By: Jamie Reno
My heroes have always been war veterans. And cancer patients. When you think about it, the two groups have a lot in common.
Recently, I interviewed a Marine combat veteran who'd endured four tours of duty in Afghanistan. This guy had seen one of his best buddies killed in an improvised explosive device (IED) blast.
But when he learned that I’d been through four battles with stage IV non-Hodgkin's lymphoma, he asked me how I made it through.
I just shook my head in amazement and said, “It was absolutely nothing compared to what you must have gone through in combat, seeing your friends die and getting shot at.”
He said in all sincerity that he could easily handle being in a war better than going through cancer treatment.
I told him I never wanted to find out which “fight” is tougher. We shared a laugh. And at that moment I was reminded, again, how much war veterans and cancer patients do indeed share.
I respect and admire every man and woman who puts on a uniform and fights for our country, and every man, woman and child who's been diagnosed with and fights cancer.
We fight very different battles, of course, but cancer and war, which are both fitting metaphors for the other, bring out the best, and worst, in us.
Both are ultimate tests of our strength, courage, and love for life.
Both can be pure hell.
And both can cause deep and lasting psychological trauma.
Last year, I reported for The Daily Beast that about one in three veterans of the fighting in Iraq and Afghanistan suffer from Post-Traumatic Stress Disorder (PTSD), which is a form of anxiety that develops in reaction to physical injury or severe mental or emotional distress, such as military combat, violent assault, natural disaster, or other life-threatening events.
It is widely known that PTSD is common among our troops and veterans. But what is less commonly known is that it’s also very common among cancer patients.
Researchers in the February 2013 Journal of the National Cancer Institute confirm that nearly one in four newly diagnosed breast cancer patients often start manifesting symptoms of PTSD shortly after hearing the words, “You have breast cancer.”
According to the National Cancer Institute, the physical and mental shock of having a life-threatening disease, of receiving treatment for cancer, and living with repeated threats to one's body and life are traumatic experiences for many cancer patients that can often lead to PTSD.
I've never been formally diagnosed with PTSD. But I know I have it. No question about it.
I still sometimes have nightmares about my cancer. And I still have a hard time even driving by the hospital where I had my initial chemotherapy. It triggers a lot of emotions within me. Fear, especially, and anger.
The way I see it, every cancer patient has some form of PTSD. It typically is not as severe in cancer patients as it often is for war veterans. But it is very real.
But what matters is that for all the trauma that accompanies fighting cancer, and fighting wars, they also both give us an immeasurable appreciation for the precious gift that is this life.
That old cliché’ is true, you know: What doesn’t kill us really does make us stronger!
I cannot tell you how glad I am that you have reported the PTSD in cancer patients as well. Very little has been written about it for those who experience a life-threatening disease. As someone who has PTSD herself, I recognized it in my daughter while she was treated for cancer and realized how utterly traumatic diagnosis, treatment and SUFFERING were to her and are to patients. Even caregivers for sick family members can be traumatized. Anytime one comes close to death and loss by violence, surgery, disease, etc. we are rewired. The brain resets into the fear and vigilance mode.Once you come close to death, anything is possible. I know it well. Cancer treatment can be ravaging in many ways.
I was formally diagnosed with PTSD - it struck about six months after the 'umbilical cord' connecting me to the hospital was severed with the words "We'll see you in three months!" and I was 'thrown out' into the world to try to regain some sort of normality and make sense of the past ten months. In hindsight it was an interesting experience, at the time it was hell!!! The 'Welcome Back' to work was wonderful, but since my colleagues had no and could have had no understanding of where I was the 'leniency' of the first day back didn't last long ... and, frankly, I couldn't cope with the pressures and a cared less about the work. It was a long slow process, one complicated by an unrecognised lack of testosterone - I won't say 'undiagnosed' because I had diagnosed it six months after treatment ... it took the medical profession another four and a half years to catch up with me!!!!!
I could add that, thankfully, I was stubborn enough to seek assistance - "Why should I go on suffering alone when there's help available just up the road?" I went back to the hospital and sought assistance. After a lengthy consultation they eventually asked, hesitantly, "If we make an appointment would you be agreeable to seeing a psychiatrist?" Me need a psychiatrist? How DARE they!!!! I am perfectly sane!!!! Well, good sense prevailed. What had I to lose? Absolutely nothing! And if I didn't like what the psychiatrist said I could dismiss it!!!! I agreed.
I went back to work, sat at my desk, and typed "Having cancer SUCKS!!! It REALLY SUCKS!!!" and it all just started to flow. At times I couldn't keep up with the flow, but after two days and 27,600 words ... the entire cancer experience; my opinions, both good and bad; absolutely EVERYTHING was on my computer - and I felt WONDERFUL, cleansed, restored, whatever you want to call it.
Interesting that when I eventually saw the psychiatrist, a Professor no less, what I had accidently done in my 27,000 words was one of his strategies for effecting a 'cure'.
It's the exercise of writing, not the writing itself; it's a unique kind of writing in that there is no expected audience. I wasn't writing for someone to read my words - my mental filing cabinet was sitting there with the drawers open and the files and papers strewn across the floor, all the mental filing that had been neglected because I was using my emotional and physical energy simply to survive - all my furious typing was, in effect, a process of sorting out the papers, putting each paper into its correct file, putting each file into its correct drawer and closing the cabinet.
I printed off a copy and copied the file to disk ... both disk and paper copy went home and were put away [at the bottom of the underwear drawer] unread; and there they remained for several years. They saw the light of day again only because one of my nurses was doing his doctoral thesis and asked to interview me about my experience.
It's a hell of a therapy for PTSD .... but it's one that really works - at least it did for me!!!
As a Vietnam combat vet, heavy combat, and a cancer patient with two different primary cancers, multiple surgeries, and now advanced incurable cancer, I am quite sure that if PTSD is a real thing, I must surely have it. Nobody has ever mentioned the possibility of this other thing to deal with, or what to do about it, if anything. Seems to be some sort of connection between the two though.
Thank you. THANK YOU! IT IS REAL!
My very first post to this site was last week and it asked if there was such a thing as Cancer PTSD. I have dealt with the fear after hearing the diagnosis "You have a malignant egg sized tumor. We have you scheduled for a CT scan three days from now, a PET scan to stage your cancer. We would suggest you go to The James Cancer Center for surgery. We can set you up with a surgeon." Shortly after the PET scan I heard, "The cancer is stage three. You have at least two lymph nodes involved. We want to do radiation and chemotherapy for six weeks to shrink the tumor as much as possible. Then you will have six weeks to re-gain strength and then the resection surgery." After the surgery I heard, "We will begin stronger chemo in four weeks and do this for four months. Then we'll see where we are."
Well we did all of that and I had a tremendous force of Prayer Warriors among my family, friends, and church family. I received over 100 cards. I was encouraged and lifted up on Facebook and Instagram. I continued to be paid after all my vacation and sick-leave was depleted. I was told my job was now to "fight for my life and not worry about the office." Amazing, amazing people surrounded me. I learned I was like George Bailey and had had no idea how much people cared about ME.
Then I was told, "Your neuropathy is taking a toll (I was falling and could only feel pain in my hands and forearms, my feet and from the knees down). We are cutting one of your drugs from the protocol." That scared me. As bad as the neuropathy was, I was terrified to STOP any of the chemo cocktail. I was fighting the Beast with the chemo and I was scared I was letting my guard down by deleting one of the drugs.
I finally completed my four months of daily chemo, saw my oncologist (a wonderful physician by the way) and he said those words you mentioned: "See you in three months for your first scan!" As I worked on regaining my strength (again) I tried to see THAT as "DOING SOMETHING". I was counting the days until that scan. I went back to work part time 5 weeks after the last chemo. Slow going. All that time there was something nagging at my brain. I should be happy. The chemo was done, no more radiation, the appetite is coming back. Why am I not happy? At peace? Was I ungrateful for the many people who loved and cared about me and all they had done for me? I had a recurring nightmare that the doctors were trying to put the cancer back in me. I'd wake up in a cold sweat and my husband - trying his best to help me - would say, it's gone, why would you worry about that?
Had my first scan - "Clean and clear! No cancer! We will schedule your next scan for September!" We all rejoiced. But I continued to secretly cry, have that nightmare deal with the constant pain all the while attempting to be strong for my husband, daughter and friends.
So I asked on here, "Is there such a thing as cancer PTSD?" and today - a day during which I can NOT stop crying - I read this post. I still feel weepy and I still fear and HATE cancer. But a part of me had relaxed just knowing I'm not an ingrate.
Now my question is - what do I do now? I'm already on an anti-depressant. I love and trust the Lord. I can only say the spirit is willing (to be at peace) but the flesh is weak. HOW do I deal with this? I have a son-in-law out there somewhere that my daughter (and I) have yet to meet, a wedding to plan someday, grandchildren to spoil. All things to look forward to. How do I pull out of this pit of unease?
Given what you have been through, how could you not have PTSD? When given the "cancer free" ticket you , and those around you, think life goes back to normal. Your loved ones celebrate, "Yeah! You are done, we don't have to worry about you anymore! " We can expect you to do all you used to do." But there is no going back to the way things were, whether or not your cancer is curable. Mine is not curable, Multiple Myeloma, but new treatments are turning it into a chronic condition. I always showed a positive face, didn't want people to worry. I think invisible wounds contribute to PTSD, whether you are a war or cancer warrior. The hair's grown back, the cards stop coming, but you are still wounded. It was my caregiving husband though who felt people should know, we will never be done with this, both physically and psychologically. (Today is a maintenance chemo fatigue day, so I lay here writing on this beautiful summer day instead of hiking.) We did join a support group through Dana Farber. Since I am almost 3 yrs. post diagnosis and in remission I initially didn't think we needed the group. But it has proven to be so helpful for both of us to talk with others on the same path, especially since my husband gets to talk with other caregivers. The other thing that helps is exercise. The right one is the one you WILL do. For me its mostly yoga, walking, hiking. I have also joined a mediation group and am trying to make it a daily practice. And writing, as you have read from others, writing is very therapeutic for those dealing with PTSD.
Good luck, keep posting, you are not alone!