Breast Cancer and Grief Stages
You were shopping, sitting on the examining table, waiting in the doctor's office, or maybe getting ready to leave for work when you got the news. The doctor or the nurse said, "The results are back. You have cancer."
And then your mind went blank. You didn't hear another word. Although that moment is vividly seared into your mind, it's also wrapped in a kind of haze. The first time my doctor mentioned cancer, it was in the context of a biopsy. I had no idea that redness, pain and swelling could be cancer symptoms, but the surgeon was saying I needed a biopsy to rule out inflammatory breast cancer.
It seemed that the doctor droned on forever, but it was probably less than a minute. The words lymph vessels did penetrate my haze, and I asked him to go back and repeat that part again and say the name of the kind of cancer because I'd never heard of it before. I left the office in a daze, and couldn't answer any of my husband's questions.
The preliminary report from the biopsy came back benign, so when the nurse called as I was about to walk out the door for work, I assumed that the final report was OK. Don't doctors give the bad news, and nurses the routine reports? Apparently not. I got the bad news about my pathology report over the phone. Once again, I froze in disbelief, and my husband and son sensing something wrong stood there while I struggled to comprehend what was happening.
Almost everyone who has a cancer story remembers that moment of shock when the world stopped.
Many people are familiar with a concept called the stages of grief. Psychiatrist Elisabeth Kubler-Ross worked extensively with dying patients. Based on her interviews with them, she developed a theory that dying people will go through the stages of denial, anger, bargaining, depression, and acceptance. Her 1969 book On Death and Dying made her theory well known and helped to change the ways that dying people are treated in our society.
Of course, as with any theory, other researchers have added to and refined the stages; now some researchers list seven; others pare it down to three.
You may not have thought to apply grief theory to your cancer journey. We don't go through the stages in exactly the same way, but most of us will have our own version of them for any grief event--and breast cancer definitely fits that category.
Understanding these stages can be important to your treatment and recovery. That very first reaction of shock is your mind's way of numbing you to the overwhelming pain of facing the certainty of uncomfortable, even painful, treatments, the loss of your hair and breast, and the possibility of death. It's too much, so we shut down.
When you understand that you were in shock, you realize that the doctor doesn't really expect you to remember everything she said when she gave you the diagnosis, so you won't be embarrassed to go back and ask again. When you share your news with your friends and family, you'll know that they are going through the same shock you went through, and you won't expect them to respond right away. They'll need time to absorb the news just like you did.
Grief stages sounds linear. Finish Stage I; progress to Stage 2. But in fact, we recycle them over and over during our treatment and recovery. A bad pathology report, the news that we will need chemo after all, or a symptom of recurrence can all send us back to that moment of shock.
The good thing is that we are constantly learning how to manage better. The new shock is just as devastating, but in the back of our mind, we remember that we've been here before and we did get through it. We know that we have been developing resources through previous illnesses and grief experiences that will see us through this new one.