The Wreckage

I might be depressed. I don’t know what depression feels like. I have a generalized concept of what it might look like, or how society views depression, but I’m guessing what it feels like is quite different. I also imagine it can present itself in very different ways. Most would not think I’m depressed. I’m eating, sleeping, going to work, and generally, I’m a happy person. I suppose my life could maybe be more fulfilling. I could have more money, a nicer car, a job I really love, be married, have kids, a nice house with a wrap-around porch, take vacations, be stress-free, but that’s not what my depression stems from. My depression = coping with cancer, and my future.

My acupuncturist says I’m grieving. Grieving? Grieving what? My life before cancer? That’s a given. Chemo ending? It’s quite possible. Chemo sucks but there’s this weird comfort in the routine of it and knowing that it’s (hopefully) kicking cancer’s ass, but now that it’s over, comes the wreckage. Not just physically, but also a huge eruption of emotional carnage.

Knock, knock. Who’s there? The aftermath of cancer.

There’s a huge difference between chemo and radiation, and not just procedurally. It seems like people line up to help you get through chemo, and then when it’s over, they’re gone. Don’t get me wrong, radiation is nothing anyone wants to hold your hand through, nor can anyone, but I think as a community there’s a perception that when someone makes it through chemo, they’re all good. Their hair grows back, they look good, or at least better, they’re going to work, but physical appearance isn’t everything. Especially when you’re dealing with cancer.  

There’s a huge emotional support gap when transitioning from chemo to radiation, and it’s not just family and friends. It’s within MSTI, too. I’m not going to the chemo suite every week anymore so I don’t get to chat with the nurses about how I’m doing. I don’t see my oncologist weekly anymore either so when I have concerns or questions they just seem to pile up. I feel like I really have to go out of my way to figure out who or what at MSTI is there to help me cope with all this BS. I see my radiation oncologist once a week. She checks my skin and then asks what kind of emotional support I’m getting. None. It’s the same. Every. Single. Week.

I talked with a social worker the other day. I guess a month after radiation I’m supposed to have a Survivorship Wellness Plan appointment when my doctors and I will plan the healthiest me there can be, and basically what the next 5 years will look like. Because, my doctors already know about my cancer and how it works, now it’s my turn. I have to plan how I can help myself, but really, a month after radiation? That doesn’t work for me so I requested my packet now. I started to read it. First page says, “Congratulations on finishing your cancer treatment.” Are you kidding me? Congratulations? It goes on to tell me to:

Eat a healthy diet, with a focus on plant foods

Limit alcohol consumption

Achieve and maintain a healthy weight

Be physically active

I’m truly educated now! Things I absolutely had no idea I should be doing, or wasn’t already doing prior to my diagnosis. I can totally move on now. Ugh.

No, what my depression, anxiety and sleepless nights come from is truly one of the scariest potential outcomes of early-stage breast cancer diagnoses. It’s known as the micrometastatic paradigm. This paradigm states that some patients with early-stage breast cancer have distant micrometastatic cancer present at the time of their initial diagnosis, putting them at risk for the later development of metastatic cancer. The statistics running rampant on the internet proclaim that 20%-30% of early-stage survivors (Stage I, II & III) will develop metastatic breast cancer in their life (Stage IV). Did you shit your pants after reading that? That’s one of my biggest anxiety triggers, and probably a reason I should stay off the internet.

Although I don’t know my specific statistic, even though I could ask my medical oncologist but I don’t out of fear, I do know I’m not even close to 20-30%. My radiation oncologist breaks it down for me like this on a scale from really good to really bad:

2cm tumor - in the middle

Aggressive, Invasive, Her2neu+ - bad

Clean lymph nodes - really good and in some ways triumphs some of the bad

The odds that a little bugger, as she refers to it, got out, are very slim for me, and if one did, the odds that the chemo took care of it are very high. Her personal opinion is that I was cured with surgery. She told me to look myself in the mirror every day and tell myself:

YOU DO NOT have a single cancer cell in your body.

You are you--YOU are GREATER than any statistic!

P.S. I saw a psychiatrist today. I’m not crazy. I’m not depressed. I just have anxiety, and I now have a plan to work through it. I was also told I don’t have Stage IV breast cancer so worrying about that isn’t particularly helping me. So there’s that.