By Dr Attia Anwar
October is celebrated as a breast cancer awareness month. This month is dedicated to raising awareness about breast cancer and how it can be prevented. I am taking this opportunity to talk about the women who are living with breast cancer and the myths we used to associate with people having cancer.
Living with breast cancer or with any cancer is scary. This is especially true for breast cancer because patients are relatively young and are usually mothers having children. We have attributed living with cancer to a battle or race. Imagine the arena of the Olympics and somebody is running a race and people are motivating him to run, fast, and run. There is a lot of adrenaline rush and that helps the player to perform well. On battlefields, people are motivated to give their lives for certain purposes. It is helpful there also. Now imagine someone living with an advanced stage of cancer, she is vomiting and having pain, undergoing chemotherapy lying in bed thinking about the future of her and her children. It has no resemblance with the high emotions of racetrack or war. But we use it often, as someone is fighting a battle. Usage of these military terminologies may have been thought to have some benefit. But it is counterproductive.
Living with cancer is not a short-term race or a limited period fight it is lifetime coping. There are no winners or losers. When we say it is a battle then people who are unable to overcome it think of themselves as a loser. If we make it a battle, then people whose cancer is advancing sometimes believe it is their fault that they did not fight properly. Living with cancer is awful, scary, and boring. A positive attitude helps you to cope with any setback in life and makes your healing better. But a genuinely positive attitude comes from acceptance of reality first. You cannot motivate people to alternate the facts and there is no sense of heroism or romanticism attached to cancer. Although a positive attitude helps you in almost everything, believing that cancer patients should have a positive attitude all the time is also a myth. Without properly working on your feelings and feeling them genuinely, a positive attitude has no importance. It is a major disease and in the advanced stage, there is no cure. So talking about your feelings genuinely rather than suppressing them is more helpful. It is harmful to feel or look more positive than you are.
Thirty percent of people have depression and anxiety and need the help of a therapist. Encouraging them to seek help is important. I do understand this language of fighting battle is used to evoke strength in unimaginably difficult times. But remember that living with cancer is not running a race, in which you can motivate people to run fast. So putting pressure of fighting on patients can have the opposite effect. We should challenge this idea and break away from how we are conditioned to think like that. Cancer is from our cells. Having a war with ourselves is not a pleasant experience. What we can do instead is live as well as possible. Coping, gentle positivity, setting short achievable goals. Drawing support from closed ones are some answers.
While dealing with breast cancer patients, I often tell them, that they should not feel that they are contributing to their cancer when they are having a bad day and they cannot be positive. Truth is when you are on chemotherapy or dealing with the pain of advanced cancer you cannot be positive. Our body does not work in this way. We cannot be vomiting and positive at the same time. So having a positive attitude all the time with this devastating condition is a myth.
What we can do is take positive action. Accepting the pain, showing up for appointments, taking proper medical and self-care, staying socially connected, and communicating with loved ones are helpful strategies. So instead of necessarily thinking everything is great taking action is more important. If that is meant by a necessary positive attitude. But we cannot deny the reality that it takes a physical and emotional toll on the patient and acceptance of this is very important. One of my patients with advanced breast cancer while talking about her legitimate feeling said. She wakes up at night and looks at the faces of her children thinking that it may be the last time. So having cancer, particularly breast cancer which happens at a younger age you have to think and re-plan so many things. You have many unfulfilled dreams. Although it can teach you the importance of living each day, it is tiring. Making small attainable goals like attending the graduation of a child can help. You can be gently positive and allow yourself to process your feelings and accept reality. That is not going to affect the natural course of disease.
Early detection of breast cancer is important. This is a cancer of the external organ so if we keep examining our breasts once a month and notice small changes on the skin and inside. We can detect any change at an almost curable and very early stage. We cannot see or feel what is happening in our liver but we can do that about the breast. So breast self-awareness is important. It has a definite early stage and treatment at the early stage is a difference of life and death.
A generally healthy lifestyle like eating a healthy plant-based diet, being physically active, and sleeping well free of stress can reduce the chances of the development of all types of cancers. Mammography is gradually losing its importance for early detection. So awareness of breasts is the most important thing we can do. For full advice on the prevention of breast cancer readers are referred to my article about breast cancer in October 2023.
The author Dr. Attia Anwar is a consultant family physician with a postgraduate degree from the Royal College of GP UK. She is a strong advocate of health and well-being and wants patient participation in decision-making regarding health.
