When you have cancer, there is such an intense focus on your physical health – the reams of appointments and treatments can make it feel like a full-time job – that your mental health can get neglected. For the strongest minded of people a cancer diagnosis can really pull the rug out from under your feet but for those of us who already suffered with anxiety it can be a sheer drop underneath as well.
Walking in Cumbria on New Year’s eve
You see, me and anxiety go WAAY back. We’re old pals. Well, more frenemies. I already came from a long line of worriers when at the age of 16 I had quite a nasty car accident. I got thrown out of the back window of a Mini, landing on the road, fracturing my skull and leaving me with life-long scars on my face and arms. This was quite a massive life event for a naive teenager from deepest darkest Wales and I developed Post Traumatic Stress Disorder soon afterwards. I barely knew what this was at the time but I knew I was terrified to sleep on my own or without the light on and kept going over and over the details of the accident with anyone who’d listen. This was nearly 25 years ago and I was given a bit of talking therapy at the time but was too shy to really voice my feelings and work through it.
Injuries after car accident 1994
So, for many years I thought the racing heart, sweaty palms and overwhelming fear I felt at times of difficulty were the signs of a heart attack! Obviously, I’ve since learnt I had started suffering from panic attacks. They have become more infrequent over the years as I and my mind have matured and taken stock a bit more. I would not describe them as severe and they can be easily controlled with medication if needs be. When the garden is rosy I can completely forget about them but when times get tough they tend to rear their ugly head and appear, jazz hands splayed with a “TAH DAH!!!!”
Obviously at the mention of the word cancer the anxiety and panic attacks grabbed their sparkliest jackets and shoes and elbowed each other out the way in the rush to get to me! These days though I have a few more weapons in my arsenal to fight them with. I found Cognitive Behavioural Therapy (CBT) the most helpful. It’s a talking therapy course that helps you to recognise when your mind is being unkind to you – we can so often be our own worst critics. Second to this is practising mindfulness – something I’ve unfortunately allowed to lapse a bit. I found a brilliant app called Headspace which provides you with guided meditations on a range of subjects by the wonderful Andy Puddicombe. He’s a British guy, who went off and trained as a Buddhist monk, survived cancer and is now living one of those sickeningly sunny, healthy lives in LA whilst being an absolute genius. When I get on a roll and do 15 minutes a day, I find it really helps to quiet all the busy thought traffic in my head (it’s seriously like the M25 at 8am on a Monday morning in there sometimes!) I’m also a big fan of acupuncture, I go to my therapist, pour my heart out, she pops a few needles in and I lie in a scented, darkened room for a bit listening to soothing music. I see it as being a sort of beauty treatment with spikes.
But at the moment it feels like I’m losing the battle a bit as I’ve not yet taken up the offers of counselling, of which there are many. I’ve always suffered from health anxiety, Dr Google has diagnosed me over the years with ailments in every part of the body from a brain tumour to an ingrown toenail. I have found diseases online and considered whether I have them that your average GP would struggle to name. I’ve had x-rays, ultrasounds, blood tests and investigations for various aches and pains that turned out to be nothing. But when it came to finding a lump in my breast I was oddly blasé. I just didn’t think it would be cancer. I presumed it was a cyst. I’ve had them removed from my ovaries before and I’d not long finished breast feeding so that was the obvious choice right? Even when the GP found a second lump under my arm I asked her “you can have more than one cyst at the same time can’t you?” and when my mother-in-law asked me about how big the lump was and I described it as being about the size of a walnut I ignored to look of concern that flashed over her face and pressed mute on the alarm bells. Oh the Alanis Morisette worthy irony.
The last pre-cancer picture of me looking perfectly healthy
Cancer comes with its very own specialized form of anxiety. There’s the obvious fear of death that pervades every thread of your life from imagining your child without his mummy to picturing your own funeral. There’s the sudden fear of germs that comes with being on chemo and immuno-compromised. I’ve grown up around animals, farms and mud and was always a great advocate of letting children and germs collide to build up their immune systems. Becoming hyper-aware of possible nasties on every surface I touch and trying not to breathe in every time someone coughs has been one of the most stressful parts of cancer for me.
I’d describe myself as being a mildly superstitious person, the kind that will avoid walking under a ladder but also won’t have a breakdown if a black cat crosses my path. I like to hedge my bets…but with cancer hanging around my anxiety has escalated these superstitions into a big deal, so much so I forced Steve out into Storm Eleanor the other day to retrieve our Christmas stags from the driveway and put them away in the garage ‘just in case’ we forgot to do it by the 6th January. I just can’t risk the bad luck. I won’t even get onto the fear levels when Freddie gets near a mirror!
The Bland festive stags summing up how we all feel after Christmas!
Scanxiety (Scan anxiety)
By far the worst aspect of cancer anxiety is what we in the cancer community call ‘scanxiety’. This is the particularly severe type of anxiety experienced while waiting for scan results. Like an actor is only as good as their last film, so a cancer patient is only as well as their last scan. Any scan could show up that dreaded spread and waiting for the results is excruciating.
It goes something like this…in the period immediately after the scan you start to question whether they would call if something showed up, or would they wait to tell you in person? Every time the phone rings your heart races and you jump a mile. No news is good news right? Wrong, I’ve had bad results I’ve had to chase up myself after a fortnight. As appointment day gets closer you become more tetchy and snappy with everyone around you and lose all ability to concentrate on anything other than ‘is this the one where it’s game over’? The anxiety levels peak while you sit in the oncologist’s waiting room trying not to lose your shit every time someone tries to make jovial small talk. Then the seconds slow down into hours as you micro-analyse everything from here on in. How does the nurse look who is taking you in to see the consultant – is there pity in her eyes? Do you see the consultant or registrar – if the consultant walks in are they there to deliver bad news? What is their demeanour – cheerful or about to deliver a death sentence? (In my experience, most oncologists have one demeanour that can politely be described as scientifically dispassionate). Should you look at what’s written on the paper in front of them or will you see something you don’t want to? Inevitably in my case the results are generally more complicated than a ‘yes you’re fine’ or ‘sorry it’s bad’ so all that effort goes to waste. Then you go back around to the beginning again as you wait for the next scan!
It makes sense to be aware of your body when you’ve had cancer and be alert for any signs of possible secondaries. But my anxiety means I’m poised like a lion about to spring on its prey at the merest twinge. When that spot showed up on my hip in a PET-Scan the oncologist asked if I’d had any pain there. No, was the answer but I bet I will now. Lo and behold by that evening my hip had developed an ache. Now every back ache (I have a lot since my C-section) has me questioning if it’s in my spine, soreness in my side – could it be liver mets? I woke up the other morning feeling really sick which is very unusual for me and was quickly googling brain metastasis as I’d remembered being sick in the morning could be a sign. If you’ve ever nearly stepped out in front of a car and jolted back to the pavement, heart racing as it’s whizzed by – that’s what it feels like. About 20 times a day.
It’s OK not to be OK
I get a lot of comments on how strong I seem and how well I’m doing. But I wouldn’t want anyone else going through this to think I’m sailing through, my cup runneth over with anxiety and stress. One of my coping mechanisms when times are tough like this is to live life at 100 miles an hour and fill my time with distractions.
I’ve said it before while talking about the, weird and unscientific pressure from everyone to remain positive while you have cancer, but it bears repeating…it’s OK not to be OK. Being diagnosed with cancer one of the biggest life events possible and it’s important to treat your mind while treating your cancer. Some Macmillan centres offer free counselling and you can also access talking therapies through your GP or in some areas by self-referral. Maggie’s Centres provide a great place for all things soothing. Talk to people online. Talk to your family and friends. Help is out there, you are not alone.