A personal account - Thriving: Broadening the Paradigm Beyond Illness to Health - personal experience with breast cancer

When I heard my doctor's diagnosis of cancer, my life changed and will never be the same. There are few words that are frought with so much emotion, so many interpretations, so many reactions as the word cancer. To many it is synonymous with death. For others, it brings images of bald heads, vomiting, thinness. For most, it means complete vulnerability and lack of control. After my aunt was diagnosed with cancer, she went home, pulled all the curtains closed, refused to leave the house except for chemotherapy treatments, and allowed very few visitors. She waited for death. My mother lived three years with cancer. During the first two she played bridge, went to church, spent holidays visiting my brother and me, even entertained in her home. She graciously answered any questions people asked her about her disease, then discreetly changed the topic of conversation to her visitor. She lived with her cancer, maintaining her previous life as best she could.

Ten professional women together wrote a book titled Breast Cancer? Let Me Check My Schedule! (McCarthy and Loren, 1997), in which they describe how they fit breast cancer into their busy, successful, and productive lives. These women describe how they not only maintained their professional lives, but found new interests, new skills, new priorities that improved their lives. Their struggle with cancer brought about unexpected transitions and growth in their lives - they thrived.

The articles in this Journal issue have raised the question of what differentiates those who merely survive, those who are resilient (returning fully to previous physical and psychological functioning), and those who thrive (reaching even higher levels of functioning, psychologically and/or physically) after a personal crisis. As one of the ten professional women who wrote that book, I would like to tell of my experience with metastasized breast cancer, then to relate aspects of my experience to the theories and concepts discussed in the previous articles in this issue.

Diagnosis

My mother died from metastasized breast cancer in August 1988. I knew there was evidence of a genetic predisposition to breast cancer, but I was still young and would not worry for many more years. It never occurred to me that "many years" would be only two. I found a lump in my breast in June 1990. The following September, a biopsy was followed by a lumpectomy and 2 months of radiation. I thought I was through with cancer, that mine was found early and caught in time. However, I was not so fortunate. In July 1991, metastasized breast cancer was diagnosed in my lower abdomen. I have been "submerged" in breast cancer ever since with three surgeries, five different regimens of chemotherapy, two types of hormone therapy, three months of radiation, and a stem cell transplant after high-dose chemotherapy (commonly called a bone marrow transplant). Throughout these 8 years, pain control has been a constant problem. I have unpredictable, intermittent debilitating pain an average of 10-14 days per month.

Survival and Resilience

Throughout surgery, radiation, and chemotherapy, I continued my work as a university professor - teaching, research, and service. I also continued scuba diving and skiing. I was determined that this disease would not interfere with my life, and, for the most part, I have been successful in keeping it from doing so. I arranged my surgery and treatments around my teaching schedule. I taught some classes between bouts of nausea from chemo and others while taking morphine for pain, and continued to attend conferences and supervise graduate students' research. I postponed the original biopsy until after an APA meeting and a scuba diving trip over Labor Day. My oncologist scheduled chemo treatments around ski trips and dive trips. To reduce fear, she likes to tell new and nervous chemo patients that I went skiing in Austria right after a chemo treatment.

My oncologist was puzzled as to why my cancer did not grow, yet did not go away. "Cancer doesn't act like this," she said, "it never sits still for long." I laughed and replied "I am living my life so fast that it can't catch up !" There has been a sort of desperation to the way I have been living life these 8 years - not willing to give up anything in life, but attempting to cram it all into a shorter time frame. I certainly am not in denial - having studied and learned everything possible about the disease, participating fully in all prescribed treatment regimens as well as some alternative treatments - and I have begun to redirect my research interests toward the psychosocial issues surrounding cancer. There is no cure for metastasized breast cancer, only palliative treatments to prolong life, or at least make it more comfortable. Statistically, only 15% of metastasized breast cancer patients live 5 years, yet in 8 years mine has not spread to any major organ and remains only in the lymph nodes. It has grown very slowly, in fact, imperceptably until this past summer. My cancer seems to be defying the statistics.