The Mental Challenge of Breast Cancer

Breast cancer (or any cancer) can be just as mentally challenging as it is physically challenging. Or, as in my case, it can be more of a mental challenge than a physical one. I have been told so many times in the past eight months, “you look great” and whilst part of me has been absolutely delighted with this (because if I look fine, I must be fine, right?) a lot of the time my looks have been deceiving.

At 30 years old, last June, I was going through life having a lovely time. I was single, financially independent, owned my own house, had been skiing 3 times that year, was looking forward to travelling around South America in the summer and I had a decent job that, despite moaning, I did enjoy. Then, one Monday afternoon, I ran straight into a brick wall. Not literally of course. But when the nurse, who 3 hours earlier had assured me that the lump in my breast would be nothing to worry about, said the words “we are very concerned about the results of the tests” I literally felt myself crash into a wall. To be honest, I think physically crashing into a wall would have hurt less.

A few years ago, I had had therapy after a relationship break up and my counsellor had told me that a broken heart was a real thing: you had to heal the wound just like any other injury. Well, on that afternoon in June my heart broke more than it ever had for me, my mum, my family and my friends. No matter what I did during the following days, I kept running into that wall. And it bloody hurt. More than anything ever had in my whole life.

Two days after being told by the nurse that they were worried about my lump, I was back at the hospital and was told, “yes, it’s definitely cancer.” At that point my doctor asked me if I had, or wanted, children. I thought to myself “WTF! You’ve just ruined my 5-year plan and we are talking about having kids!!” Of course, she then explained that chemo could make me infertile. Oh great, another thing to have to process in all of this. If I’m being totally honest, none of this came close to the pain of hearing from my breast care nurse that I would most likely lose my hair. Strangely, infertility and even dying didn’t come close to the painful thought of losing my hair. Let me try to explain why. I am a PE teacher and I have done a lot of research over the years on why girls don’t engage in physical activity. Some of the things that we must try to avoid saying are things like, “if you are inactive you have a higher chance of diabetes etc. in later life.” “Later life” doesn’t mean anything to the girls – it’s too far away for them to process. They want to know what will happen if they don’t exercise NOW. And this is the only way I can explain why the thought of hair loss was more painful than the thoughts of infertility and morality – the latter two were much further away than losing my hair. Hair loss was going to happen immediately – infertility and dying were things I would have to process further down the line. In addition to the fact that I loved my hair and that it was a massive part of ‘me’, I had absolutely no control over losing my hair. For a self-confessed control freak it was really difficult for me to deal with.

I can’t actually remember why I went to my GP in the middle of my fertility treatment a couple of weeks after my diagnosis, but we got talking and he suggested I see a counsellor. Like I said, I’d had counselling some years previously and it had helped me move on during a tricky time, so I agreed. Looking back, he was correct to refer me and I am grateful he did. I was a mess. I was suffering from intense anxiety every time I had to step into the hospital. There were times when I almost had a full on panic attack and having never been an anxious person before this was scary. During the time leading up to any hospital appointment I was absolutely vile to be around. I wasn’t coping mentally and what was worse was that I felt absolutely fine physically – how could I have cancer when I wasn’t even ‘sick’? On the way into my initial appointment with my doctor, I had broken down in the middle of the corridor and wept in my mum’s arms. I didn’t care that people were walking past and looking at me, I was absolutely distraught about the fact that I was in this situation and I just couldn’t see how I was going to cope with the enormity of what faced me.

After my GP referral for counselling I had to wait a long time for a mental health appointment. After two absolutely disastrous appointments with my local mental health team (which really did very little for my overall sanity) I eventually had my first appointment with a lovely therapist a week before my last chemo.

During the 5 month wait to see a counsellor I went through a lot and it is only now, 8 months after my diagnosis that I’m coming to terms with everything that I have been through.

In some ways, the fertility thing has actually taken some general life pressure off. I can use the eggs I froze at any point so I don’t have to worry, my biological clock can tick as much as it likes – I have 20 eggs in a freezer so if Prince Charming doesn’t come knocking while I’m in my PJ’s watching Netflix, I can get a sperm donor later down the line.

Before breast cancer I was constantly wanting more, planning things and looking to the future instead of focusing on the current day. When the future isn’t certain you have to change your outlook and shift your focus in order to stay sane. A huge part of this way of thinking has been down to my mindfulness journey.

Now, if you’d told me 8 months ago that I would be mediating daily, I would have told you to do one! I was once described by an ex-boyfriend as “more highly strung than a race horse.” I thrived off stress and I actually loved being busy. Some days I think that I got cancer because everything happens for a reason and something had to happen to make me chill. On other days, I think that is absolute rubbish and I really miss the busy, driven, motivated girl that I was. I would go as far as saying that I have had to grieve for that person. Anyway, that person would not have meditated. Fast forward 8 months and since Christmas I have been doing mindfulness every Thursday at my local Maggies Centre. I’m not going to lie and say that this has been a totally pleasant experience, there have been some weeks where it has been so painful to work through these things that I have nearly given up. In one of the early weeks, my teacher said, “you won’t be able to move on from this until you accept it’s happened.” I remember thinking when I was driving home, “I’m never going to accept that I got cancer. I’m too bloody furious that I got it. I don’t want to accept it.”

At some point during the first week of February, I finally accepted that I’d had cancer. I call this week the ‘dealing with the difficult’ week. It was the worst week since I was diagnosed, I cried every day. If you’d have asked me what is easier, chemo or trying to move on from treatment, at this point I would have said unequivocally that chemo was easier. Having started the mindfulness, I dealt with this difficult week in a different way to how I would previously have dealt with it. I let myself cry and I let myself be in pain. Previously, I had always made myself stop crying and sort myself out: you could say “man up” (I hate that phrase by the way!) This time, every time I cried, I cried until I naturally stopped. On the Sunday afternoon I cried all afternoon reading all the cards and letters people had sent me during treatment. One of the cards was from a university friend, her mum has had breast cancer and she wrote advice that her mum had shared with her,

“Healing isn’t taking the fast lane down a motorway. Healing is taking the country back lanes with lots of pot holes and dead ends.”

Reading that quote and processing it was the start of my acceptance and the start of me believing that I could move on from this. Bad things happen to good people, and I could spend the rest of my life thinking “why me?” But the real question is “why not me?” I’m not special, I’m not super human. I’m genetically flawed and the oestrogen in my body decided to take advantage of that. I am however in control of how I deal with this and for a complete and utter control freak it was comforting to work out that I DO have control over something. Since that week at the start of February, things have got better, I’m getting there. Not on the motorway, but on the country lane and that is absolutely fine. Will things always be ok? Maybe not, but that’s ok because how we deal with things is the most important thing and what defines us as human beings – we are all flawed and we have to accept this. You don’t always have to feel great or look great, it’s ok not to be ok as long as you find a way back to where you want to be.

Here are my top tips for dealing with the ‘difficult’:

1. Talk to someone who is not involved – a counsellor or your GP. My counsellor has been so great, she’s reminded me of what drives me when I was totally lost and I don’t have to protect her feelings as she is not invested in me like friends and family are.
2. Look into mindfulness. I would recommend a course. I have tried Apps on my phone but the course was so much more beneficial. I can assure you that living in the present is a lot easier than the past or the future, it takes practice but it’s a lot less tiring.
3. Find a way to accept your situation. It may be totally unexpected when you do accept it like when I read that card from my friend. I was so angry with cancer for months, now I have accepted that I’ve had cancer I feel indifferent. It’s a chapter, not my whole story.
4. Learn to recognise signs of stress. Mine are a clenched jaw, getting hot and a racing heart. Breathing through these signs helps. I sometimes realise when I’m watching telly that my jaw is clenched even though I am not doing anything stressful. I make my jaw relax and take my focus to my breath and that releases my whole body.
5. Be kind to yourself. You need to recognise when to give yourself a break. Many of us are kind to other people but we forget ourselves.
6. Write. I have written the most painful things down as well as funny things and really pointless things. Nobody has to read them, I have some things that no one except me will ever read. Writing this for Sara has been a bit selfish, I needed to write it down to process it and if it helps someone else that’s great. But I have done this more for me than anyone else! Reading through what you’ve written once you are out the other side is really therapeutic too.
7. Exercise. This is one thing that I’ve had control over. I know my body and I know what it can do. There were tough times, my hair falling out all over a treadmill was a low point but the important thing is that I ran through the tears. Luckily the gym was quiet and I don’t think anyone noticed! I have cried when running lots of times – sometimes out of sheer elation to still be able to do it and sometimes because I was hurting. I cried after my first post chemo yoga class, my body hurt so much and I couldn’t do lots of the moves. 6 weeks later and I can do everything in that class, that has done so much good for me mentally to recognise that progress even though it was a painful experience at the time. I can feel my body coming back to me after months of feeling it was letting me down. It of course hasn’t let me down, it’s been bloody brilliant but it’s taken me until now to realise this.

April 2019

The information and content provided on this page is intended for information and educational purposes only and is not intended to substitute for professional medical advice.