Felicia Mitchell, retired from college teaching, is a poet and writer who makes her home in southwestern Virginia. She is a survivor of stage 2b HER2-positive breast cancer diagnosed in 2010. Website: 

Felicia Mitchell

Felicia Mitchell is a survivor of stage 2b HER2-positive breast cancer diagnosed in 2010. Catch up on all of 

Sometimes the best advice you can give somebody dealing with cancer — from breast cancer, which I personally experienced, to the many kinds of cancer our family members and friends have experiened — is the simplest advice. Recently I found myself telling a friend with a new cancer diagnosis, “It is okay to cry.”

My friend, of course, knows that. In fact, we had shed some tears together just before I said it. But for some reason, I always want to say this out loud. Here it is again: “It is okay to cry.” Say it aloud. It is okay to cry. I should know. While I sometimes talk about my cancer days through rose-colored glasses, my journals remind me of how often I did cry.

Does this track record mean that I am an easy crier? Recently, I took a test offered within a “New York Times” article on crying entitled, “What Kind of Crier Are You?” The result of the test proclaimed, “You aren’t a crier, and that’s ok.” While explaining why I might not get as teary-eyed as others, especially women, it suggested that “it might be worth talking to a mental health professional to explore why.”

Well, I did speak with a mental health professional about crying when I was dealing with cancer because my crying got out of hand. We all should remember to seek help if crying will not stop. If we do not recognize the problem in ourselves, we have to hope our friends will notice and help us to seek relevant assistance. In my case, I told my breast cancer nurse navigator, and she got me connected with a therapist within a day. In that case, crying signified how depressed I became when I began processing my complicated year during the last days of treatment.

Now? Am I too bottled up? Not really. I think the problem with that survey, as interesting as it is, relates to the questions it asks. I did answer “yes” to important ones, I think, as in “Your neighbor has only months to live. Do you break down when he tells you?”

If a researcher wanted to ask what brings the tears on for me, I could provide a list of reasons, despite the fact that I can be stoic and clear-headed in a crisis. Here is a list of a few personal triggers, and by no means all triggers, in no particular order: a sappy “Reader’s Digest” story, losing electricity during an ice storm after returning from a chemo treatment, a marching band with trombones blaring, breaking a wrist, the death of a cat, the death of a dog, the accidental mowing of a rare plant I monitor by the Appalachian Trail and sad movies.

So, no, I do not think I need to seek professional help. I know how to cry. I just do not tend to cry when somebody gets a standing ovation or my home team wins the Super Bowl, among other things. That is the point of what I am trying to say here. Know your personal crying style. Figure it out based on your own triggers and needs. Anybody who has experienced cancer is going to have a unique crying style.

When and where should a survivor cry? In the arms of a friend sharing in your cancer diagnosis? In the bathtub after a mastectomy? In your car in the parking lot of the cancer center? On the phone with a friend as she is telling you she is now on hospice? On the phone with a friend dying of cancer who calls to say goodbye? At the grocery store, when you see a box of Moon Pies reminding you of your father, who died of complications of Parkinson’s disease and cancer? Every time you think of your brother who died young of cancer? Every time you speak your mother’s name? Or whenever you, so uniquely you, want to? You choose.

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Crying is a natural response to a cancer diagnosis, and acknowledging this can be comforting. Personal crying styles vary, influenced by individual triggers and experiences. While some may cry easily, others might not, and both are valid. It's crucial to recognize when crying becomes overwhelming and seek professional help if needed. Understanding one's unique emotional responses, especially after a cancer experience, is important. Crying can occur in various situations, and it's essential to allow oneself the freedom to express emotions authentically and without judgment.

Even stoics need to cry now and then. My advice from personal experience is this: it is okay to cry.

When Cancer Makes You Cry, Cry It Out

Cancer survivorship takes courage. We are often called to step outside our comfort zone. A big step for me as a survivor of invasive HER-2 breast cancer is to shift screening care from oncology back to gynecology. I may be a little late in making this decision, but my oncologist’s impending retirement inspired me to try gynecology again as a home base for breast health.

Five years after the original cancer diagnosis, my oncologist did say I could transfer care for post-treatment follow-ups and general screenings to a primary care doctor. I was not ready to cut ties. While I might be past the HER-2 breast cancer experience, knock on wood, I am still high risk for cancer. With family history of breast cancer, my personal history and dense breast tissue, I felt comfortable with an oncologist.

To be honest, I feel like I slipped through the cracks of my routine gynecology screenings the first time around. After moving to stage 2B cancer from “no cancer detected,” in one year, I felt safer in the cancer center. Annual visits addressed bloodwork, mammograms, the occasional MRI and general questions. I got advice about breast cancer and related matters such as blood sugar, bone density and heart health. To keep a body in balance, to hope to avoid further cancer or catch it early, diligent care is required.

For survivors feeling “once bitten, twice shy,” routine care can affect our relationship with the breast screening system. I finally feel ready to shift from the safety net of oncology, especially because I advocated to move from a nurse practitioner to a gynecologist. After having previously visited a nurse practitioner because I had aged out of pap smears and had no discernible “female” issues, I decided the transition from oncology would be easier if I returned to seeing an experienced specialist in gynecology.

While change, such as a new doctor, can take a little getting used to, change is not bad. For example, it might be good to have a new perspective. There are also a few research developments that will make this shift easier psychologically. The 3D mammogram, which my oncologist assured me works better with dense breast tissue, has become more widely available. Practices regarding follow-up, which can include ultrasounds or other testing, have become more commonplace.

I plan to be more involved with my gynecological care this time around. I will ask more questions about mammogram reports. Because I still wonder why I could go from a report of no cancer to invasive cancer in one year, and never feeling a lump with two tumors hiding out for a time in my dense breast tissue. I will be assertive about seeking further testing as warranted as we follow mammogram trends.

I hope never to have cancer again, but if I do I hope it is found earlier. I say this not out of regret, but out of a mature sense of self-advocacy. Making a decision related to survivorship is intensely personal, yet it is best informed by advice from medical professionals we trust and breast cancer research. In my case, I feel comfortable with the new normal that heralds a new year.

If you are wondering about when or if to leave a trusted oncology office, if the office suggestes that it is time, talk to your oncologist and do research about options for breast health care with, for example, a gynecologist or internist. Read up on specialists that are taking new patients. Read mammogram reports and ask questions. Compare trends and ask more questions. Never feel shy about your own health if your gut says follow-up is needed to look more closely at something.

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Transitioning from oncology to gynecology for breast cancer survivors can be challenging but necessary. Survivors often remain with oncologists due to high cancer risk and comfort, but changes like retirement can prompt a shift. Advances in screening, such as 3D mammograms, support this transition. Survivors should engage actively in their care, asking questions and seeking further testing if needed. Decisions about care transitions are personal and should be informed by trusted medical advice and research. Survivors should explore options and advocate for their health confidently.

As I shift from an oncologist to a gynecologist for breast screenings, I examine both my reluctance to let go of the past and my hopes for the future.

A New Year, A New Approach to Survivorship After Cancer

I cannot celebrate Thanksgiving without thinking of the year I wanted to cancel it and just curl up into a chair with a book. This was when I was beginning chemotherapy for breast cancer and still working my job while getting used to the roller coaster of experiences. A few days without interacting seemed like a fabulous idea to me.

The idea of any group effort, of any expenditure of mental energy, made me want to get back into bed and pull the covers over my head. Thank goodness my family did not listen to me. Although they would have, if I had been adamant about any choice — they are not bullies. What unfolded instead of a day with me feeling sorry for myself was a day that reminded me why maintaining family ties, even when we feel so tired and unable to connect, is important.

That Thanksgiving worked out well because nobody expected me to do anything. My sister-in-law and brother arrived with a full meal from a chain store, from turkey to pies, augmented by some personal touches like cranberry relish. My sister-in-law and my brother served, washed dishes and brought everything to me. They were in charge, and I accepted pampering.

Also special is the fact that this Thanksgiving Day brought my son, ex-husband and me together as a family, setting a stage for future ways to handle our new normal that coincided with my cancer journey. Our little dog, loving all the attention, enjoyed a special Thanksgiving walk when my son got me out of the house in the afternoon to walk down the road a little bit and back. The cats got some turkey too.

There were only a few pictures taken on that special day. One is of my son and me with Spot. I love the photo not because it is perhaps the last photo of me with all the hair I used to have but because of the look in my son’s eyes, a mixture of love and compassionate concern. Another is of me curled sideways into an easy chair, dozing. My brother likes to document everything, not just the jovial moments.

If you are planning a holiday with not only family but also cancer, here are a few tips I learned that Thanksgiving:

 Listen to your heart. If you think a visit will be too fraught, say so; if your heart is willing, but your body is tired, consider being honest about how you feel and let somebody else pick up the pace for you.

Even if you are the one who wants to be in control, let go for at least a day. Let somebody else serve you and wash your dishes, even if your kitchen could use a good scrub or remodeling.

You be you: you with cancer, not you who might be in better health, be the life of the party or the one fussing over everybody’s coffee cup.

Ideally, your guests will, like mine, stay in a hotel to afford you the privacy you need while experiencing chemo fatigue and/or nausea.

The most important thing to remember is that you are in control. If minutes before everybody shows up you think you cannot muster any energy whatsoever, suggest a Plan B. Anybody who loves you will be sympathetic to your needs, even if that means asking your family to leave the food at your doorstep as they tiptoe away.

These are just a few tips that might allow your Thanksgiving to create a new memory to balance out the harsher memories cancer can sometimes create.

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Facing chemotherapy during Thanksgiving, the author initially wanted to cancel the holiday due to fatigue and emotional strain. However, family support transformed the day into a meaningful experience, emphasizing the importance of maintaining connections despite illness. The family provided a full meal, allowing the author to rest and enjoy the day without responsibilities. This experience also helped establish a new family dynamic, including the author's son and ex-husband. The author shares tips for celebrating holidays while managing cancer, highlighting the importance of self-care and open communication.

When I felt inclined to spend a holiday alone during breast cancer treatment, I was encouraged to think of ways to make new holidays with my family. 


Tips for Making a Thanksgiving Manageable With Cancer 

October went by in a blink of the eye, no pink. Well, almost no pink. I did pause at Kroger one afternoon to covet a dozen small pink roses, only 10 dollars, and imagined arranging them into two vases, one for me and one for a friend who is a breast cancer twin.

I even held the roses in my hands heartfully, just for a moment. They had come all the way from South America to my Appalachian town, perhaps not the best use of jet fuel, yet still so pretty. Perhaps not the best use of $10, either. I could spend that money on two cartons of power greens instead. Survivors need power greens more than roses.

I thus bought two cartons of power greens instead of a dozen pink roses, roses so beautiful that I almost went back and put them in my basket. Would it hurt to spend a little money to mark Pinktober? Would it hurt to share a little pink love with a dear friend? I had pretty much been ignoring Breast Cancer Awareness Month, which this year coincided with worries over cleaning up my yard, downed trees and roof after Hurricane Helene.

Instead, apologizing for ignoring October, I sent my dear friend a “gift” article from the 

. “This is such an uplifting story,” I told her. “She threw a ’70s-themed ‘cancerversary’ to dance in death’s face,” by Amber Ferguson and Drea Cornejo, is indeed a heartwarming story about the magnificent spirit of Deltra James, a woman who lives with metastatic breast cancer.

I also wanted to send everybody I know another story I read in the 

, a reprint of a classic column by Marjorie Williams, “The Halloween of My Dreams.” About a tender moment with her daughter and her last Halloween before dying of liver cancer, this essay is so poignant that it makes me cry. Not everybody has my interest in cancer heroes though.

Another thing I did in October was collect coats to donate to local flood victims. One was in fact a bright pink. I bought because it was the sale color and not because I am a survivor of breast cancer (survivors can be frugal, saving not just for a rainy day or pink roses but for more treatment down the line). I like to imagine that a breast cancer survivor picked this coat.

I do love pink. But October? It is a hard month, and all the pink reminds me of that. It is not only the month I learned the full extent of my cancer after a mastectomy but also the month my mother was diagnosed with her first (not last) breast cancer. For decades, I have tended to relive the shock of my mother’s diagnosis. This year, I did not dwell on it. Nor did I let my mind linger too long on another October, a brother was diagnosed with a terminal lymphoma.

Being preoccupied with cleaning up the yard and arranging for people to help me with trees, etc., helped. Pinktober was going to whiz right by until I saw those pink roses in Kroger beckoning me. They say flowers are nature laughing or something like that. Roses, more like a lucid dream, are beguiling. Maybe somebody else bought that bouquet to mark a cancerversary or Pinktober?

I thought I was past fretting about the past. Was I? As I was driving to Kroger, the phone rang, the cancer center calling to change the upcoming date for my annual follow-up bloodwork. I recited the date aloud to try to remember it as I could not write while driving. Thinking about the cancer checkup (what these lab results can reveal, what the annual mammogram can reveal), I walked into Kroger. It is no wonder the first thing to catch my attention was a bouquet of pink roses that helped me to calm my mind.

October, often associated with Breast Cancer Awareness, can evoke mixed emotions for survivors. The narrative reflects on the internal conflict between indulging in symbolic gestures, like buying pink roses, and prioritizing practical needs, such as purchasing nutritious greens. The month also brings memories of personal and familial cancer battles, underscoring the emotional weight of anniversaries. Despite the challenges, acts of kindness, like donating coats, offer solace. The story highlights the ongoing journey of living with cancer, where reminders and reflections are intertwined with daily life.

Preoccupied with other worries during October, a month full of cancer anniversaries, I reflect on how Pinktober caught up with me.

Felicia Mitchell

When Cancer Makes You Cry, Cry It Out

A New Year, A New Approach to Survivorship After Cancer

Tips for Making a Thanksgiving Manageable With Cancer

A Month Without Pink, Almost

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