The Mind of Cancer

There is never a good time to be told you have cancer. This is the story I told myself as I pulled into my driveway to share the news with my husband. Only minutes prior to arriving home I had learned that my husband had a cancerous tumor inside his stomach. He was mowing the lawn, one of his favorite things to do, and I had to ruin it by sharing with him the results of his most recent endoscopy.

I can’t say that we were completely surprised due to the many events and tests leading up to this news, but regardless, this isn’t the news that anyone asks for. I took a deep breath and headed for the backyard. He stopped the lawnmower and I asked him to sit next to me on the deck. I told him that the results of his biopsy showed that the spot in his stomach was gastric adenocarcinoma, an aggressive form of stomach cancer. Without much emotion on his face, he said, “OK, well I am going to finish mowing the lawn, and then we can talk more about it.”

I, of course, must process information immediately, whereas he can put it aside and save it for later. Or can he? This is a question that I regularly consider. What goes on in his mind? Is he just mentally tougher than I am? Is it healthy that he can compartmentalize these things? Or maybe he just puts on a strong front for me? How do patients with cancer process such news?

When your spouse has cancer, you have cancer. It may sound extreme to say, but it’s the truth, and I have heard it a dozen times from families in similar situations. We chose to be married because we didn’t want to be apart. We chose to get married because we preferred living together, more than living separately. We are both independent people who are capable of being on our own, but we don’t want to be. His problems are my problems the same way mine are his. And so, together we face the life that cancer brought us. That, however, doesn’t mean we process news the same.

Many cancer survivors and patients I speak to are not as blindsided by the news as one might expect them to be. There were events or problems that led them into the doctor’s office to begin with. There were tests done looking for something, anything to explain the abnormal ailments that are disrupting their lives. That doesn’t mean the big ‘C’ word came to them any easier though. Some hear the news and feel confident that they will fight it, they know it will be hard, but they have witnessed others successfully fight cancer. Others are hit a little harder, they feel scared, they feel worried, the unknowns come at them and not only do their minds go into overdrive, but their bodies fill with adrenaline and they shake, quiver and some even say that suddenly they can’t hear and the room goes dark.

When I asked my husband later what he felt and where his thoughts went when I told him the news, he said he was sad, and he was worried. He was sad for me; it wasn’t fair to me that I would have to go through this. He was sad for his daughters. He was 8 years old when his mother died and he had to be raised by one parent, and he wanted nothing more than his children to have two parents. What a simple request?

He worried about how we would handle it if he died. He feared how all his loved ones would process the news. Initially, there was little concern for his own wellbeing. This is not unusual, as I speak to victims of cancer, I hear similar stories. There is little worry about how they will handle treatments or death, but more worry about how the ones they love will survive the rough roads of transitioning to a life without them. They worry about how their loved ones will handle watching them suffer through the pain and discomfort that comes with surgery, radiation, chemotherapy or any other cancer treatment.

Cancer makes your mind wander in many strange directions. If ever you wanted to know what an emotional rollercoaster really felt like, get on the cancer coaster and go for a ride. One minute you are sad, sad for your future, sad for you or your loved one’s state of being, and the next minute you are angry. You’re angry it even happened to you, and anger turns to guilt.

A cancer survivor may feel guilt that they survived the same prognosis as another patient they’ve met, or they may feel guilt for their spouse who has had to change their life to care for them. Amongst the bumps and the curves comes the question that never goes away even as a survivor, why me? How did I get cancer to begin with? What did I do wrong? A parent may fear that their child will get the same prognosis. There is no escaping all the emotions that come with cancer, and for many those highs and lows stay with them even if cancer doesn’t.

Rare breed

Stomach cancer is a rare breed of disease, it is one of the top three leading causes of cancer-related deaths. It isn’t a type of cancer you hear much about and it isn’t one you want to Google. As a person that likes data and has a love for science, cancer brings uncertainty and confusion. The same people that like to share statistics about how well the newest drug works are now telling you to ignore statistics. The statistics you read online don’t know you, they don’t factor in the many variables of your life. They don’t consider your unique self. Statistics only increase the level of uncertainty you feel when you are seeking answers.

There are many lessons that must be learned when you’re diagnosed with cancer and the biggest one of all is to be patient, live your life one day at a time, and stop looking ahead. Don’t plan, don’t prepare for the worst, that only wastes the time you have living what is left of your best life, yet the fear of optimism stalks you. My husband is strong, because since the removal of his stomach, he struggles to eat enough calories to fuel his body's needs, serving as a constant reminder to what he faced.

However, he didn't spend a lot of time angry that this happened to him. This changed when in the middle of a nationwide pandemic, we sat on the phone and listened to the oncologist tell us once more that he had cancer. Again, or still? It doesn’t matter, months earlier we were happy to hear that the surgery was successful in removing the tumor and all the margins were clear, yet it still didn’t stop the cancer from spreading. This time around, we talked. We sat down and we cried for a minute, then we remembered that nothing was going to happen tomorrow, or even next week. We knew what came with news like this; more tests. We knew because we had lived through this before. Even if we wanted it to, cancer doesn’t always move fast. It makes people suffer in the last years of their lives. We had processed the long-term effects of cancer once already; it didn’t take as long to process information the second time around. Is it possible to get “good at cancer?”

Cancer makes people vulnerable

I saw a shred of optimism leave my husband as he got the news the second time. A person can feel confident in beating cancer, round one, but cancer round two that has spread outside of the original location feels like cancer won, and you lost. Cancer makes a person vulnerable. You see people you love cry that you didn’t think were criers. You witness people that are smart and capable of taking care of themselves rely heavily on you. Not just physically, but mentally and emotionally too. You become not only an extra set of hands, but a set of ears too.

Patients with cancer need you by their side when they meet with their oncologist. No matter how capable they are, they can’t take in and remember everything they are told at a doctor’s appointment. Their ears are ringing and tunnel vision creeps in as the news of each scan layers on more fear. Some are too numb to cry. The crying will hit them later when they least expect it. Maybe while they are watching their children or grandchildren play. Maybe it will come to them simply while they are at the grocery store. Or while they are laying in their chair unable to sleep due to symptoms of chemotherapy. The emotions will come, and they won’t always be prepared.

In some instances, after processing the news of a cancer diagnosis, the patient may realize that the fear and worry they are facing isn't permanent, and that for them cancer isn’t a death sentence. Several breast cancer survivors shared with me that they quickly realized that they would survive their diagnosis, but not without discomfort.

Checking all the boxes

The breast cancer survivors had to check all the boxes, face the treatments and in some cases, undergo surgery. With recovery time they could move on with their lives and with a new level of gratitude and respect for the disease and others who face it. It may sound simple. However, treatments such as chemotherapy take every ounce of goodness out of you before you can begin to recover. One cancer survivor told me she chose to keep her cancer journey private. She said she knew that she would survive, and she didn’t want to be treated differently by her grown children, so she didn’t tell them until she was nearly finished with treatment. This may be rare, but the reasoning behind her decision isn’t rare. When you are diagnosed with cancer, people around you simply don’t know how to act, or what to say. People say things that make your skin cringe, and your eyes roll to the back or your head. They want to offer you the latest and greatest cancer treatments they heard about on the internet. It can take a lot for a person living with cancer to avoid coming unglued when they hear, “Have you heard about fill-in-the-blank-miracle-cure?”

As the caregiver, it can often fill me with frustration when a person tells me to not forget to take care of myself. First of all, I feel that I am doing a pretty good job of that, but mostly, they are forgetting what happens at home, the condition of the person suffering, you can’t ignore that to go out for some “me-time.” Your purpose has become taking care of your loved one. Be it so that they can get through this and live a long healthy life with you, or to make them as comfortable as possible for the remainder of their days. There is simply nothing perfect to say to someone that is living with cancer. I have learned that the best thing to say is a simple, “I’m sorry.” Those two words sum it up, simplify it, and keep a person from saying the wrong thing at the wrong time.

What goes on in the mind of a patient with cancer depends on the individual. Most can confirm that they feel every emotion, sometimes all in one day. They are afraid, and there are very few moments in the day that they are not thinking about cancer. Cancer follows them around wherever they go. Sometimes it shows itself with pain, discomfort and other physical symptoms. But even when it is hiding, the possibility of treatments working or not flood their mind. Cancer doesn’t go away. Cancer victims never get a day off from thinking and breathing cancer. No matter how hard they try, cancer stalks them, and they just never know when it is going to strike again.