Pink October: When a Woman Has Cancer

For many years, doctors, psychologists and other specialists have emphasized the important role of the psyche in the struggle with neoplastic disease. Due to the fact that breast cancer is the most common type of cancer among women in Poland, the topic of psychosocial functioning of women with breast cancer appears more and more often in considerations in the field of psycho-oncology.. What do women feel after the diagnosis? How to support? How to talk

Cancer diseases are a difficult element of our civilization. In fact, each of us can tell a life story related to cancer. Friends and relatives are sick. Breast cancer affects mothers, friends and neighbors. A socially known topic, but often causing anxiety, introducing anxiety. Conversations about the disease and diagnosis are very difficult. There is still little open conversation, there is embarrassment, silence in the face of the disease. The topic of cancer causes embarrassment, and at times it seems better to keep silent than discuss it. How do I talk to someone with cancer? How to accompany a loved one when they receive a diagnosis of the disease? There are certain behaviors that could create a "cancer label". What does this mean exactly?

Support in disease: what's that mean to us?

It should start with the fact that a loved one is present and accompanies the woman who is undergoing a diagnosis. The most important thing at this point is that the woman is not alone. It is important to be with her, if only in silence. What could that mean for her? It is a support for a start - when the ground is crumbling under your feet. Over time, it becomes important to ask the cancer patient how they can be helped at the moment. A woman who receives information that she is waiting for treatment knows best what she needs.

Questions about what is important to her "here and now" put the environment into action. It is best to address the patient directly:

• What kind of help do you need? 
• What should I do?

Truth and openness to listening

In honesty, you cannot pretend that everything is fine, because it is not, and telling a sick woman - "I know what you feel" is not right, because no one but her knows what is going on and what she feels at the moment. You have to listen and want to hear her voice on the matter that matters most to her. Always and everywhere truth and openness to listening. Calm conversation can be empowering, building hope and faith that the meaning in life still exists.

Release your emotions 

It is very important to let the sick person express their feelings, emotions and thoughts. As supporters, everyone also has the right to talk about how they feel and what is happening. It is not allowed to lie that everything goes smoothly. After all, human stories can be difficult. Identifying your own fears, fears, and feelings in the conversation may result in a very valuable communication between the supporter and the sick person. Sometimes this is what a woman expects - honesty, not another "strong" one by her side.

Allowing yourself and a woman with cancer to express emotions is a way to release your accumulating negative feelings. There is time for adaptation from diagnosis to treatment phases. This is a completely new situation. No human is born with the ability to face such difficult challenges. Each of us creates a new story.

What is helping a sick woman all about? The most important thing is the willingness to open up to the mental state, needs and emotions of a close, sick woman. Sometimes she herself indicates, according to her own needs, the best possible way to accompany her in the treatment. Sometimes you have to look for these paths together.

What to avoid while supporting a sick woman?

There are situations when a sick woman looks for information and comfort for herself in the reality changed by her disease. Her closest circle knows about the disease and may even actively participate in treatment. However, there are certain attitudes that should be avoided in order to be the most efficient support possible. What is it about? What should not be done when contacting and talking to someone with cancer?

Independence and disease: what is it aboutmean?

Although the disease may significantly limit the efficiency in everyday life, a sick woman deserves independence all the more. She should not be replaced, and the disease does not mean that the woman cannot do anything anymore. My mother, sister and friend with cancer expect normality. In her life, enough changes and the disease takes a long time. Giving advice or lecturing is like "bringing a woman downstairs." Do we know what is good for a sick person if we are not in their place?

Looking further - pity and all its symptoms are completely excluded from a relationship with a woman suffering from cancer. There is an element of sensitization of sick women against this background. After all, they are always organized, they drive actions, they have many roles in life, and the disease often limits this. One must lock pity under a lock, allow for activity and, if possible, independent action. You can't pretend that everything is fine if it isn't.

Manifestation of emotions in illness 

Closeness to someone who is sick, who is important in our lives - daughter, mother, sister, friend, etc., talking about your feelings and what is hard cleanses your mind and soul. You cannot treat, for example, the anger of a woman suffering from breast cancer personally. Each person affected by such a story has the right to manifest emotions - pain and sadness, and even more so, and it must be allowed to do so.

Illness is such a moment in life that aggression and helplessness can dominate. When there is pretend, play, communication and authentic relationship cease to exist. What could this mean at a later date? The emerging loneliness and isolation take away peace and harmony and introduce fear and helplessness.

Constructive actions in the fight against the disease

Psycho-oncology and psychology more and more popularize the idea that optimism affects the sense of quality of life or the level of fatigue during treatment. Women's ways of coping with oncological treatment are considered particularly important. What does it mean? The constructive actions include, for example:

• treating the disease as an inconvenience that must be dealt with and undertaking this fight;
• a positive reevaluation involving an attitude that aims to increase the hope felt and enjoy the experience so far.

This attitude is drawing strength from the inner resources and capabilities of a woman suffering from cancer. Many stories of patients confirm that constructive approach to disease coping strategies increases the chance of better functioning in various psychosocial dimensions (e.g. higher quality of life, greater physical and cognitive fitness, satisfaction with fulfilled life and professional roles).

Physicality and neoplastic disease 

Breast cancer affects a part of the body that is of particular importance to a woman. Growing breasts are a symbol of maturation and emerging femininity, and breastfeeding - a symbol of motherhood. The breasts also have an intimate dimension, and the loss of them is difficult for many women to accept. After breast amputation, women often find it difficult to accept their own body and have to re-integrate their physical self. The awareness that their bodies have been mutilated as a result of treatment makes them feel they are losing their attractiveness for those around them, especially for men. What else is going on?

Contemporary culture promotes beauty, a slim figure and places great emphasis on the affirmation of a beautiful and perfect body. Losing a breast - in such terms - disfigures the body, destroys it. Amputee women experience many difficult emotions. These difficult experiences must not be ruled out, they are needed, because every loss must be experienced and mourned.

Researchers after mastectomy and a series of negative psychological and social effects associated with it, which are called the "half woman" complex (1). Changing the way you experience your own body affects your entire psychosocial functioning, your self-acceptance, and it also changes the way you experience your sexual relationship.

The impact of the disease on a woman's life

The experiences of the disease and its impact on every sphere of a woman's functioning are very complex and multidimensional. A woman has many life roles, and if her life were to be reduced to a fight or victory against cancer, it would greatly limit her existence and sense of identity. No sick person would like to be seen solely through the prism of "the person with cancer" or "the person who won the disease".

A woman as a mother, wife, research worker, teacher, granddaughter, daughter, friend, etc., means so much more. Hence the strong, in every sick person, striving to regain normality, through dress, care for appearance, return to work and daily activities. Some women want to cut themselves off from the disease, erase it from their memory, but this is impossible to some extent, as post-treatment health monitoring examinations are necessary.

The family participates in the disease 

It should also be noted that the functioning of the family as a system is very much affected by the fact that one of its members gets sick and then the whole family begins to fall ill at various levels. The disease affects others and changes the dynamics of each other. The family of a sick woman is often left without support, and the difficult emotions she experiences have an impact on the patient and her mental state, which closes the circle of negative states, and at the same time may reduce the effects of treatment. Family, husband, partner, acquaintances, friends, work colleagues, random people often do not know how to react to the disease and its consequences (e.g. lack of breasts).

Associations and foundations as a source of help

A big role, not only in accepting your own body, but also your mental and physical condition, is played by the support of your relatives, e.g. your husband or family, and - at least in some areas - being with other amazons. This is a real example for women that they are not alone in their situation.

Cancer support should cover three basic areas: 

• mental functioning (both through informal activities involving friends or family, as well as support groups, assistance from a psycho-oncologist or psychiatrist);
• practical and physical activities (self-service, travel or shopping);
• information (reliable, needed at the time of important decisions, as well as changes taking place).

The Amazon Association is a self-help, non-medical organization. It provides psychological support and practical help to women suffering from breast cancer. The oncology portal zwnikraka.pl provides a lot of detailed information on the diagnosis, treatment process and information on how to cope with the difficult path of going through cancer and the fight against cancer. These are just examples, but there are many more institutions offering support.

The above-mentioned examples of behavior, ways of reacting and supporting women with cancer are a general canon that you can read about in many publications. They relate to psychological theories but are built on the experience of the disease.

Źródła:

Brandt A, Przybyła-Basista H. Decision on breast reconstruction in women after mastectomy - motives, concerns, perception of effects. Psychooncology 2016; 20: 17-26);
Maria Rogiewicz, "Practical textbook of adult psycho-oncology", Wyd. Practical Medicine, 2020;
http://www.amazonki.org.pl/;
https://www.zwrotnikraka.pl/