She had known many losses over her forty years.
Her husband died several years ago. She lived in a car. Her eight children were under the protective care of her sister-in-law. After her recent diagnosis of cervical cancer made at a local emergency department, she required a four-week psychiatric admission for depression. Recently discharged, she was admitted under my care for treatment of her cervical cancer.
“I can feel a mass on your cervix,” I began. “The CT scan and my exam show that mass to be only in the cervix. That’s good news. This is curable, but will take some work to get there. First, I’ll have to find the results of the biopsy done in the ER last month.”
My words were met with hollow eyes and a vacant stare.
“What are you most afraid of?” I continued.
A whisper followed a long pause. “My kids,” she replied, barely audibly.
Her response was only a partial answer, the subject of a longer sentence. A thought, which when completed, sounded more like “My kids… after I die. How will they get on?” After all, there was really only one thing she had left to lose.
Although much has been researched, explored and written on the subject of cancer, its prevention and treatment; relatively little is understood about cancer survivorship; the way our minds and bodies cope with and react to cancer diagnosis. For instance, the American Cancer Society Annual Report 2016, describing the most up to date information of cancer facts and figures, reports that 92% of cervix cancer patients with local disease are cured. And due to effective prevention with HPV vaccine, smoking cessation and effective screening with pap smears, the risk of dying from this disease continues to decrease every year. Women with advanced disease are living longer due to recent interventions with newer active biological agents.
However, despite the increased cure rates, relatively little is understood of the long term consequences of cancer and its treatment for the two thirds of people diagnosed, who can expect to live at least five years. From Cancer Patient to Cancer Survivor: Lost in Transition describes several goals of survivorship care, all of which are geared toward general biological functioning and prevention of future cancers. And although understanding the psychosocial burdens of cancer (i.e. the day to day consequences of a cancer diagnosis) is advocated by major national cancer treatment societies, research into their understanding has been largely left to nongovernmental organizations such as Livestrong.
Cancer does not only affect an organ or a body. Cancer affects people and the society in which they live. Cancer affects the way we think about others and ourselves. Cancer affects the way we behave and interact. In short, a cancer diagnosis changes everything. As people are living better and longer after a cancer diagnosis, it is now time to understand how cancer changes our day-to-day behaviors, our interactions, our fears and hopes, our work and family lives, our finances, and our societal biases. It is time to understand how this one word can change everything.
I never found the result of the biopsy that proved her cervical cancer diagnosis. Instead, as her treating oncologist, I would need to perform the biopsy myself. Reexamination clearly showed a golf ball sized mass protruding through the cervix. A 30 second office procedure removed the mass. The pathology report proved this to be noncancerous.
She will quickly recover from the procedure. But it may take a lifetime to recover emotionally from the burden and trauma of a four-week misdiagnosis of cancer. A word so feared that merely assigning it could render us nonfunctional.
This article was recently published on Thrive Global.