On my last day of breast cancer treatment, I expected to have a spring in my step: my cancer had been caught early, I’d had amazing medical support, and my treatment hadn’t required chemo-, just radiotherapy. For months, I'd been reminded how lucky I was. But within a few weeks post-treatment, I was spiralling into depression.
Diagnosis
I couldn’t have imagined the rage I’d feel upon hearing my cancer diagnosis. Media depictions of cancer patients in films and charity adverts had me believing that people diagnosed with cancer were dignified and temperate, smiling gratefully at others’ kindness. My only encounters with cancer patients had involved me saying teary goodbyes to loved ones in palliative care — my mother’s husband, and a few years later, a dear family friend. Hearing my diagnosis immediately brought my worst fears to the fore, and after the year I’d already had, those fears morphed into bridled anger.
Thirteen months before my diagnosis my mother suddenly passed away. During my childhood, she battled ovarian cancer — a diagnosis I didn’t learn about until my teens. She remained in complete remission but ultimately died from heart complications. As the executor of her estate, with much to do, I compartmentalised my grief for the next year.
At the end of that first year without my mother, just days before Christmas, a radiologist detected an irregularity in my breast scan. In the new year, my GP confirmed the diagnosis. My mental health, already fragile, buckled. But I thought, ‘At least my mother won’t have to go through it again.’
In Canada, mammograms are recommended every two years. Yearly tests are encouraged, but not strictly, for those with a genetic history of cancer. In the UK, it’s even less often. My GP, herself a breast cancer survivor, noted that catching my early-stage cancer was a stroke of luck. Had I attended my scheduled screening the prior year, instead of skipping it in lieu of executor duties,
doctors might have missed it. I likely would’ve put off the next exam for another year, and by then it would’ve spread. My GP promptly lined me up with the same doctors she’d had following her diagnosis.
Treatment
Treatment isn’t just about medical care. It includes how you’re treated by friends, loved ones, and strangers you tell, inexplicably, about your diagnosis. It also involves how you care for yourself. And honestly, I might’ve cared for myself better, but there’s no playbook for one’s emotional game in these situations. No cancer patient arrives at their diagnosis with a clean slate. If you’ve been grappling with something, you might think as I did, ‘Well, bring it on. I’m already in shambles.’ Doctors and patients need reminding: the point of diagnosis is when it’s time to pay attention to the patient’s mental state, the time to check-in. But I was so angry, that I skipped this crucial step, and numbly attended the seemingly endless appointments, surgeries, and finally post-op.
Recognising how fortunate I’d been, I proceeded almost apologetically. I rarely discussed my diagnosis and treatment, and kept to myself when I wasn’t trying to make the nurses laugh. Most patients were dealing with worse cancers, so I felt I had no right to complain. No right to my fear, anguish, and rage. Meanwhile, my medical team were so skilled and so caring. I sometimes imagined that I looked like a charity advertisement with my gracious smile. But beneath it all, I could feel a distant seething.
The relative daze I was in throughout my treatment could be attributed to the radiation, but in retrospect, it was also an indication that I wasn’t doing as well as I was letting on. In need of control over my life, I told no one of my deepest feelings. If I had, I’d have been set up with a counsellor. I realise now that I believed I needed this rage to propel me through.
Post-Treatment
During treatment, you’re reminded to take it one day at a time. This may seem Zen-like, but with chemicals, radiation, and anxieties ripping through my body and mind, it was hardly mindfulness. Rather, I’d been constantly seeking mindlessness. It’s probably unsurprising that after the initial relief of hearing the clinic doctor declare the treatment’s success, I left the hospital with a kaleidoscopic range of feelings.
One in two people in the UK will be diagnosed with cancer in their lifetime, with similar numbers in Canada, and there are never enough resources. You’re sent out the door with a few sheets of after-care instructions, including the number for post-treatment therapy. On the day that could’ve been among the happiest of my life, I felt something dragging on this elation I wanted to feel, like holding a weighted helium balloon.
Studies show that a significant number of cancer survivors deal with depression post-treatment. The reasons are varied. Grief, for example, is common among cancer patients, who ‘may grieve for many things, such as the loss of their sense of health and security, a lost body part...’ They may be sensing pressure to be grateful, or to now live the rest of life to its fullest. Or, they may be feeling alone and uncertain about how to move forward after months of having a dedicated team of carers. All these, and more, may niggle at the brain. I was already exhibiting signs of depression, but it can be difficult to know where the cognitive effects and fatigue of treatment end, and the symptoms of anxiety and depression begin. By the time I sat down with a counsellor, the anger had metastasised. I couldn’t get comfortable with my new identity — being a ‘survivor’ who was terrified that the cancer would return.
The first counsellor I met seemed a great fit, but I was scheduled on her last day at the clinic. The second counsellor I met with had a woo-woo approach that my angry heart and mind had no patience for. Besides, I thought I was draining resources from ‘real cancer survivors’ so I stopped going. Eighteen months after my last treatment, I was still struggling, still angry, and still unable to pick through the feelings. Then came the pandemic and lockdowns.
One of the best things I did for myself was tell my oncologist. When they ask how you are doing, they’re not being polite, not just performing their job duties. This is when you must dig deep and tell the truth. My oncologist put me back in touch with the Cancer Clinic counselling — a resource that is supposed to end after a year.
Under lockdown, I met with someone over the phone, and I discovered I felt safer with the visual anonymity. The counsellor was well-experienced with delayed and complicated grief. After helping me work through some of it, she gave me coping mechanisms to try and recommended external clinics to contact. I sought out a couple of other counsellors until I came upon one that felt right. Sometimes, this search felt harder than battling cancer.
Recently, I met with other cancer survivors and while validating, it was also devastating to learn that they too had felt a kind of rage and depression that they’ve never quite been able to shake. I can say that I’m now on the other side of the worst of it, passing my five-year cancer-free marker last spring, albeit with little to no fanfare. And I continue to step forward.
