One of Cancer’s Dirty Little Secrets

Perfect timing. Well blog at the New York Times published this yesterdayAnxiety Lingers Long After Cancer.  

Depression has been studied in cancer patients and their spouses.  Two years after diagnosis, those levels tend to return to the levels seen in the general population. Anxiety might be a different story.

The analysis, which looked at 43 studies involving 51,381 patients with a range of cancers, found that over all, nearly 18 percent of patients experienced serious anxiety two to 10 years after their diagnosis, compared with about 14 percent of the general population. But in a cluster of studies that looked at couples, anxiety levels in that time frame grew to as high as 28 percent in patients and 40 percent in their spouses.

Forty percent in the spouses. They get even less psychological attention, in my opinion, than the patients do.

I’d like to be that person says, “Sure, the cancer might come back and kill me, but since I have no control over that, I never think about it.” Fact is, I can say that all I want, but wanting that to be true and it being true are two very different things. I feel the pressure to put it all behind me; to get over it; to move on and; for god’s sake, to just stop talking about it. Hence this nugget that helps me feel like I’m not such a freak.

People who have not confronted a life-challenging illness may be perplexed by the residual anxiety in patients, long after they have successfully completed treatment.

I know that some of the joys in my life has been diminished by this very dynamic. It makes me sad and angry sometimes, these ripple effects, but I am learning to accept that we don’t all function at the same level of awareness. We are, after all, on our own solitary journey at some basic level.

The private psychological torture of cancer is real. There is no such things as “just a headache” or “just a twinge in my back” after cancer. I keep it to myself, but any new ache, pain, or illness is considered in the light of the possible return of the beast. I wait it out and so far it’s all been nothing, but don’t mistake my silence for inner peace.

In my opinion, if you want to be in it for the long haul with someone who has been through cancer, you need to make space for these silent psychological battles and the unrelated ways turmoil pops up. Maybe I’ve had a sinus headache for a couple of days in the spring. I’m bound to be cranky from that, plus the tidal wave of fear that it’s not a sinus headache. I might be a little snippier than normal. Maybe a lot. My advice is to give me a little space. Assume the best, understand that I am fighting some epic invisible battle against existential fear. Don’t assume that I’ve suddenly become an unrecognizable monster.

And if you can’t do that, the honorable thing to do is to bow out. Abandonment is hell, but ripping the band-aid off quickly is the kinder option.

On the flip side, I know people who seem to be stuck in the fragility and preciousness of the cancer world. I definitely don’t want to live there. Like everything else there’s an ebb and a flow, a delicate balance, a complicated dance between the forces of acknowledgement and of wallowing. The article mentions the field of psycho-oncology.  Outside of the large urban cancer centers, I’ve seen little evidence of these practitioners.  Again, the spouses and children seem to have no place at the table.

So why was this perfect timing? Collateral damage has been rearing its ugly head in recent months, ushered in by an increasing unspecific lack of ease within me. I pulled up the calendar and sure enough, July 14, 2008 was the day I got the first phone call – the cells from the biopsy were malignant. Even when the mind doesn’t remember, the body never forgets.

2 thoughts on “One of Cancer’s Dirty Little Secrets”

  1. Luckily, where I work, UCSF Medical Center, has Psycho Oncology, Survivorship, and Art for Recovery programs. My exposure to them is limited to looking at charts for billing errors, but half the time when I open them a window pops up saying “Patient is Deceased.”

    1. Thanks for the reply, Dave. Sounds like a great set of programs. I suppose in the midwest, we pull ourselves up by our bootstraps. 🙂

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