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For some breast cancer survivors, October is the cruelest month


There is a quote from “Anne of Green Gables” that I am tired of hearing already. “I am so happy to live in a world where there are Octobers,” Anne said. “It would be terrible if we jumped from September to November, wouldn’t it?” “

No disrespect for one of literature’s most beloved protagonists, but it actually looks pretty good.

October is National Breast Cancer Awareness Month and I am someone who has had breast cancer, which to me means October is essentially 31 days of quiet PTSD. My inbox is full of marketing emails featuring the stories of other survivors. My hummus suddenly has a pink lid. I appreciate the focus on fundraising, but the spotlight is a double-edged sword. And with 3.8 million breast cancer survivors in the United States, I’m not alone.

“It’s definitely not my patients’ favorite time of year,” said Kathleen Ashton, psychologist at the Cleveland Clinic Breast Center in Ohio. “Some people appreciate the opportunity to raise awareness, but the majority of my patients find the month painful. “

Becca Forrest, 37, a project manager in Durham, NC, was diagnosed with breast cancer in 2018. Since completing treatment, she has worked hard to put the experience behind her.

“But October, it’s like someone waving a neon pink flag at me all month long to remind me that the most traumatic moment of my life could happen again,” she said.

Most breast cancers are diagnosed in patients 50 years of age or older. While a diagnosis younger than that is associated with a higher fear of recurrence, it is a common anxiety among survivors of all ages, Dr Ashton said – an anxiety that can be exacerbated by the increased coverage during outreach efforts.

“Watching other people’s stories can be a real trigger for patients to worry about their breast cancer coming back,” she said.

Deborah Serani, trauma psychologist and professor at Adelphi University in New York City, said that we may feel anxious or upset at a particular time of the year because of a phenomenon known as the “birthday effect. “or” birthday reaction, “a unique set of disturbing thoughts or feelings that arise around the anniversary of a meaningful experience.

In a study six years after the Gulf War, 32 veterans were asked to identify the month they felt most badly in the past year. For 38%, this coincided with the month they also suffered the most trauma during the war.

While specific dates – like the day of diagnosis – can be obvious triggers for cancer survivors, anything that reminds you of what you’ve been through can cause an anniversary reaction, Dr Serani said.

“For some, Breast Cancer Awareness Month is a time to celebrate empowerment, but for others it can be a traumatic experience again,” she said. “Many can remember the traumatic moment to learn of their diagnosis or the treatment they underwent, how frightening or uncertain that moment was.”

One of the most frustrating things about Breast Cancer Awareness Month for Caroline Ilderton, diagnosed in 2018, is the way the disease is presented as a monolith.

“Marketing is based on images, but there is no single image of breast cancer,” said Ms. Ilderton, 61, a therapist in Charleston, SC. “Each person’s experience is different.”

The month can be especially difficult for those whose cancer has progressed. “It can feel like only happy stories are presented,” said Emma Fisher, 40, who has incurable stage 4 metastatic breast cancer.

It’s hard to see campaigns where ‘everyone laughs and smiles, has bake sales and runs fun errands,’ said Ms Fisher, who lives in Sheffield, England, and volunteers for the advocacy group. of MetUpUK metastatic patients.

“It makes me feel invisible,” she said. “It’s almost like metastatic patients are this dirty little secret of the breast cancer world, because nobody wants to portray breast cancer as a killer.”

For Bri Majsiak, 27, who underwent a preventative mastectomy after her mother died of breast cancer, the month can seem like a seasonal movement every business wants to jump into.

“It’s a pink tsunami of ‘We see you, we smell you’, then it’s November and it’s like, ‘Well it’s over, it’s time to get the Thanksgiving stuff out,’ he said. said Ms. Majsiak, co-founder of The Breasties, a non-profit organization for people affected by breast and gynecological cancers. “Breast cancer lasts 365 days a year, not 31,” she said.

It may seem like all eyes are on you this month, but “it’s important not to feel pressured to be a breast cancer advocate,” Dr Ashton said.

Ms. Ilderton allows herself not to participate in outreach activities, then allowed to change her mind and participate after all.

“You don’t have to use your experience to scream from the rafters as some sort of preemptive story,” she said. “Maybe you just want to tell another person about it in a more intimate way.”

Limit your exposure to things you might find disturbing, Dr Ashton said, which can mean taking a break from social media. Davia Moss, 36, a breast cancer survivor in Syracuse, NY, bought an Instacart Express subscription for October so she wouldn’t see rows of pink-wrapped groceries at the supermarket. Ms. Majsiak unsubscribes from as many marketing emails as she can.

Don’t be afraid to set boundaries with your loved ones who might not understand why you are finding the month difficult, said Dr Ashton. Ms Moss, a nurse practitioner, politely asked her colleagues not to bring any pink ribbon merchandise. “I said, ‘October is really tough for me, and it would be so helpful if I didn’t need extra triggers here at work,” ”she said.

Realize you’re not alone in feeling distress this month, Dr Serani said, and reach out to other trusted survivors. Refocus your energy by taking on a low-stakes activity that makes sense to you, Dr. Ashton suggested, such as thanking a friend who has supported you throughout treatment.

For many survivors, October will always be a trigger, Dr Ashton said, but some find it gets easier over time.

Patricia Watson had breast cancer twice, first in 1985 and then again in 2002. These days “I hardly think about it anymore,” said Ms Watson, 89, who lives in Kansas City, Kansas. me yesterday it was Breast Cancer Awareness Month.

If you’re the friend or relative of a breast cancer survivor, any opening you make this month is undoubtedly well-meaning. But here are the things I found unnecessary: ​​using cutesy language like ‘save the tatas’ (oddly sexual), sharing my story without asking (oddly exploitative), and telling me about your size which turned out to be nothing (I I’m glad yours was a near miss, but mine wasn’t).

While friends and family may assume this is a month of celebration for survivors, they “need to understand that serious personal illness like breast cancer is a traumatic experience,” said Dr Serani.

One of the simplest things you can do is just recognize this fact, Dr Ashton said. “Say ‘I’ve heard that Breast Cancer Awareness Month isn’t always positive for survivors, how are you?’ “

Don’t make the survivor of your life a case study, said Ms Ilderton, whose friend once emailed a group “using me as an example of why have a mammogram.”

If you want to make a purchase to support the cause, take a look at where the profits are going and “think about if this is something you want to fund or if you are better off donating to a more targeted local opportunity, or to a foundation based. on research such as METAvivor or BCRF, ”Ms. Forrest said. Or ask if there is an organization you can honor that was helpful during the treatment, Ms. Majsiak said.

Above all, said Ms. Forrest, “if you know someone who’s been through this, who’s survived, maybe tell them you’re proud of them, how far they’ve come, what they’ve endured.


Holly Burns is a San Francisco Bay Area writer and 4-year breast cancer survivor.

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