Alone. Devastated. Isolated.
Shocked. Abandoned. Unsupported.
These were just a few of the
words used by women living with secondary breast cancer to describe their
feelings about secondary breast cancer.
Some women had been recently
diagnosed with secondary breast cancer after learning to come to terms with
their diagnosis of primary breast cancer, others had been diagnosed with
secondary breast cancer some years ago, and a smaller number had received the
news that they had secondary breast cancer when they first presented i.e they
did not move from being treated for primary breast cancer and then go on to
develop secondary breast cancer, and instead had to deal with this shock
immediately.
We heard that living with secondary breast cancer feels like charting
unknown territories as women try to live the best life they can, and live it to
the full, all the while knowing that it is not going to be as long as they
hoped, that maybe they won’t get to see their young children, or their
grandchildren grow up.
We heard how incredibly lonely and heartbreaking it feels not to be
offered the same amount of support and attention received during treatment for
primary breast cancer.
We heard how marginalised women feel when there is so much emphasis
given to “moving forwards” after active treatment. There was a plea to remember
that women with secondary breast cancer only finish treatment when it stops
working and no options are left for them.
We heard that women with secondary breast cancer are afraid of scaring
or upsetting women who are currently in the position of being “NED”. We heard
that they feel guilty for their feelings when they hear about others moving on
with their lives when they cannot.
We heard how it feels to try to live with uncertainty about the pace of
progression. We heard that women do not want to be defined by their disease;
they do not want to be seen as “terminal”. They want to be valued for who they
are, to be loved and supported by their family and friends. They do not want
people to pretend or avoid their situation, they need their position to be held
and validated but they also need support to continue to participate in every
day life, to be “normal.” Women strive to live the best in every moment, even
if that moment was not what they had wished for.
Some women manage to continue working, others have had to reluctantly
relinquish careers. Women relayed an experience of long periods of stability in
their health, sometimes punctuated by periods where they are very poorly,
perhaps with fatigue, perhaps following surgery or having had cyber knife
treatment, for instance. Whatever stage women are at, they continue to
contribute to their children, families and communities.
We heard that women find it hard to cope with the limited understanding
they encounter about secondary breast cancer. This widespread ignorance is
isolating and they have to make difficult choices about what to share and how
to present themselves.
We heard women share that when they were first diagnosed they thought
they would never be happy again and of their surprise that it is possible to
experience joy alongside sorrow. We heard of the challenge of balancing
profound sadness alongside the paradox of sometimes forgetting one is ill at
all. One woman told us about her idea of living for three years and how she
thought “three years, that’s not so bad, it’s a thousand days - I can do a
thousand nice things”. So, she does nice things whenever she can.
Naz told us that there is little research into the quality of
psychological well-being in secondary breast cancer, but what there was
highlighted three main points:
i) the quality of care is low or
non-existent (but improving) for women with secondary breast cancer,
ii) that psychological
vulnerability is much higher, but,
iii) cancer related
expressiveness (ie sharing emotions) can help ease some emotional burden.
In short, the psychological cost
weighs heavy, and there is disappointment at the level of care invested in
secondary breast cancer.
A few women reported coping better when they’ve received ‘good quality’
care from a breast cancer nurse or their oncologist.
How can we help a friend or
someone we know who has been diagnosed with secondary breast cancer?
Those of us with a diagnosis of primary breast cancer draw on our
experience to be supportive, to listen and hold hands, we try and put aside our
survivor’s guilt, enjoy our friendship, do fun things, but be there for
hospital appointments and the worry. A few of us shared having spent special
times with our friends whose health was failing. Our love is unconditional.
At BRiC we do not draw a line between primary and secondary and instead
see both on a continuum. We understand that having a safe and non-judgemental
place where we can share our deepest fears can help - a place to talk, to cry
and to nourish.
We are all ears and eyes. We are
listening.
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