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The cancerous tumor’s gone, but not the fear

A few days ago, I woke up abruptly in the middle of the night. My heart was beating fast. I felt a sense of terror, but the night was quiet. The worst part of breast cancer treatment was over. I was safe. I got into a fetal position and cried anyway.

After radiation treatment ended in January, I thought the overwhelming fear would end, too, but it hasn’t. I have also been having bouts of crying, difficulty falling asleep, poor concentration and a sense of a foreshortened future. All of which, needless to say, is making it hard to enjoy life.

I have begun to wonder if I’m dealing with post-traumatic stress disorder. The National Cancer Institute reports that like war veterans who find they’re still in a war zone in their minds after they return home, breast cancer patients can experience PTSD. Experts say symptoms usually begin within three months of the trauma, but may not appear until many months or even years later.

Whether it’s PTSD or some other kind of anxiety disorder, my symptoms were on full display on a recent visit to a lounge in Miami Beach. I’ve been pushing myself to socialize more, and I accepted an invitation from a friend to go out.

Over in one corner of the dimly lit space, a group of statuesque women and trendy guys were playing Jenga, a game in which players take turns building a tower out of wooden blocks. A guy I had just met asked me to join in, but the thought frightened me. I pictured the tower collapsing in front of me.

I sat by the bar and watched — and worried. What if one of the blocks injured someone? What if there was a fight and people started throwing them? It didn’t happen, of course. The intimate crowd was as safe as a private party. But I couldn’t turn off the anxiety.

A friend of a friend offered me a drink, but I wouldn’t dare — not with the correlation between alcohol consumption and the increased risk of recurrence. I moved to a cozy couch, but the second-hand smoke made me uncomfortable. I had to stop myself from asking the smoker how he could take his health for granted.

“I’m really feeling awkward,” I told my friend Laura. Her smile turned to a frown of concern.

“Do you want to go? You know, no one can tell that you went through breast cancer,” she said. “You look great. Your hair looks super cute.”

I wanted to flee, but I stayed. I had to challenge myself. My comfort zone for months had been my bed.

Minutes later, I saw on my iPhone that someone had tagged a photo of me on Facebook. I didn’t like it. As I untagged myself, Laura introduced me to an impeccably dressed Russian woman from haute-couture land. I couldn’t hear a word the tall blond model was saying because I was preoccupied with how fat my hips looked in that picture.

The nagging fear has magnified my insecurities. I’m getting used to the asymmetrical look of the breast implants and the horizontal scars, but the patch of skin discoloration from radiation therapy is hard to explain. It looks as if I had fallen asleep while sunbathing topless on a windy day, and a flying handkerchief happened to land near my collarbone. Except the contrast is reversed. How unlikely is that? It is so abnormal looking.

Both the cancer diagnosis and the treatment were traumatic experiences. I still find myself thinking about the powerlessness of being in a hospital bed, and about the pain in my mother’s eyes as she saw my pain. Still, most breast cancer survivors never have a recurrence. The tumor is gone. My body is recovering. Yet my mind seems to be stuck in time.

“You are going through a period of adjustment,” Laura said. “It will get better.”

I’m working on it. Dr. M. Beatriz Currier at the University of Miami’s Courtelis Center for Psychosocial Oncology has prescribed medication for depression and anxiety. She also referred me for cognitive-behavioral therapy, which focuses on helping you change your thoughts in order to change your behavior and emotional state.

I have had two meetings with a psychologist who wants to help me correct my “automatic thinking,” internalized perceptions that are involuntarily generated when a particular situation occurs.

“You have to challenge your fears,” Currier said during our most recent session. “You have to be willing to take a very active role in the treatment process.”


Part 1: At age 33, I’m dealing with breast cancer

Part 2: Cancer treatment complicates dreams of pregnancy

Part 3: Hanging in when chemotherapy gets rough

Part 4: Tough surgery choices: Mastectomy vs. Lumpectomy

Part 5: Silicone implans are not the only way to go in breast reconstruction

Part 6: Rebuilding the breast from body tissue

Part 7: Body fat can be used to build breast

Part 8: Facing my fears after mastectomy

Part 9: Taking control of the fear that comes with breast cancer

Part 10: Doctor knows about being a breast cancer survivor

Part 11: Radiation therapy gives her hope

Part 12: Finding strength from others

Part 13: Facebook, medication help breast cancer patient deal with depression

Part 14: A new outlook on 2012

Part 15: Breast cancer patient faces genetic mystery

Part 16: Using diversion to cope with harsh reality

Part 17: After radiation therapy ends

Part 18: Friend’s breast cancer journey is not as fortunate

Part 19: Anti-tumor meds come with scary story

Part 20: Reentry into the world after breast cancer treatment

Part 21: Too much fear, too little trust

Part 22: Chemo brain complicates return to work

From the Editor: Journalist confronts cancer, takes readers along