What my cancer diagnosis taught me about myself
"What do you think it could be?" he asked. With my bicycle helmet resting on my lap, this is not how I had expected it to be. What do you think it could be, the surgeon asked me - after I’d found a lump in my right breast, been sent for a test by my GP, had a mammogram, an ultrasound and a biopsy. “That’s for you to tell me," I replied.
"It's cancer" he answered. "We’re going to give you chemotherapy to shrink the tumour. Then we will operate to remove what is left. After that, you will get radiotherapy. Can you please take off your top and lie over there. I want to examine you."
I did as I was told. As he pushed at the lump my tears finally started to roll down my face, silently. The other person in the room, a Macmillan Nurse, gave me a folder with stuff to read. Which I didn’t. I couldn’t. Not then.
This is how I remember the moment I was given my breast cancer diagnosis, in May 2012, just a few days after my 47th birthday.
I don't know what possessed me, but as I was leaving the room I turned back and said to the surgeon, "Thank you for having been so gentle with me". I tried rescuing him from feeling uncomfortable, instead of thinking about myself. And that is the single biggest change in my life, since that day.
I had to start thinking about myself, speaking up for myself and putting myself first.
When your world collapses and you are left with uncertainty and grief for what will never be, then you have two options: crumble and break, or get a bit more fearless and strong. Actually, let me correct myself. You have a third option: a combination of one and two. I crumbled a lot and broke a bit. But I also grew stronger. And this process continues, well after cancer treatment is over.
According to Cancer Research UK, by 2020 one in two of us will develop cancer in our lifetime. That means almost everybody will be affected by cancer. Even if you have not yet had it, you are likely to know someone who has. Thinking about a common illness may be hard and unpleasant, and it may even appear unnecessary and futile. But, professionally speaking, I think it is wise to do just that - thinking about it. And, personally speaking, I am glad I did.
When it became my turn, I was amazed by how little I knew about cancer and how unprepared I (and those around me) had been. Still, instinctively I took some big decisions shortly after I found the lump.
I prepared for the worst-case scenario.
Even before my diagnosis, I assumed that this was cancer. I started to think in very practical terms how to get ready - for treatment (not for dying). Perhaps I did this because there was no one else to do it for me. And, it turns out I wasn’t alone in feeling on my own either - Macmillan Cancer Support says that one in four newly diagnosed cancer patients lack support.
I needed a personal view on treatment.
I spoke to one of my neighbours, who had gone through breast cancer twice already. She was calm and understanding. She gave me some leaflets and recommended an NHS hospital, which specialises in cancer care and the surgeon who had treated her. By the time I met the surgeon that my GP had referred me to, I already had a plan.
It felt empowering when I otherwise felt I was being stripped of choices and a say in my life.
I asked to be referred. It took another three weeks to get an appointment but, with hindsight, I am glad I did what I did. The hospital of my choice gave me a second (and the same) opinion and another treatment approach, and that's what we did.
I prepared mentally and emotionally.
Because of waiting times, I could not be fitted in for an operation straight away. I used the next few weeks to get myself into a better frame of mind and sort things out at home and at work. That way I would reduce stress and anxieties later on down the line. I decided who would need to know what. I got my hair shaved off and undertook many silent walks.
Instinctively I knew this was going to be gruelling, physically, emotionally and mentally. I needed to have some kind of a routine and tools of self-care and motivational support in place.
Exactly what that would mean, I wasn’t sure; I had to be guided by my intuition. Spending time in nature is a key part of my life and one that I couldn’t compromise. If I was too unwell to go out, then nature would need to come into my home - colours, plants, soundscapes. Unfortunately, my own therapist at the time had to stop work - also for health reasons. Unknown to me then, he died of cancer while I was still being treated for it.
I needed a responsibility and a companion.
A few days after my diagnosis I made another big decision: I was going to get a dog, finally. Because, living by myself, I knew I needed a reason to get up and go out. I needed a responsibility and life around me.
Of course, I had considered whether this would be fair on the dog: What if I die? What if I catch something from the dog while my immune system is low during chemo? What about the cost?
But, on balance, the benefits outweighed the doubts. Walking together with her turned into a cornerstone of my mental and emotional well-being strategy. I got exercise and fresh air, even when I was left almost unable to walk.
I'd created a new identity - I wasn't just a woman with cancer, I was a woman with a dog. And I got to know many new people.
I got unconditional love and companionship from a stray dog, who in turn got a new and loving home from me. We saved each other.
Now, five years on, my life has changed, mostly because I have changed - because of the lessons cancer has taught me. Of course, every person and every cancer story is different. If my cancer was to return and/or if it was to be terminal, then I may write this piece slightly differently. It stands to reason and that’s OK.
There’s not a single person, story, book, lecture or talk, which will teach us all we need to understand. That’s what we’ve got to figure out for ourselves.
Karin Sieger is a psychotherapist and writer. She specialises in support for cancer, loss and transitions and also offers cancer counselling workshops for therapists and counsellors. You can follow Karin on Twitter, Facebook and LinkedIn.
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