It comes back every time you feel a strange symptom, you get some illness and the date of periodic checks approaches. The fear of a reappearance of breast cancer, once free from treatments and the disease, is very frequent among patients affected by this neoplasm and generates a state of anxiety that is difficult to manage. A psychological stress that systematically returns when the test results confirm that everything is going well, the reports are put away in the drawer and until the next check-up one no longer thinks about them or thinks about them less.
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However, when the news of a recurrence arrives, the perspective, naturally, changes. And how do you deal with it? We talked about it with Florence Didierpsycho-oncologist at the IEO in Milan.
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The “second” diagnosis
“The psychological impact of a relapse is stronger than that experienced at diagnosis, because the burden of having to start all over again is felt enormous – explains Didier – It is a completely natural reaction. Just as it is natural to ask ourselves if this time we will have the strength to move forward, how to tell your loved ones again, what quality of life to expect, whether you will still be able to work or how to manage your children. But – continues the expert – even if you find yourself in a state of uncertainty for As far as the evolution of the disease is concerned, it is useful to implement strategies that help suspend judgment and avoid fixating the mind on the worst case scenario. This is certainly not an easy step to take – the expert underlines – but it is a challenge that must be faced.”
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Among the actions that can help those experiencing this condition and those around them manage the situation, the expert suggests some of the most important ones:
1) Give yourself the necessary time to metabolize the news and the sense of anguish that arises from it, but then try to react. “It is right to welcome and accept the negative emotions that arise from such news – explains the psycho-oncologist – but then you need to shift your attention to the present, slowly rebuilding a plan for your life, to encourage the
physical, psychological, relational and couple well-being, even in the context of illness”.
2) Share any concerns with the healthcare team at the center where you are being treated to understand what to expect and clarify any doubts.
3) Try to adapt to the new situation with the help of family, friends and psychological support. “To these
– says Didier again – we add the great help that patient associations can give through activities and moments of discussion and sharing of experiences”.
4) Continue to feel like the protagonists of your own life, avoiding treatments becoming all-encompassing. “Depending
of the type of profession – adds the expert – one can continue to work, or to take care of the family, to do the activities one prefers, or perhaps to concentrate on a project closed in the drawer: the important thing is to commit to actions that
make you feel good from an emotional point of view.”
5) Transform feelings of guilt. Feeling responsible for the disease returning is one of the most common reactions
among those who experience this condition: one feels guilty because one is convinced that one has done something that has favored the onset of the tumor again. “If it is difficult to manage – explains Didier – you need to understand why you feel responsible and where you feel responsible
feels it is necessary to improve in order to feel better. In this way the sense of guilt can be transformed into something positive, and even healing.”
6) Having people around you who transmit positivity. Be it relatives, friends or people with illness experience
Similarly, it is important that they support patients in a concrete way, that they know how to listen and communicate in the right way, without giving advice if it is not requested, or imposing their own point of view.
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Talking about metastatic disease in the family
Without a doubt, communication is one of the most delicate spheres to manage in these situations. Often, even in couples, there is a block in which everyone is left alone with their fears: neither of them wants to burden the other with their anxieties, especially when the news has not yet been metabolised. “Frequently, we psychologists hear ourselves saying ‘I don’t know how to help my wife/partner in this situation’ – explains Didier – It’s understandable. I always suggest starting by asking the person if they want to talk first, then what they have needs, how they would like to be helped and what they want. We need to become good listeners, also paying attention to non-verbal communication”.
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When and how to communicate with your children
When the time comes to talk about recurrence and metastasis to your children, communication becomes an even more delicate issue, particularly with young children or adolescents. “Involving children is fundamental because, in the right time and in the right way, they have the right to know what is happening: family life, in fact, must also be reorganized together with them – underlines the expert – The advice is not to rush and to talk to them only when the news and the negative emotions have been accepted first by the parents. With older children you can also use words such as tumor and therapy, to explain that every now and then it is normal for their mother to feel tired and that they are new treatments are necessary to make her feel better. With younger children, however, it can be helpful to try to talk about the illness through play. The important thing is to always be transparent without being too direct, and without having the anxiety of having the answer to all their questions. Children immediately sense if there is something wrong. Therefore, it is better to be sincere, reassuring them and keeping them updated.”
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How serious the tumor is and how dangerous it is for life are in fact among the first questions that can also come from them. “Pointing out that the doctors you are treating are experts in the disease and that several effective treatments are available today can reassure them – underlines Didier – More often than not, good communication can be fundamental for managing their emotions, reassuring them of the fact that together we can continue to do many things.”
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An unclear understanding of what is happening, in fact, could lead them to form an idea that is sometimes worse than reality, or even to feel responsible for the worsening of the disease for having behaved badly and having angered their parents on several occasions. “This is an aspect of communication with family members – concludes the expert – to be managed very carefully: even the well-being of the couple and their children, in fact, can become a useful and precious resource for the patient in dealing with the disease”.