This article is adapted by Dr Jane Clark from an article originally written by Jane and Dr Peter Harvey. See our introduction for a background on this series of articles.
It may seem a bit daunting to see a heading like this – after all, you’ve maybe just come through months of treatment and you were looking forward to bit of a break and now you read that you have even more work to do in order to recover!
This is not quite as frightening as it seems. One of the emotional threads that runs through much of the period from diagnosis to the immediate aftermath of treatment is that of loss.
There are many parts of your life that you may feel you have lost completely or partially, temporarily or permanently.
A loss of control
Often, one of the first things to go is a sense of control. Think of our boat analogy again, there may have been little warning of the huge storm that was about to blow up and whilst it was raging, you may have had little control. For some of you the whole process from discovery of a symptom through to treatment was so fast that it must have felt as if you had no time to draw breath.
“The plan for my surgery was in place before I was even aware that it was necessary. In some ways, that’s great, you want the cancer out but there was little time for me to process what was happening and even start to take in that it was really happening…and to me!”
For others of you, the process might have been a much more tortuous process. But in these and in many other cases there is an over-riding sense of loss of control of your life.
All of a sudden, your life is taken over by a system (admittedly there to help you) but which works to its own rules and timetables. Your diary becomes filled with hospital appointments and clinic visits, often reaching well into the future if you are on a long course of chemotherapy.
Cancer itself sometimes produces a strong sense of uncontrollability and if you add that to the surrendering of control to the healthcare system, it is hardly surprising that there is such an overwhelming feeling of being out of control.
There are other losses, too. The treatment itself can produce losses of body parts – either permanent or temporary and a consequent change of body shape and sense of bodily integrity. The loss of a breast can also carry more significance to your sense of self and being female.
There may be a loss of independence as you become reliant on others to ferry you about to appointments or to get your shopping for you. This may also reflect a loss of position or status – your position in the family, as provider (financially, emotionally, practically) to your loved ones or your role at work may feel diminished by your new role as a ‘cancer patient’.
If your diagnosis has been a struggle and you feel people may not have taken you seriously (see Moving Forward: 6: Regaining Trust in Your Body), or if you experienced a series of problems with the actual delivery of your care (cancelled clinics or lost scans, for example) you may be feeling that a system that you have trusted previously is not as robust and helpful as you had thought (see Moving Forward 13: Regaining Trust in the System).
You may have found that some people in your social network have not been as helpful as you wanted or might have expected; you may have found who your real friends are – and are not (see Moving Forward 14: Regaining Trust in Other People).
Putting your head down and getting on with it
During your treatment you may have found that the best way to deal with everything is to put your head down and just get on with it. Think back to our boat analogy and the idea of clinging on, head down, to get through the peak of the storm. You may not have had either the time or the energy to spare to try to deal with all the emotional and other issues that have arisen – you may have put them on one side to be dealt with at the time when you are feeling more up to it.
This is not a bad way of managing things. It is certainly true that the demands of treatment can take all your energy and there is simply no spare capacity to deal with anything else. Likewise, not everything needs dealing with right now – you can defer some problems until you need to.
A good example of this is concern about returning to work. If you are in the midst of a long treatment regime going back to work may be many months in the future. Unless there are work issues that absolutely must be dealt with now, it is sensible to approach them once your treatment has finished and you have more time energy and clarity to focus on this important issue.
Maybe some positives
Of course, it’s not all about loss and gloom. There are other aspects of cancer, its treatment and the aftermath that can feel very different – positive and uplifting (see It’s not always all bad) but for many people these are offset by some less pleasant experiences.
Acknowledging loss and addressing the task in hand
One of the important aspects of dealing with cancer and its treatment is to acknowledge the losses as once these are acknowledged then it becomes easier to deal with the rebuilding and recovery process.
This series of articles is aimed at helping you do this by addressing the tasks of rebuilding trust in your body, in yourself, in the healthcare system and in your social world.
As everyone is different you may only need to dip into the parts of this that you feel are relevant to you, but there is extensive cross-linking as very few of these losses occur in isolation.
Dr Jane Clark, Consultant Clinical Psychologist
The information and content provided on this page is intended for information and educational purposes only and is not intended to substitute for professional medical advice.