Help others understand level of fear?


Question from Jancy: I am not brave. Do I have to be brave? How do I make people know how really scared I am so they will understand?
Answers - Rosalind Kleban, L.C.S.W. I think that it is important to be up front and honest with people about your fears and terrors. I think that people are looking at you to be brave because then it is easier for them to witness what you are going through. On the other hand, you are doing brave things—taking care of yourself and doing things that need to be done. It's always amazing to me how wonderful breast cancer patients look. That just covers what they're experiencing within—the terror, uncertainty, fear—how they are really feeling.

The thing that is most helpful is talking to other people going through this because only they understand the terror you are going through. Some of my patients said that they felt the only time friends could identify with their terror was after the 9/11 incident, which terrorized everybody (and especially New Yorkers). Their friends and relatives could now understand the fear, vulnerability and uncertainty that breast cancer patients experience—the acknowledgement that life could change in a minute. After that tragedy, it was suddenly easier to understand what the cancer patient faces.
Marisa Weiss, M.D. Also, upon a diagnosis of breast cancer there are so many different procedures that a woman has to go through that she can feel like she is hit once with a diagnosis, but hit again and again with pieces of information, like when a lymph node inflammation comes back, for example. So the parallel to the 9/11 experience goes even further, where something horrible happened and you think that is the extent of it and not long after you may hear something equally devastating. In addition, the treatment of breast cancer is extremely difficult in that you are hardly given a chance to recover and heal from one treatment to the next. It's like being hit when you are down, and the inability to take a break and feel a little bit more like yourself again during this whole process makes it so much harder to manage all of the difficult feelings that come up naturally during the experience.
Rosalind Kleban, L.C.S.W. I think that the commonality between 9/11 and a cancer diagnosis is uncertainty. I think most people feel that they are in control of their lives. Cancer lets you know that we are out of control, and so does terrorism. As awful as those treatments are, if we felt we had certainty and we could be assured that chemotherapy would end our fear of cancer, chemotherapy would be easier to tolerate. It is the uncertainty of the future that is truly the terrorizing thing. Patients have told me that chemotherapy would be more manageable if people could assure them that the outcome would be positive. The out-of-control aspects make it as difficult as it is.
Marisa Weiss, M.D. There is a way to ease some of the uncertainty about treatment. Your health care providers can sit down with you before each type of therapy is given and can explain what is involved and what to expect during treatment. That can be helpful to you. It doesn't take that much time for them to prepare you for what will happen. Even without any 'guarantee' that the treatment will work 100% of the time (which no one can promise you), just knowing what to expect can really ease one's discomfort.

On Wednesday, June 19, 2002, our Ask-the-Expert Online Conference was called Dealing with Breast Cancer Fears. Rosalind Kleban, L.C.S.W. and Marisa Weiss, M.D. answered your questions about aspects of breast cancer that cause concern.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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