MIXED FEELINGS
Many, if not most, women experience at least some anxiety, fear and depression following a breast cancer diagnosis, but some are surprised to find that the end of radiation or chemo doesn’t always bring relief. In one study, which followed more than 500 women for three years, many breast cancer survivors reported significant levels of stress after the end of treatment; their support network suddenly changed or disappeared, they didn’t know what to expect for the future or they were scared the cancer would return.
Verna Siteman-burns knows exactly what that’s like. At the age of 49, she was vacationing in Barbados when she noticed her left breast was swollen on one side. She discovered a lump not long after she returned to Canada, and her doctor sent her for a mammogram. But before her results had come back, Verna started noticing other symptoms: Her breast had become sore and inflamed, and she developed a rash that looked like hives. It turned out she had inflammatory breast cancer, a rare and aggressive form of the disease. After chemo and a surgery to remove her breast, chest wall and all of her lymph nodes, she was given a 50 percent chance of survival.
Verna is normally an upbeat person (“I believe in positive thinking,” she says—which is why she informed the surgeon that she’d be part of the other 50 percent), but she admits that cancer sometimes took her to a dark place. “I was angry and could not for the life of me figure out why this had happened to me,” she recalls. When her treatment finally ended, she was overcome with fear. “The day I was released from seeing my oncologist, I sat in my car in the parkade and bawled. As long as they were giving me treatment, I felt protected. Once it was over, I felt alone,” she says.
This reaction, called deprofessionalization, is very common. “During treatment, women are seeing professionals sometimes daily. This confers a sense of security,” says Anne Katz, a certified sexuality counsellor at Cancercare Manitoba in Winnipeg. Once that care is over, a fear of recurrence sets in. “With every headache, you think, The cancer is going to my brain,” says Verna. “With every ache, you think, It’s going to the bone.”
There’s also the impact of hormone-suppressing drugs to consider. Because mood and hormones are tightly intertwined for many of us, women on post-treatment courses of drugs like tamoxifen, an estrogen-blocker prescribed to prevent recurrence, can experience mood swings or depression, says Dr. Tallal Younis, a medical oncologist at Queen Elizabeth II Health Sciences Centre in Halifax and professor of medicine at Dalhousie University.
However, Katz says there are resources available to women both during and after treatment. “Talking about these issues is really important— you shouldn’t hold everything inside,” she says. “Every cancer clinic across Canada has psychosocial clinicians who help people cope with the reality of having cancer and support them coming through the other side.”