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Nancy F. Koehn

Nancy F. Koehn

Posted: October 29, 2010 01:23 PM

The Mental Game of Breast Cancer

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October is drawing to a close and with it, much of the large-scale, public activity surrounding Breast Cancer Awareness month. Ah, if only the disease at hand would pack up and leave the national scene when the pink billboards and PSAs come down early next week.

But this is not to be, at least not now. 208,000 women will get breast cancer this year. 40,000 women with the disease will die in the same time span. After skin cancers, breast cancer is the most frequently diagnosed cancer among women. The lifetime risk of an American woman being diagnosed with breast cancer is about one in eight.

Look around you--at colleagues, neighbors, friends, and family members. More than one or two of the women you account for in this quick glance has had or will have this disease. I have - twice.

Since cancer, particularly breast cancer is so common, most of us know something about the repertoire of treatment options medical professionals have to call on in battling the physical manifestations of the disease.

You also know that, no matter how skilled and caring one's own doctors, each of the treatments involves collateral damage to the body. Surgery mutilates or removes the breast; radiation burns the skin, leaves it unfit for future radiation, and less strong for reconstruction; and chemotherapy just plain ole' beats the body up, inside and out, causing nausea, hair loss, nerve malfunctioning, muscle weakness, bleeding gums, induced menopause, and many more potential side effects.

When I was diagnosed with breast cancer--for a second time--in my 40s, a good friend who had battled a more aggressive cancer than mine, told me to allow a full year after I was finished with chemotherapy before I was back to my own physical ground zero.

At the time, I was incredulous. After all, I was a serious athlete who had always been in good shape, who healed quickly, and who intended to do everything in my power in terms of diet, exercise and integrated medicine, such as acupuncture and massage, to get back to where I was before my treatment started. Surely, I told myself, a year was way too long an estimate for my recovery.

How wrong I was. More than 14 months later, I am still working my way back to ground zero, physically and mentally, from the big, powerful reverberations of dealing with breast cancer and its treatment.

For me, the hardest part of moving up and out of the canyon that cancer hurls one into has been the mental journey, particularly the fear and sense of powerlessness that accompanies (persistent) anxiety. Ironically, this aspect of the landscape was, in my experience, the least well charted. For a disease that is so (tragically) high in its incidence, there is precious little in terms of received wisdom, medical research, even how-to books on how one is to keep one's spirit strong through the months (and often, years) of dealing with breast cancer.

If breast cancer continues its relentless assault on women around the world, before long there will be more resources, research and public conversation about the emotional and spiritual toll that this disease and its treatment take on millions of women each year. The relationship between emotional well being and medical outcomes will be further explored. For example, there will be more scientific attention paid to the small, but growing body of evidence on stress and its debilitating effects on the immune system. There will be increasing integration between the reactive, surgical-strike approach of western medicine and the more proactive, holistic orientation of eastern medicine.

Respect for the power of both kinds of treatment, used in concert, will grow on the part of practitioners and patients. Finally, patients will be empowered to listen to and learn from the right-side of their brains as well as from their heart, as they consider what treatment options are best for their particular situation and being. All of these developments will improve medical outcomes at the same time as they better the entire experience--woman by woman--of grappling with breast cancer.

Alas, in the United States, we are not there yet. Until we are, women must continue to pass on their strength, insights, and experience about the mental game of breast cancer to other women through largely informal networks--conversations, blogs, and email. And this "underground railroad" of support will keep on rollin' on the fuel of collective caring and respect for the entire experience of having breast cancer.

In my next post on Monday, I'll share some of the lessons I've learned as a passenger on this railroad.

 

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