Melissa is a breast cancer survivor of 2 years. She has endured multiple surgeries, chemotherapy, radiation, Herceptin and is facing even more surgeries due to breast cancer. In her earlier years, Melissa was a Critical Care nurse in the Navy and was deployed in 2004. After she retired from the Navy, she screened veterans for Post Traumatic Stress Disorder (PTSD) as a Nurse Case Manager for Operation Enduring Freedom/Operation Iraqi Freedom at a Veterans Administration Hospital. Melissa was an expert at identifying PTSD and referred the veterans to Mental Health for Treatment. So even with all of Melissa’s training, education, and military experience as a Nurse, Melissa says that no training prepared her for breast cancer PTSD, but it just made her aware that she has it.
According to the National Cancer Institute:
PTSD in cancer survivors may be expressed in these specific behaviors:
- Reliving the cancer experience in nightmares or flashbacks and by continuously thinking about it.
- Avoiding places, events, and people connected to the cancer experience.
- Being continuously overexcited, fearful, irritable, and unable to sleep.
Melissa says that with PTSD, your world becomes much smaller. A cancer diagnosis, chemotherapy, radiation, side effects, body image disturbances, etc. make up the perfect scenario for one to suffer from PTSD. Studies show that over 50% of breast cancer survivors suffer from PTSD. I believe it is much greater for women who have had “the breast cancer treatment book” thrown at them. Melissa believes that more focus needs placed on the psychosocial effects of breast cancer treatment.
Melissa now works as a Clinical Nurse Navigator in a civilian hospital for GI/GU Oncology. In order to cope with her flashbacks from chemo and PTSD, Melissa tries being proactive by avoiding the Chemotherapy Floor in the hospital where she had chemo and arranges to visit her Oncologist appointments at his satellite offices and not at the Cancer Center where her appointments were during treatment. Working with cancer patients on a daily basis does not bother Melissa, in fact, her experiences make her definitely understand what they are going through. Her coworkers know her trauma and try to shield her from the breast cancer recurrence stories as best they can.
Like Melissa, I am still learning to live with PTSD. On a recent trip to my Cancer Center, the chemo flashbacks were firing in my brain like a machine gun. It struck me that it was the same week in January that I had Chemo #2 three years previously. It was a Tuesday, the same day of the week, and same kind of cold January day, I was sitting in the same waiting room, on the same floor where I received chemotherapy, and being called back to an exam room. My brain and body could not tell differentiate between the past and the present. Several hours later, when I arrived in the safety of my home, my body literally started shaking like it would after Chemo. And I had to sleep with the television on to distract my brain in order to fall asleep – what I had to do during cancer treatment. The next morning, I vomited, just like I always did the morning after all 16 chemo treatments.
Melissa has tried therapy with a PhD Cancer Psychologist, and it didn’t work for her. She says what works for her is time and the love of supportive family and friends. But therapy certainly may work for you.
Melissa and I agree on what helps us:
(1) Have a panic buddy, a cancer survivor friend, whom you can email or call to help talk you from the past to the present. We call it “talking us off the cancer ledge.”
(2) Have a go to place – a website, a survivor story place, a support group, a news article – anything that gives you hope and encouragement. For Melissa, she keeps a clipping about a survivor who has a similar diagnosis to hers who has been alive over 10 years. For me, I go to the Posting Boards on a favorite cancer website to read survivor stories of women who had bigger tumors than I had and more lymph nodes removed and are still alive.
(3) Both Melissa and I play over in our heads all the positive things we are doing to keep cancer away – like regular checkups, taking certain drugs and supplements, trying to eat lots of vegetables, and staying away from bad things and toxic relationships.
(4) Melissa said she often has to have a good cry to clear the air of her fears. I think she is on to something. Today, I finally gave into the tears about everything I’ve been feeling emotionally, and it really helped.
(5) Refrain from sharing your fears and flashbacks with family and friends unless it is someone who really understands. Otherwise, you may end up feeling worse by being told your fears are unfounded. No one can really understand unless they have been through it or a similar life-changing trauma.
(6) Take time for yourself to do something you enjoy. As cancer survivors, often we have forgotten how to just enjoy life as we used to do. This may be because of side effects from drugs, financial struggles, or not enough energy to do beyond the basics. But it is so important to find something you enjoy that will help bring peace when you are in the midst of a full-blown PTSD attack.
Take that first step whether it is getting professional help or learning your own coping mechanisms. If you have coping skills that work for you, please share them!
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