You have to integrate what’s happened to you.
When someone finishes their cancer treatment program successfully, their oncologist tells them they are free to go. Your doctors step away and tell you to get on with your life. You’ve been put through the wringer.
Your doctors say you are on the other side. But you have so much work to do before you’re ready and able to move on.
You have to sort through what has happened and make meaning from your experiences.
You may say you wouldn’t wish your experience on your worst energy, but since you had to go through having cancer, there are invaluable benefits that you have accrued.
From the chair I sit in as a psychologist, you aren’t wholly healed when your doctors say you are. You have to reconcile yourself with how your illness has changed you. You have to determine who you are because you have invariably changed, and you have to determine how to move forward.
Michael Bury, a sociologist, argues, “a major illness is a biographical disruption that dismantles who you knew yourself to be and dramatically alters your sense of self.”
<< Details in the stories that follow have been changed to protect privacy. >>
A childhood friend of mine is currently receiving treatment for breast cancer. She’s focused on getting through chemotherapy. She’s been thrown into menopause. She mused, during one of our weekly walks, that she could die.
She’s not thinking too far down the road. Her attention is focused on the immediate. She has surgery scheduled in eight weeks. Her team will remove the lump in her breast. When she’s healed from surgery, she will receive radiation.
After her cancer treatment finishes, my childhood friend will have to determine how to return to normal life.
Parts of her body will be radically altered by the surgery and radiation. It will take a year to flush the chemotherapy drugs from her system. She closed down her business when she was diagnosed with cancer, so she will have to figure out how earn an income again.
My personal thoughts focus on the psychological impact of having felt a bullet whiz by her head. If she hadn’t been diagnosed when she was, her cancer could have metastasized. If it had been caught by the radiologist reading her mammograms earlier, however, her cancer might not have progressed as far as it did. These facts will need to be grappled with when she has the energy and the mental space to look at them.
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I want to switch gears and talk about Spencer’s experiences next.
Spencer was a client of mine whose stage-three colon cancer was diagnosed six or seven years ago. He had surgery and then chemotherapy. He read the medical literature and understood his cancer and his treatment regime at a deep level.
Spencer needed to talk about the possibility that he would die.
He talked about the financial wallop that not being able to work for 18 months had on his family. He talked about his children’s fears that he would die, and being unable to guarantee that he would not. He talked about his oldest child shouldering too much of the emotional burden for the family, and how his youngest child refusing to discuss cancer at the supper table.
Spencer was diagnosed with cancer several weeks after being laid off from his job. We discussed how Spencer couldn’t philosophically resent being laid off from work because having free time enabled him to schedule the colonoscopy that identified his cancer. If Spencer hadn’t been laid off, he would not have gone for the colonoscopy and his cancer would have been more advanced when it was found. Would he have survived a delay in treatment? Was being laid off from his job actually a blessing?
Losing his job was instrumental in prolonging Spencer’s life. Stories like this become important as people rewrite their life’s narratives.
Spencer had to come to terms with how he might have died if his employer hadn’t let him go. We need to ponder these events and make sense of them. We need to extract the meaning and tell ourselves and those around us the stories that emerge.
After Spencer’s doctors released him from treatment and told him to get on with life, Spencer had to find another professional position. He needed to take a break first to recover from chemotherapy, but he ultimately found a job that he loved. He succeeded in that position, and then found another job that he enjoyed even more.
Spencer and I discussed the impact his cancer has had on him for almost five years after he finished chemotherapy.
The meaning you extract from your experiences, and the retelling of this meaning in stories, is strongly connected to your mental health. It’s how we make sense of our experiences.
Spencer said he couldn’t continue to see life as a precious gift, every day, for the remainder of his life. He said that glow had to fade. He said he knows every day, however, that he may not live for long. That his naivety was destroyed and he can never get it back. He knows how vulnerable he is – and how vulnerable the rest of us are.
Spencer spoke at length about the importance of his relationships. He said he values his children and his wife more because of his experiences with cancer. He said these relationships have become the most important thing in his life.
Spencer was an athlete before his diagnosis. He was able to work out religiously during his cancer treatment because he was fit when he discovered he was ill. Outwardly his body wasn’t dramatically changed by his cancer treatment over time.
There are many pieces to pick up after a major illness.
The obvious pieces include how to make peace with your body for betraying you and how to learn to trust your body again.
You have to paste together your personal finances like Spencer and his family did. You have to decide what kind of work you want to do, like my childhood friend will. Can you step back into the kind of work you did after you physically recover? Do you need to do something more meaningful? Many who come close to death can’t simply step back into the life that they had.
I read Left on Tenth by Delia Ephron about a year ago. This autobiographical memoire chronicles Ephron’s experiences being diagnosed and successfully treated for AML, a fierce leukemia. Ephron documented that she knew her cancer could return after she finished treatment. If you’re looking for a good read about how cancer affects a person, I highly recommend this book.
It takes time to adjust to a major life event like surviving cancer, so give yourself time and space to re-write your narrative.
Your story may continue to change for years as you and your situation evolve, like it did for Spencer and like it will do for my childhood friend.
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Dr Patricia Turner, PhD, Psychologist in private practice in Calgary, Alberta.