Cancer: a Defining Experience?
The pink ribbons that abound in October have come to symbolize breast cancer awareness and celebrate cancer survivorship. However, these ribbons should also serve as a reminder of the work that needs to be done to address the emotional impact of cancer. Around 40 percent of those living with cancer experience significant emotional distress, including feelings of depression and anxiety. While research also tells us that most people who are post-treatment are no more likely to experience psychological distress than those who haven't been through cancer, post-treatment can be a vulnerable time for cancer survivors, with signs of depression often going unrecognized and untreated.
As a psychologist and a daughter who lost a mother to breast cancer at a young age, I know first- and secondhand that the weight of cancer can become a very defining experience. I've heard many patients share how much cancer has taken from them. They'll discuss how they feel the cancer stole their beauty, vitality, youthfulness, security, independence and even innocence. I have witnessed the loss of one's life structure as they once knew it, including their careers, hobbies, family roles and physical and social activities. These personal, psychological and social costs of cancer have become engrained in our societal psyche.
I have also learned that cancer can be a "teachable moment" for redefining one's life and one's identity. In that vein, I have heard from patients who said they were changed by their experience with cancer for the better. After going through treatment, women have said that they are more assertive, able to speak their minds, less worried about what people think of them and even more able to enjoy the small things in life. There is a greater appreciation for what's important, and usually these things are people, their faith and simple moments in life. I've even heard survivors say " cancer was the best thing that happened to me" on more than one occasion.
I too have been defined by cancer. I grieved deeply -- and still do to this day -- for the loss of my mother. I am also grateful to be able to make meaning from that loss by putting it into a deeply rewarding career. Most everyone touched by cancer is going to fall into the statistical picture at times. We have to grieve the loss of our health, bodily integrity and identities. There will be times when we long for our previous selves, and there will be triggers that remind us, like the pink ribbons in October, that cancer has left its mark on us personally. But we also can glean from the resilience of so many others among us and before us who have taken their scars and made them into symbols of strength, unity and empowerment.
Redefining oneself is an active, unfolding and iterative process. One can easily get overwhelmed by the day-to-day physical side effects, treatment decisions, medical appointments and financial demands that cancer exacts. However, defining how you're going to face these challenges may be the first step in forging a new identity that will build upon itself as you face each new challenge. It's like approaching the diagnosis with a choice of two attitudes: "I am a victim of cancer and I have to get through this," or "I may have cancer, but cancer does not have me." These are just examples. We all have to find our own definition and, fortunately, there are many to choose from.
Dr. Alyson Moadel-Robblee is the Director of Psychosocial Oncology at Montefiore Einstein Center for Cancer Care and Albert Einstein Cancer Center. She also is leading the development of an Integration Oncology Unit at Montefiore. Dr. Moadel-Robblee is a health psychologist who leads programs designed to help patients and their families cope with the psychological and emotional effects of cancer and cancer treatment. Her Bronx Oncology Living Daily (B.O.L.D. Living) program, sponsored by a grant from the Entertainment Industry Foundation's Revlon Run/Walk, offers a variety of free support, educational, and mind-body workshops designed to empower and nurture cancer patients, survivors, and loved ones. Moadel-Robblee is also an associate professor of Clinical & Epidemiology & Population Health as well as in Clinical Medicine at Albert Einstein College of Medicine.
