Did you ever wonder why it seems the first course of action recommended in breast cancer is to see a BREAST SURGEON? Why not an oncologist? Do you know I never ONCE met with an oncologist during my stint with "conventional" cancer diagnosis and it was NEVER RECOMMENDED? By the time I might have been ready for that, I was already convinced an oncologist did not know much more than I did about cancer, so I skipped it and continued with my holistic healing path.
Breast cancer: therapist on the other side
Counseling women with breast cancer was Cordelia Galgut's speciality but she was unprepared for the strength of emotion when it was diagnosed in her
I didn’t have a diagnosis yet but I could see on the screen that I was in big trouble. The radiologist who was taking an ultrasound scan of my right breast looked deadpan. I asked: “Is it serious?” “At least it’s not lung cancer,” she replied. What? I presumed she was confirming indirectly that she thought it was cancer, but I was stunned by her comment.
Summoning up the courage to speak again, I asked what she could see. “Are you a medical doctor or a scientist?” she responded, as if that would answer my question, and then told me that I’d have to have a biopsy. When I said I wanted to know more, I was told that this was not possible.
These dreadful moments three years ago, when I first learnt, in my late-forties, that I had breast cancer, began a voyage of discovery. As a counsellor and psychotherapist helping women with breast cancer, I’d imagined that I could understand well enough what they were going through. In fact, I didn’t have a clue. Having breast cancer changed what I said to women with breast cancer for good.
Throughout my experiences over the past three years I’ve found my “trained psychologist brain” to be in conflict with my “breast cancer-sufferer brain” because the stuff I was taught about mental processes and my experiences as a cancer patient have often been contradictory.
After my biopsy, my doctor confirmed that the mass on the scan looked like cancer. “Am I going to die?” I asked. She looked blank and changed the subject. This made me feel I’d been wrong to ask her. It also made me panicky. I now realise that such questions are very common among women who have breast cancer diagnosed, so the doctor must have heard them plenty of times. Though nobody would have thought so from her reaction.
Things went from bad to worse. I phoned for the results of the biopsy and got a nurse, who avoided my questions several times until, reluctantly, she said: “Yes, it’s cancer.” That was actually a relief. Once I knew, I could start to face the future. After the surgery to remove the tumour, the surgeon told me that I had been “naughty” for asking questions, making a fuss and saying how I was feeling about what was happening to me.
I felt I wasn’t doing cancer “properly”
One of the key lessons I have learnt is that health professionals simply don’t accept extreme emotional reactions in the face of cancer. The vast majority of people I have met since my breast cancer was diagnosed struggle to realise that it is normal to respond emotionally, even negatively. I have had to put up with so many comments that have left me feeling very alone, such as: “You must be more positive, or your cancer will come back!” There’s no research evidence to back this up, by the way. Someone else said: “Don’t dwell on it; it’s not doing you any good.” I shouted back: “Well, you try it if you think it’s so bloody easy!”
Comments such as these make women feel they are not doing breast cancer “properly”. And it all adds to the distress and emotional fallout of what has happened.
As a psychotherapist supporting women with the disease, I realise that the fear of getting breast cancer had stopped me from really listening to what women were telling me about what they felt and what they were going through. Also, my psychological training had taught me that, after extreme trauma, people would go through a variety of stages, from shock to acceptance, in about a year or so.
It’s clear to me now that it is wrong to expect people with breast cancer to behave like people with other types of trauma.
There is a very complex emotional response in women, simply because the cancer affects the breasts, which are laden with sexual and other significances. One woman said to me: “I’ve had thyroid cancer and breast cancer, and it’s different. It affects you in a different way because your breasts are part of your femininity.”
Treatments for breast cancer are harsh and it has been easy for me to feel that my identity as a woman has been under attack.
In May 2004 I was told that I had one small hormone-sensitive tumour in my right breast. The following November I was told that I had something similar in the left breast. The second tumour had probably been there at the time of my first diagnosis, but my left breast had not been scanned at the time. So I had surgery on both breasts and have large scars on them, a constant reminder of what I have been through. So is the skin damage and loss of sensation I have suffered as a result of the two rounds of radiotherapy I had for 12 weeks after surgery.
Physically, it was hard, but I had expected that. It was my emotional response to the radiotherapy that knocked me sideways. Subsequently, a number of women have told me that they have found radiotherapy harder than chemotherapy. It perhaps stems from the vulnerable position you have to adopt on the treatment table; naked from the waist up.
After several weeks of radiotherapy, I remember joking that I was so used to exposing my breasts in public that I’d have to watch it in case I inadvertently got them out in Waitrose. The humour was self-protective, of course, belying a deep upset at what I was going through.
I can’t recapture my peace of mind
Three-and-a-half years on, I have a good prognosis, but I’m still suffering emotional fallout. Thankfully, I have had no recurrence of the disease to date, but I still dread the scans. People say: “Just get on with your life. Don’t think about it.” But I cannot recapture the peace of mind I had before cancer.
Knowing what I know now, I work very differently, as a psychotherapist, with women with breast cancer. I’m more open to what women are telling me and no longer pay much attention to what my training taught me about what women should be feeling at different stages.
If there’s one thing I wish people had said to me during my breast cancer experience, it is: “The way you’re feeling is perfectly normal. It’s not just going to go away. You’re not doing breast cancer wrong. Why wouldn’t you feel like this?” These words would have been enormously supportive. They’re the ones I try to offer my patients whenever I can.
Dr Cordelia Galgut is a senior accredited counsellor and psychotherapist
Breast cancer in numbers
Over 100 women a day in the UK are told that they have breast cancer
8 out of 10 survive beyond five years
One third of cancer patients (all types of cancer) develop significant problems coping with diagnosis and treatment
14% of cancer patients seek counselling or support groups after diagnosis
29% of breast cancer sufferers adopt a fighting spirit
22% of breast cancer sufferers are engulfed by feelings of hopelessness
Source: Cancer Research UK; The Lancet; Journal of the National Cancer Institute; Oncology Issues
1 comment:
I was told that I had something similar in the left breast. The second tumour had probably been there at the time of my first diagnosis, but my left breast had not been scanned at the time.
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