October is breast cancer awareness month. Having worked with breast cancer patients since 2017, I have heard from so many patients about how this disease has impacted them. I thought I would share a few themes that I have noticed over the years (in no particular order):
Navigating the medical system can be confusing and/or stressful – With a diagnosis of breast cancer, patients can find themselves with multiple doctors and medical professionals involved in their care. It is typical to have a surgeon/specialist, a medical oncologist (a doctor who prescribes chemotherapy if needed and monitors this process), and/or a radiation oncologist (a doctor who plans and oversees radiation therapy if needed). It is possible to be referred to additional specialists if required. Patients are still expected to see their family doctor or general practitioner (GP) for general ailments and symptoms, such as pain. Patients also are required to undergo a number of investigations, imaging and regular blood work as needed for their treatment. It can be tricky for the patient to coordinate all these appointments, especially if not feeling well.
Waiting is hard – Unfortunately, the process of getting a diagnosis takes time as people often wait for imaging and testing, as well as wait for an appointment to meet with a specialist. If treatment is required, often there are wait times for surgery, as well as chemotherapy and radiation. Waiting when diagnosed with a potentially life-threatening disease is not easy! (If you are in this situation, there are some things that may be helpful from a counselling perspective).
‘Chemo brain’ is a thing – Many patients report feeling ‘brain fog’ and note that they struggle with memory issues while undergoing chemotherapy. For some patients, these symptoms may persist for some time after treatment. Those diagnosed with cancer often have heightened stress, anxiety and/or depression as a result of their illness. For some patients, their diagnosis or experience of treatment can be traumatic or remind them of past traumatic experiences. This is just something to be aware of.
Stage of cancer does not equal emotional impact – In my experience, those diagnosed with ductal carcinoma in situ (DCIS) or stage I breast cancer can have just as much of an emotional reaction as someone diagnosed with stage III or IV breast cancer. However, often these women feel guilty that they are experiencing an emotional response to their diagnosis as they are grateful their illness was caught early. It’s ok to have an emotional response to a diagnosis regardless of stage of disease.
Post treatment can be tricky – Breast cancer treatment can involve a number of interventions, including chemotherapy, surgery, radiation therapy and hormone therapy. It should be noted that many women have multiple surgeries and treatments that take months or years depending on diagnosis, as well as wait times for investigations, surgeries and treatments. After having gone through all of that, there are regular follow ups which can be stressful (I have yet to talk to someone who doesn’t express some level of stress/anxiety regarding follow up testing post treatment).
Also, many patients noted that their supports can ‘dry up’ once they are done treatment, however, they still feel that things are not ‘normal’ yet. It can take time to recover from cancer treatment, both physically and emotionally.
Make space for grief – Grief is our emotional reaction to change…and with a diagnosis of breast cancer (well, any cancer or illness) comes a lot of changes. From daily routines and plans for the future, to appearance and physical changes. Often people with cancer are encouraged to ‘be positive’ and therefore feel guilty when they experience grief in response to the changes that they have encountered unexpectedly. There is no ‘right’ or ‘wrong’ way the feel when diagnosed, undergoing treatment or recovering from illness.
Medications can impact mood – Depending on diagnosis, many women with breast cancer are prescribed hormone therapy to reduce their risks of recurrence. Sometimes, women notice changes to their mood or experience heightened emotions. Also, sometimes steroid medications are prescribed to help manage the side effects of chemotherapy. Steroids can impact mood, as well as responses to stressors (less patience and/or more reactive). It’s just something to be aware of if you or your loved one is taking hormone medication or steroids. If it is a concern, you can discuss your experience with your prescribing doctor/oncologist. Counselling may also be helpful in managing mood related side effects from medication.
Sometimes people don’t know how to be supportive – Often people diagnosed with cancer share with me that the people they expected to be there for them have let them down in some way. Maybe those people just don’t have the bandwidth to be there emotionally. Or maybe having a friend or family member diagnosed with cancer makes them concerned about the possibility that it could happen to them as well. Whatever the reason, this can be hurtful.
On the other hand, I have heard so many stories of people being surprised by supportive acquaintances, co-workers and/or neighbours who have brought meals, offered rides and practical support, as well as emotional support.
A little self compassion goes a long way – It’s easy to be hard on ourselves when we are going through a challenging time in life. It can be helpful to consider how you are relating to yourself; are you being critical or kind to yourself? Self compassion is the idea that we treat ourselves as kindly as we would treat a friend who was going through the same situation. This is a helpful practice for anyone, not just those navigating changes due to breast cancer. In my experience, this typically does not come naturally but is something that we have to practice.
Living with cancer – I have had the privilege of working with many women who are living with stage IV disease. If you saw them out and about, you probably wouldn’t be aware that they are living with cancer as they are balancing their medical care and symptoms with their daily routines; school drop offs, pick ups, family commitments, work, parenting and household duties, etc. If this is you, you are amazing! If you know someone like this, please encourage and support them!
Each person’s experience with breast cancer (or any illness) is unique. My hopes in sharing these observations is that (1) if you have been diagnosed with breast cancer you will know that you are not alone and (2) if you know someone with breast cancer, you will have some understanding in knowing how to be supportive.
If you feel that counselling with someone who is familiar with cancer-related issues/concerns would be helpful, I would be happy to connect with you! You can find me at: https://www.joannanicholsoncounselling.com/