"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.'
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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.
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“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".