Thursday, February 12, 2015

After Active Treatment Ends: When People Stop Asking


This essay also appears in the Breastcancer.org Blog.

When I was diagnosed with breast cancer, my family and friends rallied to support me. They expressed love and concern, and offered their help. I was grateful for the many ways they showed they cared: they cooked meals, drove me to appointments, and even introduced me to other breast cancer survivors. But soon after my active treatment ended, those same friends and relatives seemed curiously incurious about how I was doing. In fact, most of them stopped asking altogether. As I recovered from mastectomy surgery, I was anxious to get back to “normal” as quickly as possible and I tried not to talk incessantly about cancer, even though in those early days it was always on my mind. After the first couple of months, when most of my family and friends had stopped asking about my health, I told myself their silence was entirely appropriate. After all, I didn’t look any different than I had before. Though I had chosen not to have reconstruction, I wore breast forms. I had opted to do that in part because I didn’t want to draw attention to the fact that I’d had breast cancer. So, why should I expect people to keep asking about my breast cancer? It’s not as if I had absolutely no one with whom to share my experiences and concerns. My husband was (almost) always happy to listen, and one good friend continued to ask me from time to time how things were going. But with virtually everyone else, it was as if nothing had ever happened. Although I felt very strongly that I didn’t want to be defined by breast cancer, I found myself wishing I could talk more openly about it. However, it seemed as if my friends and relatives wanted to forget that I’d ever had cancer. As long as I seemed fine, maybe they could assume I was fine. As long as they couldn’t see the ways in which cancer had changed me, perhaps that made it easier for them to imagine that cancer hadn’t changed me at all. As anyone who’s gone through diagnosis and treatment knows, that wasn’t true. I wished I could share both the good and the bad of cancer’s aftermath with my loved ones. I’ve sometimes wondered whether my women friends and relatives refrain from asking how I’m doing because of fear — the anxiety that they might be the next person diagnosed with breast cancer. It’s not an unrealistic concern, given how many women are diagnosed each year. Mostly, women manage not to dwell on it, but maybe my diagnosis had brought that fear to the surface for those close to me and reminded them of their own mortality. Asking how I’m doing might bring the fear rushing back, so perhaps it’s easier not to. I’ve also imagined that people might feel awkward about my breast-free state. Maybe they’d rather not think about the fact that I have a flat chest. I’d like to tell them that the flatness doesn’t bother me, that I’m just glad to be alive. Maybe I’d make a joke or two about my lack of cleavage. Maybe I’d even offer to show them. But it’s not a conversation I feel free to initiate myself. Of course, it’s possible that I’ve got things backward. Maybe my family and friends would love to ask me lots of questions, like how I feel about having chosen non-reconstruction, or whether I have any lasting side-effects from treatment, or if I’ve had any cancer-recurrence scares. Maybe they’re curious about all of that, but don’t want to intrude and don’t realize that I’d welcome their interest. Have you had feelings similar to mine about the reactions of your family and friends? Or do you prefer that people not ask how you’re doing, since you’re trying to move on? I’d love to hear from you about the things people have asked, or not asked, since you’ve finished your active treatment.