Cancer Survivor – Page 2

Patient vs. Survivor: The Impact of a Label

^{(Photo by Joshua Hoehne on Unsplash)}

The first devastating realization I had following my breast cancer diagnosis was that I was now a cancer patient. In my mind I immediately went from “happy-go-lucky, fitter-than-average” to “sick beyond belief”.

Except that nothing physical had changed. But my mindset had. And when I found out that my triple-positive tumor was going to require chemo, I knew that everyone else was going to be aware of my hairless, frail status.

Cancer. Patient. I imagined myself pathetic and scrawny, walking around hunched over in a hospital gown with light shining off my bald scalp. Sounds dramatic, huh?

How do your labels affect you?
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Recently, however, I learned that there’s been a change in the language surrounding those individuals who have been diagnosed, are undergoing treatment for or have finished cancer treatment. The word “patient” as it relates to someone’s status has been supplanted by “survivor” much earlier in their cancer experience.

This is curious to me because I went through a mini identity crisis after I was done with chemo and radiation–I thought that only then could I start calling myself a (hopeful) cancer survivor. But I was a bit anxious about doing so, because I didn’t know whether I truly deserved that title. I thought that I needed to have some special designation before I qualified as a survivor.

These days, the survivor label is given when you receive a diagnosis. The idea is that while initially we didn’t know your status, now that we’ve confirmed your tumor, you are going through the experience of surviving the disease. As stated on the Cancer.net site, “When people talk about ‘survivorship,’ they are usually referring to navigating their life experiences and challenges resulting from their cancer diagnosis.” Read more about how ‘survivor’ is used here.

This sounds a lot better to me than using the term “patient”. By referring to myself as a patient when I didn’t have any reason to–meaning no physical symptoms–I was imagining myself sicker than I really was, which increased my anxiety levels. That made my entire experience worse and it didn’t have to. I did that to myself (‘cept that I was only using the common labels of the time).

How are you choosing to define yourself?
(Photo by Brett Jordan on Unsplash)

Instead of putting my energies into dealing with the side effects of treatment, I went down a dark hole.

Language matters! While there’s no doubt that cancer brings on stress and anxiety, terminology can make a difference in your cancer experience and that can either help or hinder you in the process.

So I urge you to consider the words you use to refer to yourself and pay extra attention to how that feels to you. You could be making yourself miserable without even realizing that you have some control over this.

Year 7 Mammogram in the Books

It’s enough to make me get a little cocky.

A few days ago I had my 7th yearly mammogram since my cancer diagnosis. Let me stress first, I am very aware of how fortunate I am. My appointment was early in the morning, my husband came with me (like he’s been doing, since he didn’t come during my diagnostic mammogram seven years ago) and I got a clean bill of health from the radiologist quite quickly.

I didn’t even feel those few minutes of hovering as I waited for the results. The technician had allowed my hubby into the mammogram room to wait with me, and he and I casually chatted so I didn’t notice the time pass.

Wow, things have changed.

‘Scuse me while I sit back and reflect on how fortunate I am for getting this far.
(Photo by Fuu J on Unsplash)

Every year, this feels different, cancer feels further away and I feel less “impending sense of doom” that I had in the first several years.

That’s why something like Kate Middleton’s announcement that she had started chemotherapy for cancer shocked me back to reality.

No matter how good I currently feel about my own situation, there are many reminders that cancer is still a terrible disease that doesn’t care who you are or what you have going on. And it’s still grabbing people and throwing them into treatment.

So much for my cocky attitude.

At times like these, I take a moment to reflect on gratitude for how far I’ve come and, as suggested by my oncologist, how much more life I have in front of me. I don’t think I would have ever felt this appreciation as deeply if I hadn’t gone through the soul-tearing experience that cancer is. Which is not to say that I’m glad I went through it, because I’m not.

Still reminders like Kate’s announcement help counter the selfish little feelings that I sometimes get when I see the free things available to cancer patients now and pout that those weren’t there for me. Yes, those are “human” feelings, but you know what, I can do without them.

Instead, it’s so much more fulfilling to bask in the golden hour sun, taking deep nourishing breaths, and shoo away the everyday concerns that disturb my sleep. At least I have the luxury of being able to busy myself with them, the bothersome little things, and know that I’m still around to have them be a bother.

Why I Get Irritated Searching for Yoga Photos

^{(Title image: Photo by Katie Bush on Unsplash)}

This is getting annoying.

I’ve been posting a lot about yoga, specifically about yoga for cancer populations.

Yoga programming for such populations is *not* your garden variety beginner/intermediate yoga. With the possible exception of well-practiced, life-long yogis who experience a cancer diagnosis, most of the people taking these yoga classes will have limitations to their movement and will need thoughtfully-designed sequences that offer appropriate modifications.

In a number of cases, these individuals may be older (for example, the average age at diagnosis for a woman in the US with breast cancer is 62). Many of them will not have an established yoga practice but may be attracted to yoga due to its reputation as being a mind-body activity: people with cancer not only have to deal with the disease and physical side effects of treatments, but also the emotional repercussions of being diagnosed with a life-threatening illness. Yoga can help.

So why am I irritated? Because the photo databank I use for my blog is replete with photographs of bodies in yoga poses. However, the poses shown are nothing that I would ever consider twisting a cancer patient into.

Make no mistake: the photographs are lovely, the yogis are impressively advanced, but what kind of a message does seeing mainly *these* kinds of yoga photos send to those cancer patients considering trying out yoga?
(Photo by Oksana Taran on Unsplash)

The yogis shown almost without exception are young and flexible. And when I’ve searched for “senior yoga” etc. to increase the diversity of the images…sure, I can find some but they’re locked behind a paywall (mine is a free blog without a budget for such niceities). Apparently, an older individual doing yoga is considered “exotic”.

This type of exclusivity feeds the narrative that yoga is for youthful, injury-free people who have the funds to attend studio classes. Someone who might be older, recovering from surgery, limited in range of motion and conscious about their budget due to treatment costs…well, I wouldn’t be surprised if they felt that yoga wasn’t welcoming of them and their needs.

This is, of course, so ironic, because of all the different exercise modalities, yoga is one of the most perfect for cancer patients. These are the people who need yoga the most!

Yes, I’ve written (griped?) about this topic before. Yes, we’re becoming more accepting of diverse bodies in diverse situations. But good luck trying to illustrate a blog post on yoga for cancer patients with actual photos of cancer patients doing yoga!

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I’m not expecting to easily find every type of person depicted doing yoga in a given (free) photobank. But in the US we have a problem with making yoga accessible, and the more images that we run of only a certain kind of human doing yoga, the more we inadvertently push the idea that yoga is only for that certain kind of human.

White Paper: “Yoga Interventions for Cancer Patients and Survivors”

^{(Title image: Photo by Raimond Klavins on Unsplash)}

I’ve been writing a lot lately about using yoga to mitigate cancer therapy-related side effects.

In this post, I want to bring your attention to the white paper entitled, “Yoga Interventions for Cancer Patients and Survivors” [Important: this links to the download page on the yoga4cancer website, *not* directly to the pdf itself]. It’s an evidence-based review of research regarding the benefits of a yoga practice in coping with negative side effects that afflict cancer patients and survivors, followed by recommendations for teaching yoga to this population.

This 24-page document (quoted directly from the paper’s abstract) “(1) provides a summary of research on the benefits of yoga for cancer patients and survivors, (2) highlights the most beneficial components of yoga for cancer survivors, (3) identifies barriers and solutions to the creation of accessible, evidence-based yoga programming, and (4) offers guidelines for developing yoga programs that best meet the unique needs of cancer patients and survivors.” [Again, this links to the download page.]

The white paper is written in non-technical language, distilling the research down into a form that doesn’t require a scientific background to understand. Additionally, editions are available in Spanish and Japanese, both available on the download page beneath the English version.

If you’d rather not download, you can read the English version below (or click the “download” button underneath the paper for a pdf):

yoga-interventions-for-cancer-patients-and-survivors_white-paper Download

Unexpected News at my 7-Year Oncology Appointment

^{(Title image: Photo by Gary Fultz on Unsplash)}

A few days ago I had my seven-year post-diagnosis appointment with my oncologist. Seven whole years. And it was a weird conversation.

He said something that set me aback. He told me that he didn’t think I should worry about the cancer coming back. Essentially, I was cured (note: MY words, not his, but that’s the idea). [See bottom of post for disclaimer!]

He’s alluded to this before during previous appointments. But this time around felt different.

I’ve officially hit SEVEN!
(Photo by Himiway Bikes on Unsplash)

I returned home a bit confused. See, for the last seven years, I’ve been a full-on cancer survivor. Still holding on to the fear that at any moment, I would get those terrifying scan results back and–WHAM–I’m a cancer patient once more, back on that sickening rollercoaster ride through treatment.

As difficult as it was to accept that–even trying my best to live a healthy life–I had somehow been smacked down by cancer…now, I had a new problem. Reentering life as maybe not-so-much a cancer survivor anymore, but rather just a healthy, active postmenopausal woman with years ahead of her.

And that is a weird feeling.

For the first five years after my diagnosis, I was frustrated, even angry. Cancer was a devastating detour at a time when I was already struggling to find my way back into a career. Well, forget that. Derailed. I was bitter.

Eventually, I realized that while life sucked, it sucked for a lot of people and I wasn’t special in that regard. That was an important turning point in how I perceived my own role in my cancer story–it was humbling but also gratifying.

Humbling because my experience could have been so much worse. There were people whose treatment did not end well. I was incredibly fortunate, even when it felt like I’d been thrown in a sack and beaten with sticks. At least, I made it out.

Gratifying because early on I held myself responsible for getting cancer, even though I had literally done everything protective (lots of exercise, high fitness, plant-based diet, breastfeeding, not smoking, not drinking) that I could think of. I was desperate with frustration and helplessness about this. Letting go of that guilt was healing.

Feels like I’ve got the green light to hurry up and get on with the rest of my life now.
(Photo by Possessed Photography on Unsplash)

So the last two years have been more about understanding my perspective and then stepping out of it to view things more objectively. Mindfulness and meditation helped with that, which is why I often write about them here. But I hadn’t been ready to get out of the breakdown lane and drive myself back into mainstream life, in part fearful of the pain of having the expectation of cancer-free “normality” smashed to smithereens by a potential diagnosis.

Gradually, that’s changed. But this last appointment felt like getting shoved out the door by someone yelling, “YOU’RE OKAY, DAMMIT!” Here I am, standing and blinking in the sunlight, trying to make sense of exactly what that means for me now. Wow, after seven years, I can actually stop being afraid.

I don’t know if I even remember what that feels like.

Yes, I’m still going to refer to myself as a survivor, because it’s a part of my natural history. I’m never going to forget that experience and I continue to be driven by a need to support others going through this disease.

And if it does return? Well, at least I will have had a brief glimpse of life completely outside the notion of cancer.

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Of course, because we’re talking about cancer, the statements above call for level-headness in the midst of levity. While my oncologist feels that the chances of the same cancer coming back are low, the possibility for a brand spankin’ new tumor, breast or otherwise, never goes away. It happened once, it can happen again. But that’s life. I’ll take it.

yoga4cancer: Bringing the Benefits of Yoga to Cancer Patients and Survivors [VIDEOS]

(Title image: Photo by Zoltan Tasi on Unsplash)

In February 2022, I started a yoga teacher training program with a singular goal: to eventually teach yoga to cancer patients and survivors.

With its mix of physical postures (asanas), breathwork (pranayama) and meditation, yoga is ideal for someone going through the traumatic experience that cancer can be. Yoga can provide enough physical exertion to count as moderate exercise and the ability to help the practioner calm their mind, things that are so important for improving cancer treatment outcomes. However, classes must be designed carefully and taught thoughtfully.

Yoga4Cancer Q&A for Cancer Patients and Survivors (Yoga Alliance on YouTube)

Keep in mind, yoga teachers were yoga practitioners first. Many of them got really good at the practice, developed great flexibility and balance and gained respect for the tradition of yoga. But that doesn’t automatically make them appropriate yoga teachers for cancer patients, who need an instructor that understands the nuances of what cancer is and how treatment affects us.

A yoga teacher and breast cancer survivor by the name of Tari Prinster addressed that need by creating yoga4cancer (y4c), “an evidence-informed Oncology Yoga method tailored to address the specific physical and emotional needs left by the cancer and cancer treatments. The approach matches breath and movement to stimulate the immune system, improve flexibility & strength, reduce anxiety and boost overall well-being” (from the y4c website).

I’m planning to begin the y4c advanced 75-hour certification program (see informational video here) either later this year or early next. I’ve been so impressed by y4c’s emphasis on understanding the unique situation that cancer patients and survivors are in–it’s not just your garden variety beginner yoga class with “also for cancer patients” dressing. The program is well-thought out and comprehensive, and I’m so excited to embark on this next leg of moving closer to my teaching goal.

In the meantime, here is a selection of videos created by Tari and her instructors that are specifically geared for the mental and physical needs of cancer patients and survivors:

Yoga4Cancer Oncology Yoga for Cancer Related Fatigue (Yoga Alliance on YouTube)

Yoga4Cancer Yoga for Bone Loss (Yoga Alliance on YouTube)

Yoga4Cancer Yoga for Range of Motion (Yoga Alliance on YouTube)

Yoga4Cancer.com Yoga for Anxiety (Yoga Alliance on YouTube

yoga4cancer.com Yoga for Lymphedema (Yoga Alliance on YouTube)

yoga4cancer.com Yoga for Constipation (Yoga Alliance on YouTube)

Enjoy!

“So, What Should We Talk About?”: My Six-Year, End-of-Chemo Appointment

A little over a week ago, I had another oncological appointment. This one marked my six years since completing chemo for triple positive breast cancer.

Honestly, at this point, the conversation between my doctor and myself has turned much more social. There are not as many pressing matters to discuss. My bloodwork is normal and boring. I don’t have side effects to speak of, at least not any that I can attribute solely to cancer treatment (hello, menopause, ugh). And even my oncologist is openly positive about my future.

Wow, have things changed.

Six years ago I was dealing with the effects of a nasty fingernail infection that landed me in the ER (be forewarned before clicking that link: it was pretty gross!). But for this appointment, I was asking my doc how HE was feeling.

Our conversations have become pleasantly mundane and I enjoy catching up with him. Also, I am panicking less.

As a cancer survivor, I do not like surprises. When my doc says to schedule an exam, I’m going to do it fast!

Much less. Even when I do lapse into micro-panic, I have accompanying moments of calm. That is a definite improvement. At the same time, cancer is cancer. So when my oncologist noticed that I hadn’t had a pelvic exam this year, he told me I needed it. And then before our appointment ended, he repeated that I should get one.

For a brief instant, my emergency alarms went off.

Maybe it was the fact that he repeated himself and seemed very serious about it. After six years of hypervigilance, I still get unnerved by slight shifts in tone of voice. I think that’s hard-wired in me, seared in via anxiety, even though my days of being a hot stress-mess are behind me.

It’s so tempting to wipe my hands off and pretend that everything is normal, but cancer teaches us that some nasty stuff might be lurking under the surface of, “I’m sure it’s nothing”. My days of innocent ignorance are gone.

So, yeah, I’m fine. Still no recurrence of a cancer in my breasts. Probably not anywhere else either. I’ll remain optimistic and look forward to seeing my oncologist in six months and chatting again.

But I’m going to schedule a pelvic exam soon.

From a Safe Distance

It’s hard to believe that six years ago I was a week and a half away from my final chemo infusion, in the thick of being a cancer patient with no idea of what tomorrow would bring.

Cancer survivorship used to be a whole lotta “looking over your shoulder” for the next thing to hit.

I also thought that I’d live the rest of my life, however much or little of it there was left, in fear, always looking over my shoulder to see if cancer was close behind. In fact, after my active treatment was over, I expected that my anxiety would increase because I imagined that whatever had triggered my tumor growth would again be unleashed and ready to attack my again.

And when I had to stop aromatase inhibitors early due to side effects, I envisioned even more terror because I wouldn’t have the medication’s protection anymore.

None of this suggested that I would have a very pleasant future. Either I would get cancer again…or I’d be consumed by worry over getting cancer again.

Reality turned out to be quite different.

The more (1) I practiced being present, coupled with the (2) increasing distance between my last dose and today, the easier it has become. Now, that might sound like a no-brainer, but it was news to me.

And I don’t know exactly when I turned the corner on my fear but it was probably after the worst letrozole side effects ceased and I was able to reflect on and accept that cancer happened and now I was moving past it.

It took years to get to that point, but it would have probably come sooner if I hadn’t convinced myself that I’d never get there.

And how are things different now? I don’t think of cancer every minute of every day. And when I do think about it, it doesn’t seem as daunting.

I realized this after meeting a cancer survivor who works at a store that I frequent. She revealed that she’d just received her three-year “all-clear”. The relief on her face was unmistakable.

And it struck me that I used to have that incredible sense of gratitude too. And I still kind of do for a short bit, but it fades quickly as I turn my focus to the rest of my daily responsibilities.

Yes, I am still seeing my oncologist twice a year, having annual 3D mammograms AND the occasional MRI, so it’s less likely that something’s going to sneak up on me. But the concern is no longer as all-encompassing because it doesn’t feel as likely.

Of course, I could be kidding myself. Even after six-plus years I know that every set of scan results is a door to either “no evidence of disease (NED)” or “we’ll get you in to see the oncologist ASAP”. So far I keep going through the NED door…and it keeps opening onto a bright day.

In the midst of taking things for granted, it’s nice to stop and think about that.

Again, the Mammogram

It feels like it wasn’t all that long ago that I had my five-year 3-D mammogram…and here I am with my six-year scan.

I’m writing this prior to the scan and will follow up with the results at the end of this post, but I find it useful to write while I am still experiencing the little uncertainties that come with scans. Like a Schroedinger’s-esque situation, I am both a cancer survivor and a cancer patient right now, since no matter how small a chance that another tumor will be found in my breast, survivor and patient are my only two possible modes of existence.

For this short period of time, I’m both survivor and patient.

For my own sake, I try to release all expectations at this time. I don’t want to relax and tell myself that I’m sure that the scan will be clear, because the drop down from that back into “cancer patient” state would be too fast and steep, so I breath deeply and anticipate nothing. But that’s hard to maintain.

At the same time, just a few weeks after seeing my oncologist who skillfully performed a clinical breast exam and found nothing, it’s very unlikely that a mammogram would bring up anything life-changing for me at this time. In fact, if anything were found, it would be a tumor in its nascent stages that would be much easier to treat than the one I had in 2017. Or so I tell myself.

To be frank, it’s not locating another tumor in the breast that constitutes the scariest scary outcome. No, it’s the not finding a tumor in some other part of the body — perhaps a lone sleeper cell that evaded chemotherapy’s effects and circulated through my body before grabbing onto a vital organ and silently beginning to grow.

That’s the real bad news…but it would not be the news I’d get today.

This brings me back to that situation that all cancer survivors face: accepting that there are no guarantees.

For the next hours before my mammogram I will focus on work, think of nothing to do with cancer and take deep conscious breaths. As I sit in the waiting room I will gently distract myself, submit to the squishing of the scan and hang in the stillness of the present moment until I get my response…and hopefully go on for another year. Maybe.

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So, I’m back now with the outcome that I was both hoping for and (to be honest) expected: All clear for one more year!

And even though I always play it cool before and during the scan, the difference in my state is really noticible after I get the thumbs-up sign. Those minutes of sitting and waiting for my results [note: as a cancer survivor, I get my answer on the spot, which I really appreciate] are a little uncomfortable — I float, trying to focus on my breathing. But to this day, even when I’m “not expecting bad news”, I cannot shake that tickle of unease.

And that’s just another part of being comfortable with being uncomfortable. Still working on it…

Finally Normal: My Six-Year Oncological Visit

I hit another cancer journey milestone this past week: my six-year oncology appointment.

Like my last few appointments, this one felt commonplace and unintimidating…and if the nurse had let me sit down for a couple of minutes after coming into the exam room, my blood pressure would have been lower. As it was, the reading was not that far from normal.

For the first time since cancer, my bloodwork is all normal!!!

One other thing that was strikingly normal: for the first time in six years, since all the cancer madness began, all my bloodwork, both Complete Blood Count (CBC) and Comprehensive Metabolic Profile (CMP), was completely normal. Nothing that would suggest a year’s worth of cancer treatment in the past.

This is so curious because for years, nothing felt normal.

Now everything is.

Ironically, it was my oncologist who was experiencing illness and I had to switch my appointment time so that he could get to his doctor.

I was hit by the realization that everything that had felt out-of-control and hopeless six years ago no longer existed. I was the one who had kept the idea of cancer alive in myself. I still defined myself as a cancer survivor because perhaps I needed some way to justify what I considered to be my shortcomings, as in, “I used to be able to do this, but…”.

This was a battle I fought in but only memories remain. In the present moment, there’s only silence.

Returning to the cancer center for this appointment felt like I was visiting a battlefield from a war that I had fought long ago. The echoes of battle cries…just the wind. The clashing weapons and falling bodies…not there anymore. This may sound like such an overly theatrical description, but that’s exactly what it seemed like.

This doesn’t mean that I’ve got the rest of my life figured out. There are still so many unknowns, including an increased chance of cancer recurrence — and I still need to schedule this year’s mammogram, something else that slipped my mind as I was basking in the idea of being “normal”.

But that tortured soul who, on top of all the other stressful things going on in her life, was hit with a cancer diagnosis…she doesn’t exist anymore. If I’m so unfortunate as to have the cancer come back, she won’t be experiencing the aftermath.

I will. And I feel like I’m so much better equipped to handle all that uncertainty than she ever was.

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I still call myself a cancer survivor. But it’s only one of a long list of “skills” that I have on my resume.