, many people find themselves navigating complex questions around identity, confidence, femininity, intimacy, and what it means to feel at home in their body again.

Host Laura Carfang is joined by Susan Smaellie, a certified holistic sexuality educator, and Anna Jensen, a breast cancer survivor and advocate, to explore the emotional and psychological impact of breast cancer beyond the clinical experience.

Together, they discuss how survivorship can influence body image, relationships, sexuality, and sense of self and why these conversations are essential, yet often overlooked in traditional medical settings.

In this episode, we discuss:

• How breast cancer impacts body image and self-identity
• The emotional and psychological effects of treatment
• Why conversations about sexuality and intimacy are often missing in cancer care
• The connection between physical healing and emotional healing
• Fear of recurrence and how it can show up years after diagnosis
• The importance of community in survivorship
• The role of vulnerability in healing
• How cultural expectations shape how women process illness
• Finding meaning and growth after cancer
• Resources for connection and support

About Our Guests

Susan Smaellie is a certified holistic sexuality educator and social worker who focuses on helping individuals understand the interconnected relationship between mind, body, and emotional wellbeing.

Anna Jensen is a breast cancer survivor and advocate who shares her lived experience to help others feel less alone in their survivorship journey.

Resources Mentioned

Image Reborn Foundation
Retreats and educational programs supporting emotional healing after breast cancer

SurvivingBreastCancer.org
Free programs, expert-led education, support groups, and community for individuals impacted by breast cancer

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

What happens when breast cancer leaves behind more than physical scars?

In this episode of Breast Cancer Conversations, Laura sits down with Dr. Jim Jackson to explore the hidden emotional impact of cancer, including medical trauma, PTSD, fear, triggers, and healing. Dr. Jackson is a licensed psychologist, neuropsychologist, and Director of Rehabilitation and Recovery at Vanderbilt’s Critical Illness, Brain Dysfunction, and Survivorship Center, where he works with people facing life-threatening and chronic medical conditions.

Together, Laura and Dr. Jackson unpack why the experience of breast cancer can feel traumatic long after diagnosis or treatment begins. They discuss how medical trauma can develop not only from cancer itself, but also from the difficult encounters, procedures, scans, uncertainty, and dismissive moments that can leave a lasting emotional mark. Dr. Jackson explains why he prefers the term medical trauma over medical PTSD, noting that people may experience PTSD, but also anxiety, depression, OCD, and a wide range of other emotional effects.

In this episode, we discuss:

• What medical trauma is and why the term matters
• The difference between medical trauma and medical PTSD
• How breast cancer can trigger fear, anxiety, and emotional distress long after diagnosis
• Why caregivers and loved ones can experience trauma too
• The importance of dignity, humanity, and being truly heard in healthcare
• Dr. Jackson’s upcoming book, Reclaiming Your Life from Medical Trauma

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

Cancer treatment is hard enough — but dealing with insurance denials and medical bills can make it even harder.

In this episode of Breast Cancer Conversations, host Laura Carfang sits down with board-certified patient advocate Jenni Nolan to uncover the hidden financial challenges cancer patients face when navigating insurance, billing, and prior authorizations.

Jenni has spent more than two decades working inside the healthcare system and now helps patients resolve denied insurance claims, correct billing errors, and navigate complex medical bills so they can focus on their care instead of paperwork.

Together, they discuss the biggest insurance pitfalls cancer patients face — and what you can do to protect yourself financially during treatment.

If you’ve ever received a confusing medical bill or had insurance deny a treatment your doctor recommended, this episode will help you understand what’s happening behind the scenes.

Topics Covered:

• Cancer treatment insurance coverage
• Medical billing errors and insurance denials
• Prior authorization delays in cancer care
• Financial toxicity and the cost of cancer
• How to appeal an insurance denial
• Why coding errors can impact coverage

Jenni Nolan is a Board Certified Patient Advocate (BCPA) and founder of Clear Healthcare Advocacy, where she helps patients resolve complex insurance claims and medical billing issues. With more than 20 years of healthcare administration experience, Jenni specializes in helping patients navigate the financial side of medical care

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

When someone is diagnosed with cancer, the focus naturally centers on the patient.

But behind every diagnosis is another story — the story of the caregiver.

In this powerful episode of Breast Cancer Conversations, Laura Carfang steps aside from the microphone as her husband William Laferriere hosts a deeply personal conversation about caregiving.

William is joined by Dr. Eswar Shankar, a cancer researcher and faculty member at The Ohio State University Wexner Medical Center. Dr. Shankar shares his personal experience caring for his late wife through cancer — navigating treatment, fear, uncertainty, and ultimately grief.

Together they explore the emotional realities caregivers face, including:

• How caregivers navigate fear and uncertainty
• The emotional burden of supporting someone through treatment
• Why caregivers often suppress their own feelings
• The importance of empathy and presence during illness
• What life looks like after losing a loved one to cancer
• Turning grief into purpose and meaning

Dr. Shankar reflects on the lessons caregiving taught him — about compassion, resilience, and what it means to truly show up for someone you love.

This conversation shines a light on the often unseen role caregivers play in the cancer journey.

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

When Breast Cancer Changes Everything — What Do You Build Next?

What happens when a breast cancer diagnosis strips away your identity — and forces you to rebuild from the inside out?

In this deeply personal and powerful episode of Breast Cancer Conversations, Laura Carfang sits down with Christine Handy and Christine Anastos — two breast cancer survivors who turned trauma into transformation.

Christine Handy, former international model and author of Walk Beside Me, opens up about:

• Undergoing multiple mastectomy surgeries
• Breast implant illness
• Returning to the runway as a “breastless model”
• Turning her book into the award-winning film Hello Beautiful
• Reclaiming worth beyond appearance

Christine Anastos (christine@connect-and-thrive.com), environmental engineer and founder of Connect & Thrive (CAT) shares:

• Being diagnosed with DCIS while caregiving for her mother
• Cancer’s financial toxicity and hidden barriers
• Why 90% of breast cancer cases may be environmentally influenced
• Launching a public benefit corporation to bridge gaps in survivorship care

Together, these women explore:

• Identity after a cancer diagnosis
• Faith and post-traumatic growth
• The myth of “doing it alone”
• Why collaboration is more powerful than competition
• What it really means to be a “cancer disruptor”

Welcome to the conversation.

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

In this powerful episode of Breast Cancer Conversations, Laura Carfang speaks with Kathy Giusti, a two-time cancer survivor who has lived with multiple myeloma for 30 years and later faced a breast cancer diagnosis as well.

Diagnosed at 37 after what she thought was a routine visit, Kathy was told she had a fatal blood cancer and would live “three years at best.” Instead of accepting that prognosis, she helped change the trajectory of cancer research by founding the Multiple Myeloma Research Foundation (MMRF)—a model that brought scientists, clinicians, biotech, and the FDA together to accelerate treatments.

This conversation explores survivorship, advocacy, and what patients and caregivers can do when the science is moving fast—but the system isn’t.

In This Episode, We Discuss

• Getting a shocking diagnosis after a “routine” appointment
• Why multiple myeloma was once considered a “silent killer”
• How Kathy helped build a research engine that accelerated drug development
• The difference between fast-moving science and slow-moving systems
• How Kathy’s identical twin impacted her breast cancer risk and screening
• DCIS decisions and why “there’s no right or wrong—only what’s best for you”
• Why “looking healthy” can cause people to underestimate what you’re carrying
• How to set boundaries when you’re in treatment or survivorship
• Why you shouldn’t rely on only one or two caregivers—and how to “invite people in”
• Kathy’s book: Fatal to Fearless: 12 Steps to Beating Cancer in a Broken Medical System

Resources & Links

• Follow Kathy: @kathy.giusti
• Book: Fatal to Fearless: 12 Steps to Beating Cancer in a Broken Medical System
• SurvivingBreastCancer.org: Free programs, support groups, and community
• Download the SBC App: Search SurvivingBreastCancer.org in the App Store or Google Play

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

What if part of what makes cancer so hard isn’t just the diagnosis—but the spaces where care happens?

In this eye-opening episode of Breast Cancer Conversations, host Laura Carfang explores how hospital design, architecture, and the built environment directly shape the cancer experience, often in ways patients never realize—but deeply feel.

Laura is joined by Abbie Clary, Executive Director of Market Strategies and Growth for Health for All, and a nationally recognized leader in healthcare architecture and experience design. With millions of square feet of cancer and healthcare facilities in her portfolio—including projects at Memorial Sloan Kettering, MD Anderson, and the Shirley Ryan AbilityLab—Abbie pulls back the curtain on how hospitals are designed, who they’re designed for, and why women are so often treated as the “outlier.”

Together, they discuss trauma-informed design, survivorship-centered care, caregiver inclusion, gender bias in medical spaces, and why healing doesn’t only happen through medicine—it happens through dignity, control, and environment.

In This Episode, We Talk About:

• Why hospitals and medical spaces are often designed for a “default male”
• How architecture impacts anxiety, trauma, and healing for cancer patients
• What trauma-informed design actually looks like in practice
• Why cancer patients experience healthcare differently than other patients
• The importance of designing for repeat visits, not one-time care
• How caregivers and loved ones should be treated as part of the care team
• Why dignity, control, and privacy matter as much as efficiency
• Gender bias in medical design—from gowns to equipment to workflows
• Why women’s pain and discomfort are often minimized in healthcare
• Designing cancer centers for survivorship, not just treatment

About Today's Guest

Abbie Clary, FAIA, FACHA, is the Executive Director of Market Strategies and Growth — Health for All. Her work spans some of the most ambitious healthcare projects in the world, including Memorial Sloan Kettering’s new Cancer Care Pavilion, MD Anderson Cancer Center’s 2030 facilities master plan, and the Shirley Ryan AbilityLab in Chicago.

A nationally sought-after speaker and TEDx presenter, Abbie’s work focuses on transforming healthcare through strategic, human-centered design—bridging architecture, culture change, patient experience, and health equity. Her mission is simple but radical: design healthcare spaces that actually support healing, dignity, and belonging.

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.

Love the episode? Send us a text!

What happens when a breast surgeon becomes a breast cancer patient—and then faces a second diagnosis years later?

In this deeply personal and illuminating episode of Breast Cancer Conversations, host Laura Carfang is joined by Dr. Anne Peled, a board-certified breast, reconstructive, and plastic surgeon who has treated thousands of patients—and also navigated her own early-stage breast cancer diagnosis, followed years later by a new primary DCIS diagnosis.

Together, Laura and Dr. Peled unpack what patients are rarely told about DCIS (stage zero breast cancer), the difference between recurrence and a second primary cancer, and how advances in surgery are transforming survivorship—including sensation-preserving mastectomy.

This conversation bridges clinical expertise and lived experience, offering clarity, compassion, and permission to choose the path that aligns with your body and values.

In this episode:

• What DCIS really is—and why “stage zero” can be misleading
• Recurrence vs. second primary breast cancer: why biology matters
• Lumpectomy vs. mastectomy and why survival outcomes are often the same
• How guilt and self-blame show up after a second diagnosis
• Being diagnosed with breast cancer as a physician
• Navigating treatment when your colleagues are your caregivers
• The evolution of oncoplastic surgery and patient-centered care
• Why loss of breast sensation is under-discussed—but life-changing
• How sensation-preserving mastectomy works
• What questions to ask your surgeon about sensation, nerves, and recovery
• Making decisions based on your priorities—not fear or pressure

About today's guest

Dr. Anne Peled is a board-certified plastic, reconstructive, and breast surgeon in private practice in San Francisco and Co-Director of the Sutter Health California Pacific Medical Center Breast Cancer Center of Excellence. Trained at Amherst College, Harvard Medical School, and UCSF, Dr. Peled completed a unique fellowship combining breast oncologic surgery and reconstruction.

Her clinical and research work focuses on oncoplastic surgery, preserving and restoring sensation after mastectomy, improving patient outcomes, and breast cancer risk reduction. She is also a breast cancer survivor herself, bringing rare dual insight to patient care.

Support the show

Latest News:

• Become a Breast Cancer Conversations+ Member! Sign Up Now.
• Join our Mailing List - New content drops every Monday!
• Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org!
• Enjoying our content? Please consider supporting our work.