Cancer's Perfect Storm of Pain

Patient Expert

Oddly enough, while breast cancer is one of the diseases women dread the most, it's usually not very painful. The treatment can be difficult, certainly; but unless you've been diagnosed with certain rare types, severe physical pain isn't a breast-cancer hallmark. But mental pain? Emotional pain? Those are huge.

When I was diagnosed with breast cancer, the first thing I thought was, "How can that be? I feel great"

Many women have that same reaction. Breast cancer is a silent killer, growing cell by cell over the course of many years before it finally becomes apparent - a shadow on your annual mammogram, a pea-sized lump felt in your breast.

But pain? Some women experience breast pain prior to their diagnosis; and for many of us, the biopsy results in some soreness. But for most, pain doesn't enter the picture until afterwards. After you hear those words, "You have cancer."

That's when the pain begins.

The emotional pain that comes from cancer takes many forms. There's the searing pain of imagining your children without their mother. The dull, systemic pain of figuring out how to tell those you love. And the jagged, intermittent lightning strikes: They're going to cut off my breast. My hair is going to fall out. What if I lose my job?

Emotional pain ever-so-gradually fades, as you get into the rhythm of treatment and gradually realize that, hey, maybe I'm not going to die after all; at least, not right away.

But as your heart starts to heal, your mind heads in the other direction.

Worry is eviscerating; it does nothing besides make you feel bad. Yet we all do it, awakening at 2 a.m. with an outlook black as the sky outside. Deep in the night, with no daytime activities to distract you from your darker thoughts, you find yourself imagining the worst possible outcomes.

I'll be in that 20% who have a REALLY bad chemo reaction. What if the cancer has already spread? I've used up all my sick time; how am I going to pay the bills without any money coming in?

Worry, stress, and lack of knowledge combine to make every decision a nightmare. And unfortunately, cancer comes with lots of decision points.

Why is it when you break your wrist, the doctor sets it, wraps it in a cast, and sends you on your way? But when you have cancer, every bit of treatment is a guessing game you play - with no help from the audience, and death the potential penalty for a wrong answer?

Choose: lumpectomy or mastectomy? Chemo or no chemo? Six weeks of standard radiation - or one week of high-dose?

With stakes this high, it's no wonder that we can spend months playing the second-guessing game. "I should have had chemo. Why was I such a chicken?" Or, "If I'd done that clinical trial my oncologist suggested a year ago, maybe I wouldn't be looking at liver cancer today."

And let's not forget the pain of trying to use a mental blackboard wiped clean by chemo. Your best friend's cell number: gone. The date of your son's birthday: missing. The detailed vocabulary you've relied on for years: elusive as an empty cab at rush hour.

When you experience the physical pain of surgery, clicking the morphine button brings fast relief. But how do you escape pain in your heart, soul, and mind?

Laughter. Friendship. Meditation. The steady march of time - which does, in the end, heal. The farther you get from your last day of active treatment, the less intrusive the pain. Until, finally, pain - all types of cancer pain - is just a memory, fading away like summer's flowers after autumn's first frost.

Pain. Trust me, unless you're facing a stage IV diagnosis, it does go away. And it's replaced by a new appreciation for so many things you used to take for granted: a full night's sleep, a normal day at work, driving your daughter to dance class.

The silver lining? You'll find it. It's there - right beyond the pain.