Monday, 13 January 2025
Brands make a difference
Coping with breast cancer news
How does hearing about cancer in the news impact on us?
In our discussions, we thought about how we cope with news stories and information on social media about breast cancer.
Our varied responses fell somewhere on a continuum between two positions; first was 'avoidance', where we cope by completely avoiding any information relating to cancer. At the other extreme is what we might call 'immersion', where we cope by seeking out as much information as possible - leaflets from the hospital, BBC news, (Breast) Cancer research, charities and website upon website. But if we can achieve a middle ground, by gaining an understanding of our situation, we can empower ourselves to understand some of the complexities we face, for example, the 'scientific' basis for risk-reducing surgery. However, we fully understand that finding a balance is difficult and we risk being bombarded with information if we aren't careful.
So, delving
deeper into our need for knowledge, it's generally in our nature, as human
beings, to search for explanations. Answers and information can help to make
sense of what has happened to us. It's not surprising, then, that when we try
to find out possible ‘causes’ for breast cancer, we can become overwhelmed with
information about risk factors; diet, exercise, alcohol, weight, stress, etc.
and we can find ourselves drowning in an ocean of mixed messages, opinions and
facts, released by different sites. Whether
we have primary or secondary breast cancer, we are particularly sensitive to
(any) information relating to the causes and prevention of breast cancer as
well as factors aiding and prolonging survival. The headline, "I had
alcohol-related breast cancer. Here’s why I still drink", for instance,
carries the implication there was something we did, or didn't do that led us to
develop cancer. We ask ourselves 'could I have done anything to prevent it?'. It
makes us feel responsible.
We need our families and the wider community to understand how sensitive we are to information and the way that breast cancer is portrayed in the media, the way it creates unhelpful stereotypes, unrealistic expectations and misleading headlines. Very many of us are distressed by well-meaning but highly emotive adverts by the big charities - ironically the very organisations seeking to raise awareness and offer us support! Likewise, some of us felt ambushed by the prevalence of cancer across all platforms – maybe from the topical cancer storyline in our favourite soap opera or the triggering sub-story in a new film.
Our psychological vulnerability increases our sensitivity and, given that our fear of recurrence and fear of progression of disease loom high, we are vigilant for any detail we can use to our advantage, to help us survive. Our fear can drive us to grab with both hands any new developments, whether in progress or substantiated - they mean a lot to us. Friends, family, and colleagues are keen to convey their information, and social media has a cunning way of portraying the best and the worst awareness campaigns in a relentless narrative.
So, how can we work around these issues which are so important to our survival, yet that come with such mixed messages?
Naz told us that science is not always exact, it comes with a margin of error. She explained that problems with replicability and the reliability of trials are not unknown. A lot of people have lost their faith in medicine, because its growth is slow and its effectiveness questionable - though Naz pointed out that 'proper' science grows slowly and steadily. Talking through it together can help, and sharing source study references, so we’re seeing information from the original published paper, not a watered-down news report full of errors. This way we can fully assess the quality of each study and its outcomes.
In an ever more complex world, we must learn to navigate this vast sea of information, choices and options open to us, while trying not to get ourselves into an anxious state of mind where another layer of fear and apprehension follows. When we look at it from this perspective, it’s no wonder that some people shut down and don’t want to know. It can be far too much to cope with.
Wednesday, 8 January 2025
Cancer anniversaries
"Cancer is not only a date in our past, it is an experience we must take forwards with us. Whether we like it or not we must find a way to live with the uncertainty that becomes the background music to our lives. We take with us the myriad emotions of cancer - fear, helplessness, loss, despair, anger - whose voices become louder and louder when we are at our most fragile."
We all agree that our diagnosis anniversaries can be very problematic, especially when we are called back annually for mammograms and other tests. The general feeling from others is that the longer we go “cancer free”, the easier it should become, and we are expected to celebrate each anniversary as real achievement. However, as each year goes by, it can add to our sense of dread and uncertainty about our future.
We share two pieces from Naz here, at 12 and at 10 years post diagnosis, followed by two poignant quotes from previous blogs… Remember that we understand, and you are not alone. By talking about it, we can help others to find their voice, too.
Why Me? Hope, Fear and the Survivor’s Guilt
Today, Jan 2nd, 2024, is exactly 12 years since I was told: ‘I’m 99% confident it’s cancer but the biopsies and further tests will confirm’. It was the perfect opening of hell to 2013, though it dawned on me that I was comfortably numb, as I greeted my 2 year old daughter with smiles and hugs when I got home. It wasn’t me who had cancer, it was Naz.
Our memories serve many purposes. One of them is to reflect on the past to build a future. In these 12 years, my memories of the roller coasters adjusting to the ever changing symptoms I have experienced have served to understand the moment, not the future. The future is the moment, and strangely enough I have implicitly planned for the future navigating my way through the dark times with hope. I have learned that hope is survival and survival is hope. If this logic is true, perhaps I am living the future.
To live with hope is not a crime or a gift when you have been diagnosed with cancer, but a human right. The other side of the coin though is fear. While we live with hope we also live with fear that the cancer will return and we may die. This is not unusual as fear is essential to survival. If we didn’t fear danger every time we crossed the road we would not survive.
Approximately 30% of women with a breast cancer diagnosis experience return of cancer where the original cancer comes back, i.e., it metastasises to other parts of the body and is incurable with a median life line of 3- 5 years. Many of the women I got to know in these 12 years of my 'survival' so far are no longer here. They lived in hope as well as fear, just like me, they didn’t lose a battle or a fight, they did their best just like many others who are still here.
When you can’t quite explain why some of us die and others ‘survive’ this disease, it could be a combination of many factors which scientific research is trying to figure out, but you end up worrying and fearing your chances. You also experience what we know as ‘survivor’s guilt’. Strangely enough you are puzzled about your own survival and can feel guilty for surviving when others, just like you, have not. I can count endlessly the women who one by one left us too soon, sometimes suddenly without much notice. My stomach churns and I feel a cold sweat on my forehead when I look at some pictures and question why am I the only one here in person. How did this happen? Why? It was not their fault.
12 years is a long time, but as time ticks along I am fearing the return of my cancer in waves. Sometimes the waves hit the shore loudly raising alarms other times the waves don’t quite reach the shore and disappear quietly. But, I know that the space between hope and fear can be small. I know that I cannot determine how the waves change in movement. I feel guilty for not being consumed by the waves, I miss my friends and so dearly want to see them. So many thoughts cross my mind and it gets confusing.
I think of all the work I've done on anxiety and depression all these years, all the work we do in BRiC, all the research we do to better lives to improve resilience, all the women we've united, all our plans, there is so much left to do. And we will until we can.
I decide to stand and readjust so that the waves only touch what I can afford to lose, for now, and walking towards my aims, I let my tears melt my hopes and fears into one.
I am dedicating this to all of BRiC's amazing members.'
*********************************
10 is a two-digit number, although the 1 is a
bonus
Reaching 10 years of age when you are a child is
certainly a big deal. Celebrations are special and it can feel you are entering
a new era. Excitement grows as to what the teenage years may bring, which of
course are super challenging. The changes you experience build you up for the
future: the world can be your oyster, so many opportunities, so many more
decades to come, so many more milestones. You kick off the ground, running
(possibly in more than one direction).
Yet, when you reach your 10-year cancer
anniversary you are stumped with questions. Even with your gratitude cloak on,
this was not expected. 10 years? Really? I should be so lucky, you think.
This special milestone. You hear people around you are congratulating you,
giving you the thumbs up, and saying that ‘you made it’. ‘No worries now; ‘Well
done’; ‘You must have been doing all the right things’ and you may ponder...am
I responsible for this ‘success’?
Today, as I reached that 10 year ‘milestone’, I
found myself a mixed bag of emotions, low and high within minutes, tearful and
happy within seconds, a roller coaster. I found myself questioning, why me? My
brain took me back to all the women with the same diagnosis as mine 10 years
ago, whose life was taken by breast cancer too young too soon. They did all the
‘right things’, yet they were robbed from the opportunity to spend Christmas
and New Year with their children. They were denied the fun to go for a long
walk today in the sun and make memories with their family. They were denied the
joy of having your amazing daughter make you proud on so many levels. Why me? I
asked. Why them? Why are we in a position where we still have so many questions
unanswered? My stomach churns and I feel anxious.
While 10 years is certainly a long time post
breast cancer diagnosis, I find myself not so excited about what the next 10
years can bring. It's about one day at a time. It's about hanging on to the
moments and embracing them. The excitement is mixed with grief and fear that
the cancer can raise its ugly head again. It is so easy to compare yourself to
the statistics, after all the numbers can guide us.
The numbers show that 30% of women with
early-stage breast cancer go on to develop metastatic breast cancer which is
incurable. Yes, the likelihood of metastasis is greater within the first 10
years, but it doesn’t rule out many cases diagnosed after the 10 years. 10
years of dealing with side effects of breast cancer treatment and adjusting to
our new normal leaves a bittersweet taste in our buds. We want to thrive not
just survive, and we do everything we can to live life to the fullest, but with
a psychological cost which can linger for many years.
The psychological cost of breast cancer
diagnosis and treatment runs high, and the past 10 years has seen my lab work
harder every day to find better ways to build resilience in a population who
through no choice of their own endeavour the emotional roller coasters with
dignity, perseverance and determination. From all the research I’ve ever
carried out on understanding the roots of emotional vulnerability and
resilience in my entire career, never did I learn so much resilience from women
whose breast cancer was incurable. We are tough, we are strong, but the
strength isn’t the kind you think it is, we are not made of iron, we are made
to bend and not break. This is what BRiC, the centre I found, has at its heart
and mission. 2118 women and counting, we are providing a safe and educational
network to learn, share, and help each other grow. Research guides the way, but
our determination can make it happen.
So, as I usually do, I will end tonight on a
high note. That while I do not know what the next 10 years has in store for me,
I will nevertheless make a list of all that I want to achieve and more.
Because, you know what, we are not guaranteed life, every day, every breath,
and every moment, is a bonus.
This piece is dedicated to all the women who did not see beyond the 10 years.
----------------------------------
“While cancer anniversaries are hard to entertain, they are reminders of who we are and how far we’ve come. The past becomes the present, stepping into an uncertain future determined in part by its past and an ambition to survive to the best of our ability. The fight to survive becomes more pertinent, as does the necessity to practice resilience, exercising flexibility and adjustment.”
"So here we are 366 days on, a year of ups and downs, but life does move forward. There are times when I forget for a few hours, feel normal even, then other times when I cannot shake off the waves of grief and anxiety surrounding what is facing us. It’s a bittersweet moment, because of course being here is cause for celebration, but there’s sadness too as it’s an anniversary which brings our sense of time into sharp focus. Our mind starts to be drawn to the future as well as the past".
Financial Difficulties
“The
long term impact of reduced earning capability is an added stressor that makes
me feel anxious and vulnerable”
There
are many hidden financial implications of a cancer diagnosis that are rarely
called out. At a time when our ability to earn is reduced, the extra costs hit
us as a double whammy. A lengthy treatment regime and subsequent recovery means
we may need to extend our sick leave beyond that which our employer will
support with sick pay, we may not be able to return to work at the same income
level after treatment, or at all. It is common to move from full time to part
time, to change careers for something less stressful. Self-employed women may
be left without income for a considerable period and small businesses may
suffer beyond repair.
For those of us
with primary breast cancer, the trajectory of recovery isn’t linear and we
continue to take our cancer ‘effects’ forward with us. Post traumatic stress
symptoms can linger for a long time after diagnosis. With threats to our
self-esteem and self-confidence, the variability in our recovery and our change
in priorities due to the uncertainty we face, we remain at a disadvantage and
continue to be at a higher risk of long term financial insecurity. Fatigue is
another big factor as at times even if we want to continue what we love doing,
we can’t, and we have to take a step back.
Those of us with secondary breast cancer
described how financial uncertainty caused additional stress and worry which
impacted on both our physical and emotional well-being and our ability to
pursue our goals, especially for those who had been forced to give up
much-loved careers. Although those who could work part-time (depending on their
role and the support available) shared how important this was in terms of finances,
many felt that work was just not something they could contemplate, especially
if they were on an intensive treatment plan which might require daily
appointments at the hospital.
Returning to work and continuing to work can be fraught with problems, with
some of us struggling on short, phased returns with little management support. As
mentioned above, fatigue is a long term after effect of cancer and sometimes
this can be debilitating. Those who do successfully return to their old jobs may
no longer be wanting or have the energy to put themselves forward for
promotions or career progression.
The additional costs of having cancer include: travel costs to our treatment
centre, parking costs, hats and scarves and wigs for that time without our hair
during chemotherapy, pillows and pyjamas that open down the front for surgery, pure
lotions to sooth damaged skin after radiotherapy, specialist bras for post-surgery
and then pocketed bras and swimwear forever (which cost more than ordinary bras
and are mostly ugly to boot!).
Exercise and eating well are key to our health, with many of us taking
supplements, and maintaining a healthy lifestyle can be expensive. Travel
insurance costs rocket up, particularly for women with secondary cancer, and
life policies may become invalid. Getting further life cover and private
medical insurance may be prohibited. Even those who had access to private
treatment are still required to pay excess payments of hundreds of pounds. Being
at home all day during treatment means heating costs go up, especially through Winter.
Additionally, some of us had paid for genetic
testing which we were not eligible for on the NHS. This can be expensive, but
so important for many wanting to understand future family risks.
A few of us had
critical illness cover and income protection which had been an enormous help,
but it's important to check the small print to check the limits of cover.
In an effort to secure extra funds, some have
cashed in savings plans, including pension plans, or sold their homes to make
ends meet. ESA is available for some, and PIP, and prescriptions for all
medications are free following diagnosis. Some used annual leave instead of sick leave for the
time off work needed, but this of course left no holiday time, which hardly
supports a healthy recovery.
Cancer charities like Macmillan and Maggie's
can be great, and many of us had relied on help and support to access
appropriate benefits, a temporary reduction in household bills or mortgage
repayments. Not all of us had positive experiences though, and some of us had
been poorly advised, had benefit applications rejected and had to go through an
appeals process, or had poor experiences with our banks and building societies.
Having cancer can mean a permanent drop in income and lead to a necessary
change of lifestyle. For those who get by, luxuries like travel and
overseas holidays may become a thing of the past. It may take years beyond
diagnosis to return to financial stability. At its worst, cancer may bring with
it real financial hardship, the stress and worry of which cannot be helpful to
our reduced level of health and fitness.
Even those with more positive experiences
felt that the focus tended to be on short term financial help and advice during
treatment. But what about the longer term?
Some amazing entrepreneurial suggestions were
put forward about ways to earn money but very many of us simply felt we did not
have the energy to invest in anything other than trying to keep up with our
usual routines and staying as well as we could.
Being able to access to advice from
knowledgeable and informed advisors, a reduction in outgoings and support from
our families were just some of the factors which helped to increase our
resilience. Those who were younger, single parents, carers, students, or had
multiple health conditions appeared to face considerable adversity. It was
clear that the challenges continued in the longer term. We continue to worry
about what the future holds and how the financial strain will affect us further
down the line.
Friday, 3 January 2025
Coping with Chemo
3/12/2024
So today is my first chemotherapy session: one down, 5 to go. It's been a long time coming so it feels like a bit of a milestone to finally be underway. So far it has all been much more straightforward and less frightening than I had expected - the brilliant staff at the chemo unit helped with that. I had also been on a bit of an impromptu visit to the unit last week with new chemo-buddy Kirsty who I met at a Skin and Make Up session last week. That had really helped to put me at ease for today so I knew what to expect.
Reflections on my 12th cancer anniversary
Sunday, 3 November 2024
Eva's story
Just writing this makes me shake, it feels
like picking at a scab that is not quite ready to be picked, it feels raw and
something I just wanna leave well alone under the half falling off plaster.
But maybe, just maybe it will help someone else so here goes.
I was diagnosed just past my 39th Birthday in 2013, I had two young daughters who were, and still are my heartbeat and soul, they will always be my 1st priority in all of this, the fear starts there, with them, the fear of not seeing them grow, the fear of not being there for them for their life events, the fear of what sort of heartache I would give them at every little life event that was supposed to be ‘the happiest day of their life‘ if they didn’t have mumma bear in the corner roaring. It really hurts.
It even effects my ability to plan - I think
every decision is tempting faint in some way, it is not logical but it is
there on my shoulder annoying me like a wasp by my beer I was enjoying, it
just won’t go away. I just keep swatting it and take a gulp.
We have a saying in BC sisterhood called scanxiety, and we all feel it every time we feel a twinge a tweak or a lump, we poke the hell out of it for two weeks hoping it will ‘go away‘ (I am being very polite there with my ‘wording’) I have had quite a few of these moments and always get told to keep still in the scan - my reply is always the same, “I thought I was“, I am physically trembling with sheer fear.
Loosing my close BC buddies whose C returned as a secondary is also extremely sad
and a cruel reminder, I watched their ‘friends‘ drop off, I watched their
bodies slowly be destroyed and I listened as their brains processed the
overwhelming powerlessness that they felt. I miss you all so much. I write this for you my dear friends.
So how do I deal with never being told ‘all clear’ I can only speak for me, I try and connect my other senses, I smell, touch and feel things more to make my brain pathways run somewhere else, it does work but like riding a bike, it takes practice and sometimes I fall off spectacularly.
Kindness, love and gratefulness (here comes the hippy stuff, I promise I
don’t have it as a decal on my kitchen wall) kindness to myself and my endless
self jabber, love, all you need is love, love of life experiences, love of
little moments that make me happy, love of my friends, family and animals (just call me Snow White, but I don’t clean after any man let alone 7 of them)
Gratefulness, I have got this far, it is so precious to me.
Try and do all of it I say, just jump at
decisions that feel right in your gut and heart, not in a hedonistic way but in a way that
gives you peace, tell the people you love, you love them with all your heart
especially those who have been through a life threatening disease, let go of
the ones who don’t love you how you want to be loved, you don’t need them, go into nature and feel the power of
Mother Earth, experience new things, embrace all the happy moments and keep
them close to your heart and mind, grab this beautiful life by the both hands
and do a one, two, three, wheeeeeeeeee because it is so, so precious.