WHAT DO CORONATION Street and Sex and the City have in common? At first glance, not much. However both shows had a common storyline in which one of its main characters was diagnosed with breast cancer. And while they accurately portrayed the shock and fear of a cancer diagnosis and touched on the rigours of treatment, the story lines ended abruptly when that treatment finished.
As is the way in soap-land, both Sally and Samantha quickly put the experience behind them, got on with their lives and appeared to suffer no lasting physical or emotional effects. But those of us in the real world who have been affected by cancer know that life is not like the soaps, and the story doesn’t end when treatment does.
Each year in Ireland, over 2000 women are diagnosed with breast cancer. While the incidence of breast cancer is rising, mortality rates are decreasing. The good news is that improvements in the early detection and treatment of cancer have resulted in longer periods of survival – more than 25,000 women in Ireland are living following a breast cancer diagnosis. As a result, researchers are focusing new attention on the long-term impact of cancer.
“Survivorship” is the new buzz word in cancer care and increasing recognition is now being given to the so-called “re-entry” phase of cancer treatment – that post treatment period which, while most intense for the first 6 months to one year immediately after treatment ends, can require months or even years to navigate. While it is necessary to do what we can to help and support cancer patients at the time of diagnosis and treatment, we also need to support patients when treatment ends. It is no longer just about saving a life, it is also about the quality of that life for the longer term.
Sometimes there can be a code of silence surrounding the aftermath of cancer treatment. Society tends to celebrate those who can bounce back from illness, loss and tragedy. We hear stories of how people have gone on to live wonderfully transformed lives, filled with gratitude for their experiences, and while these stories give us hope and inspiration, the reality is not always so for others. At least not straight away.
There is an expectation that when you walk out of hospital on that last day of treatment, your cancer story has ended. You are expected to close the page on that chapter and pick up the pieces where you left off before your life was abruptly put on hold with those words “you’ve got cancer”. But it’s not so simple. It’s a little like leaving school on that last day – sure, there’s a sense of accomplishment and relief, and maybe some excitement and anticipation about the future, but it can also be mixed with feelings of loss and insecurity.
The fact is that for many cancer survivors the end of treatment can be every bit as terrifying as the day of diagnosis. After cancer, you can feel cut adrift and lost without the regular support and reassurance of your medical team. You may feel emotionally and physically exhausted and you may not be prepared for the deluge of emotions that hits you in the days and weeks that follow.
During treatment you have been so caught up in the day-to-day routines of survival that there may be little time to give much thought to anything beyond these routines. Now you may find that it is only when your treatment has finished that the full impact of everything you have been through hits you. And you may be taken by surprise at the intensity of your feelings of vulnerability, sadness and depression. You may be filled alternately with relief and elation at being given a second chance and with anxiety, fear, and uncertainty as you struggle to come to terms with the physical and emotional aftershocks of cancer.
Once cancer has touched your life nothing will ever be the same. Life is uncertain for all of us, but those with a cancer diagnosis have a heightened awareness of that uncertainty. Cancer lays bare your vulnerability and underlines the uncertainty of life. I have come to believe that surviving cancer is more complicated than simply being disease free. It is a continual process, which involves taking the best possible care of your health, acknowledging all that has happened and knowing how and when to ask for support. Only then can you start to move forward with your life and uncover a greater purpose and meaning. This is true of all survivors whatever challenges life presents to us.
Marie Ennis-O’Connor is a breast cancer survivor and patient advocate with Europa Donna Ireland, the Irish Breast Cancer campaign. Marie’s blog Journeying Beyond Breast Cancer was the winner in the best Health and Wellbeing category at the Blog Awards Ireland.
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