A Number Is Worth a Thousand Words

I have always liked numbers. I hate maths, do not get me wrong – but numbers themselves are comforting. Counting makes sense. Keeping track makes sense.

I like to see numbers. Work out how many days, how many hours, how much time I spend doing this or that.

And when I am particularly anxious, when I struggle to get my brain to rest, I count. I take notes. And I write down the numbers that made up my cancer journey.

538 days since diagnosis.
473 days since my hysterectomy.

Two days until my next check up.
117 days since the last one.

Type 1.
Stage 1.
Grade 1.

31 hospital appointments so far.
Five hospitals.
Two counties.

Four appointments, three hospitals in the next ten days.

146 phone calls.

Nine gynaecologists.
Two nights in the hospital.

Nine blood tests.
Two ultrasounds.
One X-ray.
Two MRIs.
One biopsy.
One operation.

Two ovaries, two tubes, one womb.
No ovaries. No tubes. No womb.

Five Macmillan nurses.

Three therapists.
One clinical psychologist.
17 appointments to discuss my mental health.

Three prescriptions I take daily.

Six panic attacks in the last three days.
Nine unrelated episodes of tears.

One in 36 women in the UK.
Over 26 cases every day.
3% of all cancers in the UK.
The fourth most common cancer in women.

90% chance of surviving the cancer for over 5 years.

All the Women I Can Still Be

I wrote a few weeks ago about my struggles with finding my identity again, feeling like myself and existing as a woman following. Tomorrow is International Women’s Day, and I spent the weekend trying to work out where I fit in. What came out is a list of everything I am, would want to be, may be, could one day be.

A friend.

A daughter.

A fighter.

A knitter.

A writer.

A career woman.

A patient.

A partner.

A winner.

A loser.

A manager.

A baker.

A business woman.

A bridesmaid.

A mother.

An advisor.

A reader.

An author.

A crafter.

A protester.

A supporter.

A defender.

A cousin.

A younger sister.

An older sister.

A rock to lean on.

A drama queen.

A hustler.

A traveller.

A dreamer.

A cancer survivor.

A gossip.

A listener.

A boss.

An artist.

A girlfriend.

A wife.

A seamstress.

A feminist.

An ally.

A leader.

An activist.

A lover.

A protector.

A flatmate.

A nightmare.

A dream.

A mess.

A blogger.

A champion.

A girl.

A lady.

A cat-lady.

A risk taker.

A fixer.

A teacher.

A carer.

A student.

A translator.

A decent cook.

A music lover.

A theatre geek.

A niece.

A grand-daughter.

A mother.

A creator.

A queen.

An entertainer.

An advocate.

A performer.

That is my list. It may evolve, it may grow, it may be missing a few items, and that is the strength of it.

Erasing the Stigma of PTSD

I must have been about 16 when I first heard about PTSD. It was on an episode of Grey’s Anatomy, one of the very few storylines I still remember more than 10 years later.

Like so many other people, at first I was convinced that PTSD was something that happened to people in the armed forces, something that veterans suffered from. A mental health condition which, unlike depression or anxiety, would have very little chance of one day affecting me.

It took a few years for me to encounter it in another context. I remember reading that someone famous had suffered from it, and thinking ‘they haven’t been to war, that’s not it. They’re exaggerating’. As I got older, I realised how wrong I had been.

PTSD Can Affect Anyone

Post-traumatic stress disorder can affect anyone who has had a traumatic experience. And any situation that someone finds traumatic, even if it would not necessarily have been considered traumatic by someone else, can trigger post-traumatic stress disorder. An accident, childbirth, the loss of a loved one, assault, those are just a few examples of events that can lead to PTSD.

PTSD can happen at any time after a traumatic event. It usually starts within a few months, but it can sometimes take years to develop, even decades if memories have been buried deep.

The first time someone told me it sounded like I was suffering from PTSD, I shrugged it off. They were the words of a friend, in early summer 2020. I was only a few months out of surgery. Surely it was normal to feel anxious, to replay conversations in my mind, to see the same scenes over and over again, to be easily triggered, to have excessive emotions, to feel numb, to refuse to talk about my situation, to avoid places and people that reminded me of cancer. Surely, it would pass.

It did not pass.

In August, a psychologist told me they believed I could be suffering from PTSD. All the symptoms I described to them, my daily struggles, were consistent with an anxiety disorder, low mood, and trauma-related mental health conditions. Post-traumatic stress disorder was a likely culprit.

The Stuff of Nightmares

I will not get into the details of all the possible symptoms of PTSD – I am not medically trained, and there are so many resources online that can offer help and advice (I will link a couple of them at the end of this post). All I can talk about it my experience of trauma, the symptoms I have that are consistent with a diagnosis of PTSD, and how it affects me at the moment.

I have had regular flashbacks for months. Moments when I lose track of where I am, and find myself reliving parts of my cancer journey. I am irritable. For months, I felt completely numb. Now, I have all of the emotions, all of the time. I have insomnia. I live in fear that something bad is about to happen. I startle easily. I avoid places that remind me of cancer. I feel sick talking about my diagnosis. I get triggered by the smallest thing – a picture of an ultrasound or a letter from the GP in my letterbox. Smells, noises. Lights.

For the last few weeks, I have been dealing with one of the nastier symptoms of PTSD: nightmares. They happen every single night, at least once, sometimes three or four times.

I will wake up feeling panicky, exhausted, sweaty, terrified. Some of the nightmares are very clear – they are memories of the worst moments of the last few years that will play in my head, over and over again. So much that I feel lost. I feel like I am back in those horrendous months before surgery. I will be reliving hospital appointments, tests, results. Sometimes they are painfully close to reality, sometimes I get told my cancer is terminal. Sometimes I do not make it out of surgery. Sometimes I learn that someone I love is going through what I did, not me.

Some of the nightmares are only vaguely related to cancer, but feature hospitals, bad news and people getting hurt. They are disturbing, sometimes violent, they often end with me walking around aimlessly. I get lost in hospitals. I wait for hours in a waiting room that gets darker and darker.

Have you ever been terrified of closing your eyes? Have you ever cried of exhaustion, knowing at the same time that you would get no relief when sleep would take you? Have you ever been afraid of what your brain would make you go through when you needed a nap?

I fear sleep. Every night, I push back the time when I will actually go to bed, because I do not feel ready. I do not want to face the nightmares again. I do not want to wake up after a couple of hours, even more tired than when I went to bed, craving the thing I also want to avoid.

Each night, the cycles repeats. Fight sleep. Push back my bedtime to 10pm, 11pm, 12pm, 1am. Fall asleep, sometimes despite myself, sometimes with the lights on. And wake up, after a couple of hours, feeling absolutely spent, frustrated, heart racing and tears all over my face.

I think the most I have slept on a single night, in the last three weeks, has been about five hours. These days, it is closer to two or three hours a night.

And as a result, my symptoms during the day get worse. I am even more prone to tears, even more irritable, even more disconnected from reality. Even more likely to have an anxiety attack for the smallest thing.

I am tired.

We Are Not Alone

I know so many people with PTSD. Friends, family members, slight acquaintances. I have read about so many more people having it, living with it, trying to overcome it.

Our experiences are all so different, but they are all valid. Do not let anyone tell you you cannot have PTSD because your situation was not traumatic enough in their eyes. Do not let yourself think you cannot have PTSD because your trauma was somehow less than someone else’s.

Trauma is personal. Trauma is subjective. Trauma is welcome to pack its bags and go away.

Useful links:

https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/symptoms/

https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/about-ptsd/

https://www.ptsduk.org/

New Year, New Challenges

There are similarities in the way I rang in the new year those last two years. Same group of friends (minus a few members), same no-drinking policy, same hope for a better year ahead. Minor differences – this time we were in France and had a seemingly unlimited supply of face masks and hand sanitizer. We played games, ate too much and had a chilled, fun-filled evening.

But instead of the fireworks of 2020, 2021 started with a panic attack and hot, burning tears.

I had felt them coming. I had had a few scary moments throughout the evening, moments where I lost touch with reality and slipped into my own mind. Moments when, unable to cope with two many conversations around me (and there were still only six of us), I retreated back into myself, into the mind that used to be my refuge, but has since become booby-trapped with dangerous thoughts.

After a year spent mostly in isolation, I had no idea how I would react to being around people constantly. Over the last three weeks, as I got reacquainted with my family and friends, it proved a challenge.

How do you talk to people who know of your vulnerability, but have not experienced it, witnessed it first-hand? How do you broach an entire year of physical and mental struggles with people who have only known you at your best, healthy self?

As usual, I pretended everything was fine. Most people are comfortable with that, that is what they are expecting. Most of my friends did not ask any follow-up questions. I managed to see both my parents and only mention the word ‘cancer’ a handful of times at most. They were not interested, they were avoiding the subject. It probably made them more comfortable to ignore the issue, so I pretended to do the same.

My mental health struggles, I was not able to hide as well. I felt down at times, which my friends noticed. I realised that confrontation, arguments and aggressive debates automatically sent me into a panic spiral. I cannot deal with conflict anymore – and in a family setting, conflict is sure to arise at some point, particularly if my brothers get started on politics. I guess I needed to experience it to learn of my new limits. I was given plenty of opportunities to test them, and I did not disappoint. Or rather, I did.

Big personalities make me feel small and inadequate. I used to be like that, and now I feel invisible. I no longer have the strength to battle for what I think, so I disappear in group conversations.

I do not want to disappear, but I also constantly feel like I am not enough. Like I am a hindrance, rather than a help. Like I am imposing myself on others, just by being there, by taking up space, quietly, without contributing much. I feel like I am a bother, like people do not want or need me around.

I struggle to make decisions. Weirdly enough, it does not affect me much at work, in a setting where I know I have to make calls as part of my job. But choosing between five different types of tea, what room I want to sleep in, or deciding what music we should listen to, all of that sends me into a panic.

It all culminated at New Year’s. Too many people around, too many different things to pay attention to, too many small decisions – where do you want to sit, what do you want to drink, which conversation do you want to listen to, too many things to look at and people to smile at. I could not keep the pretense long enough and I crumbled.

There were so many thoughts in my head at midnight. How everyone was hoping for a better year, even if quietly and without much confidence it would happen. I find it difficult to hope, to think about the future, which is what New Year is about. Closing the door on a terrible year, and leaping into a new, unknown one. To me, that sounds terrifying. 365 more days, and any one of them could bring terrible news and things.

Seeing people around me being happy is hard – it reminds me of how much I have changed, how I used to be one of them. It draws me into a downward spiral – I feel guilty about being down, about not being able to enjoy a few hours with my friends when I have the opportunity. My guilt transforms into shame, into self-hatred. Panic and tears settle in.

When it finally happened, just after midnight, it was not pretty. I withdrew into a dark room and let my tears flow, my breathing returning to normal after a good twenty minutes. It was my first panic attack of 2021, but I already know it will not be the last.

Last year, my only New Year resolution was to beat cancer. It was a worrying time, but the goal was clear, and could be achieved with medical procedures and treatment. This year, I do not have any resolutions, but I have challenges I want to reach and win. Feeling more confident. Achieving things and enjoying small victories. Letting go of the guilt. Allowing myself to shine and be myself, proudly and unapologetically. Having fun, saying goodbye to doubts and worries, and not being afraid to be happy.

The Ghost of Cancer Past

I woke up this morning in my mother’s guest room at home, a kitten biting at my bare feet, head pounding.

My first conscious thought was that I really should close my bedroom door. The second one was that today was the one-year anniversary of the actual operation.

365 (well, 366 – obviously 2020 had to be a leap year) days since life-changing surgery. A year ago, at the time I am writing this, I still had a womb. I still had ovaries. I still had cancer.

I would be lying if I said I did not feel a sense of loss. But strangely enough, it is not only the loss of my reproductive organs that I feel today. I also mourn the fact that this is the second-to-last one-year anniversary that I will have on my cancer journey. Today, and then all that is left is the 13th of January, the one-year anniversary of the final staging, the day I was told that for all intents and purposes, and as far as doctors could tell, there was no trace of cancer in my body. I was in remission.

For a year, I have clung onto these dates, the small anniversaries of each step in my cancer journey. They were frightening, I dreaded them, each one more intense than the previous one. But I also found comfort in them. I reached milestones. No matter how hard those days were, they made me realise I was moving forward. They helped me retrace my journey and let go of feelings I did not know I have.

Tomorrow, I will not be able to say ‘I had surgery less than a year ago’. I will not be able to use it as an excuse for however I am feeling.

In four weeks, I will not have any more one-year anniversaries to celebrate. It is daunting. It feels like I am losing a timeline that helped me stay anchored for the past year.

I did not expect to feel that way, I did not even expect that I would think about those anniversaries coming to an end. I am discovering more aspects of my grief every day.

Am I looking forward to being free of those dates? Will things get easier when I do not wake up each day knowing exactly what I was doing a year ago? Will I rejoice in the fact that, come mid-January, I will no longer associate each day with memories of cancer?

I will not blow a candle today. I will not celebrate the birth of my new womb-free, cancer-free body. But I will light a fire in the living room (I am not turning into an arsonist – there is a fireplace), and let it consume a year’s worth of memories and grief for the organs I no longer have.

Letting Go

I have always been obsessed with the idea of keeping it together. Finding a way to keep moving forward, even when it hurts, even when it means pretending. Focusing on things I can control, instead of delving into my issues and trying to solve them. Saving face, again and again.

Last week, for only the second time since my diagnosis, I let go. Did I forget that I was supposed to pretend? Did I not have the energy to hold back the feelings, to glue together whatever pieces of me were still whole?

The surge of feelings after my hospital appointment was both expected and unexpectedly violent. The whole experience was incredibly brutal.

First came the panic attacks the minute I set foot in the hospital. I was holding it together until then, but then I broke down. Teary, barely able to think, speaking in a whispery, soft voice that is very uncharacteristic of me, breathing hard but hardly breathing, the whole shebang. But a panic attack for me is not about letting go, it is not about losing control of your feelings. It is a sign of my body being unable to cope with a situation, and reacting physically, automatically, to what my brain cannot cope with. 

After I got home that evening, after I wrote to my friends to tell them everything was fine, after I posted here about my relief at being cancer-free, I finally let go and gave in to my feelings.

In a rare display of true emotion, only exacerbated by sheer exhaustion and the now familiar migraine that comes after panic attacks, I spent hours that night crying. I am not sure what I cried about. Relief. Fear. Anger. Acceptance. Loss. I let my feelings overcome me and tear at my carefully-crafted armour of false-strength.

And for two days, I could barely move. I was paralysed by my feelings. I felt sick, I felt useless, I struggled to even open my eyes. The only other time I can remember feeling so overcome with feelings was after the cancelled operation. I let my feelings wash over me, and take control of what happened to my body. I lay in bed, under the covers, with a pile of tissues and a box of painkillers at my side. I alternated between crying, drifting off to sleep for short, restless periods, and feeling sorry for myself. Feeling angry at myself.

Since October 2019 and the diagnosis, I had not taken a single sick day for cancer reasons that was not related to either a doctor’s appointment or the surgery. I came in the day of my diagnosis, and the day after. I came back from sick leave after surgery a week early. But last week, just like the week after they cancelled the operation in early December last year, it finally became too much. I had no energy. I had no brainpower. All I had were feelings a year in the making, an unrelenting migraine, and a week’s worth of insomnia.

So I let go. I let my feelings take over my body and my brain, and I stopped pretending, for two blessed days, that I was fine. I gave in. I knew my feelings and self-pity had an expiration date – I was travelling back to France at the weekend and needed to be back up on my feet by then.

Did it feel liberating? In a way. Because I did not go to work, I did not have to pretend to be ok. I did not have to repress my feelings and put up a brave front. I was unapologetically broken, and I was honest.

For two days, I did not make myself do anything I did not fancy. I did not eat. I drank lots of tea, I went for a couple of walks, I avoided people and listened to Christmas music. I cried for hours, in the comfort of my own bed, under the stream of the shower, in the woods at the edge of the park. I let go.

But there, at the back of my mind, were still uncomfortable feelings. Guilt, for taking days off when work was busy. For having the privilege to do so, when so many people cannot afford that. Uneasiness, for making people uncomfortable when telling them what was wrong. Anger, anger at myself for not being strong enough to keep pretending and live a normal life. Shame at not being a functional human being. Shame, shame, shame.

Two days. That is how long I allowed myself to let go for. And then I picked up the pieces of myself and put them in a suitcase and a backpack, and dragged them over the border to France.

One Year On: We Are in the Clear

If I had any energy left after my one-year follow-up appointment this afternoon, I would probably blow up some balloons and put them up in my flat.

It was hard. My eyes are raw from crying. I used about two boxes of tissues – one in the waiting room and one in the exam room.

I cried in front of the receptionist. I cried in front of the nurse who checked my height and weight. I cried in front of the doctor, and I cried in front of the cancer nurse specialist.

Follow-up appointments are rough. You can go about your life for months, but you know that everything could change in a matter of seconds, in that same room where you first got the news. The. Exact. Same. Room.

I had a new doctor again, who asked me plenty of questions about how I was diagnosed, how it came to be, what tests were done, how thick the lining of my uterus had been on the MRI scan (I have no idea). As I was battling my way through my tears, she told me it was ok to cry. It was ok to be overwhelmed, to be traumatised. She told me that I had gone through a lot for someone so young – terribly young, and she could say that because we were exactly the same age.

I do not know why that comment struck me as odd. Why of all the things she said, that is the one that stayed with me.

But it is all said and done now. A quick exam, a lot of background info, a chat about any symptoms I could have had, an inventory of the medication I am on, and I have been declared cancer-free, until my next appointment in four months.

I will have more to say in the coming days. About how they told me if things remained the same, I would be discharged after one more year, instead of four. About how my dedicated nurse was self-isolating so I was not able to speak to her, but arranged a phone catch-up in a couple of weeks to discuss my ongoing mental health problems.

For now though, I will crawl under the covers, put a good audiobook on and try and get some much needed rest. I may order a celebratory takeaway later, making up for the fact I have had maybe 4 meals in the last 6 days. I will make myself a hot chocolate and put the Christmas lights on.

In the wise words of Adore Delano – Party.

Talking About Cancer – Making Light of It

Today marks exactly one year since the day my operation was first scheduled. It is also six days until my next check-up at the hospital, for the dreaded one-year mark (or as close as we could get without having me go for a check-up at Christmas).

At the moment, it is impossible for me to spend any length of time during the day not thinking about cancer. It permeates everything, it colours every feeling, every decision I make. It makes me cry, it makes me sick with worry, it makes me crumble to the floor in the shower until the water goes cold, it makes me forget how to breathe in the middle of my morning walk, and fall over in the park.

Because cancer is all-consuming, it is almost impossible to push it to the back of your mind, and not think about it at all. You need to find other ways to cope. Ways to tame cancer, to make it less of a threat, make it into a subject you can discuss, something that can make you laugh as well as cry.

I have found that making light of cancer helps. Making jokes, bringing it up in an unexpected way and observing people’s reactions can be priceless. When you make fun of it, for a few seconds, it no longer is the big C, or the other C-word. It is cancer, and it is something you can bring up without fear, something you have earned the right to laugh about.

I have always loved dry humour. Saying something unexpected, sometimes a bit dark but that will bring a laugh upon someone’s lips – or a shocked gasp, depending on who my audience is.

Just this week, even though I am battling one of the darkest weeks I have had all year, I made two of my ‘cancer jokes’, and it felt amazing. They were awkward, they were uncomfortable. They were not necessarily funny – I definitely will not be quitting my day job to start a career as a comedian – but they did make me feel more in control. For a few precious seconds, it felt like cancer was mine to beat, mine to laugh at. If I can laugh about it, surely it cannot hurt me anymore.

I was on the phone with a friend at the weekend, and we were talking about how I have been having a lot of mood swings and have been feeling very tearful lately – even more so than usual. My friend was asking whether I thought it might be hormone-related, or could it be an issue with my antidepressants maybe? In a deadpan, slow voice, I interrupted her and said ‘God, I hope I’m not pregnant’. A couple of seconds of silence, and an awkward laugh followed. Sorry to have made you uncomfortable – personally, I think that has been the highlight of my week so far.

The other joke I made was during a group video call, with a lot more people than I am usually comfortable with. I had not spoken to some of them since the summer of 2019, before it all happened, but they all knew, either because they had been told by other people or they saw something on social media, or read this blog. We were talking about how long it had been since we last saw each other, and I said ‘well, it’s been a while. Last time we spoke, I still had a uterus’. Some faces looked shocked. There were a couple of laughs, a few shaking heads and one amused ‘Can’t argue with that’.

I have been using humour to cope for months now. Earlier this year, I uploaded a selfie on social media, showcasing my brand new short hair and using a caption that would have made my mum cringe: ‘Getting rid of my hair like I got rid of that cancer – #snipsnip’. I felt so powerful in that moment. Cancer was nothing more than a punchline. Snip snip, my hair. Snip snip, cancer.

I understand these comments might make people uncomfortable. Not everyone is happy to have a laugh about something so serious. But for me, it is a way of getting over it, of proving that cancer is not as threatening as it looks, of feeling like I have the upper hand for once.

I think it is also important to show people that I can laugh about it. If I can make jokes, if I can make light of a terrible situation, maybe people will start feeling comfortable around me and my issues. Maybe they can make their own jokes, and I will laugh at them – no puns though, nothing make me cringe more than a bad pun.

I have earned the right to make those jokes, and to laugh when you make one. Not everyone with cancer will see it that way, and for some people cancer will always stay off-limits. For me, making light of cancer is proof that it has not taken over my sense of humour. I can still be hysterical.

Well. Not etymologically.

Survivor Guilt and Impostor Syndrome

All cancers are not equal. That is a terrible thing, but that is the reality of it. Some are more deadly, some are tougher on the body. Some are quick, some take years to develop. Some are common, some are rare. Some are caught early, and some are never caught. I was one of the lucky ones. Womb cancer grows slowly, it is usually discovered early, and it can often be treated successfully with surgery, with or without the need for adjuvant therapy.

My final diagnosis was of endometrial adenocarcinoma, Stage 1a, Grade 1. After the operation, I was not encouraged to have any further treatment, as the risk of recurrence was quite low. That meant no radiotherapy, no chemotherapy. Other than the mess that is my head at the moment, the only proof I have that I had cancer are four small scars on my lower abdomen (unless you have an MRI machine at home – then I can show you I have organs missing from my body). Four small scars, only a couple of centimetres long, purple against my terribly pale skin. They will fade in time, and will no longer be so visible.

I know I am incredibly lucky. But there is a part of me – a part that I despise, and that I wish I could get rid of altogether – that feels guilty about this. That feels like I did not really have cancer, that I am claiming to be part of a group where I do not belong. My experience was so easy compared to others, it should not even count. I have no right to claim I am a cancer survivor.

I had been told that, after the results of the surgery came back, there was a chance I would need radiotherapy, even just as a preventative measure. So I had read all about it, and prepared myself for it. I had been ready for the doctor to tell me I needed a few sessions, I had researched how it would work, informed my manager of the possibility. When they instead told me they did not recommend any further treatment, and that the grade of the cancer was actually lower than they had initially assumed, I felt a huge sense of relief, which was immediately followed by a feeling of unease. So that was it, for now at least. That was my whole experience of cancer treatment, and it did not match what I most associated with cancer. No chemo, no radiotherapy. Without that adjuvant treatment and the risks and side-effects associated with it, I feel like I cannot claim that I have lived through a real, valid cancer experience. I feel guilty telling people about my cancer, I feel guilty of now having anxiety, depression and PTSD, when my experience was so much easier than most people. I should be glad, and I should be thankful.

I cry about it. I make myself sick when I think about it. I feel like I have no right to talk about these things, that it is not my place. I feel like I should not be struggling, it is shameful of me to complain, to feel bad about my situation, when so many other people have it much, much worse. Even writing this blog makes me feel guilty. Do I have the right to speak about this? Do I have the right to feel low, when people are grieving their relatives, when people are losing their lives to this awful disease? I did not even want children, so the loss of my reproductive ability is nothing compared to women who have always wanted children and have had that option ripped away from them. There was very little sacrifice on my part. I had it easy.

Those are all thoughts I have, maybe not every day, but at least a couple of times a week. There are words for them. Impostor syndrome. Survivor guilt.

I always worry that people are going to judge me if I say I suffered because of cancer. After all, all I needed was a quick operation – an hour and a half, snip snip, all done, goodbye cancer. Yes, I have follow-up appointments. Yes, I will be monitored for at least five years, to make sure the cancer does not come back – or catch it early if it does. But all that does not equate the pain and suffering of people with other forms of cancer, or more advanced disease.

I am afraid that people are not going to believe me if I tell them I had cancer a year ago. I am afraid of their reaction, of the fact they might judge me, and refuse to believe me because I show no exterior sign of having, or having had cancer at all. After the operation, when I first took public transport, I was afraid to sit down in a crowded train. I was afraid of the looks I would receive – me, a seemingly healthy woman in her twenties. I was exhausted, I was barely standing up, but I was afraid of people not realising that I was seriously ill, and judging me for taking someone else’s spot.

I always used to associate cancer with chemotherapy and hair loss, but all I needed was surgery. I kept all my hair (until I decided to cut it all off, before shaving half my head). It is something that still bothers me. I did not have the cancer experience that, for me, is the very definition of the disease. Did I even have cancer, if my experience was so easy, so short? Was my life really in that much danger, was it really overturned by the disease? Have I made it much bigger in my head than it was? Am I entitled to request help? I have a medical exemption certificate, which means I do not have to pay for my prescriptions for five years. And every time I use it, I feel guilty. Surely, there are people who need it more than I do, people whose body, whose life, whose livelihood have been affected by cancer a lot more than I have.

I sometimes feel like I should keep quiet about my mental health struggles. More than seven months passed between the moment when I first started feeling anxious and depressed, and when I finally spoke to my cancer team about it – and even then, it was only because I had a full-blown panic attack at my hospital appointment that I spoke to someone. In that moment, I was not able to hide it, to pretend everything was fine. If I had not been overcome by anxiety at that point, I would not have said a thing. After all, I am managing. I am living my life, I am still functioning. I go to work, I earn money, I pay my bills. Surely, I am not that ill. If I manage to do all this, surely I am fine, it cannot be that bad. Despite all the reassurance I have received from doctors, from my CNS, I still feel like I am wasting their time. There are people that are suffering more than I am, and they need their time more than I do. I am claiming help that I am not entitled to.

I read stories about people with cancer. I hear my friends talking about their family members, their own friends. I have lost people to cancer myself. I have family members currently undergoing treatment for advanced cancer. People who know there is very little hope. And I feel guilty. Why was I so lucky? Why did I have it so easy? And why, why do I not feel relief, why do I not rejoice in the idea that I am, as far as my doctors can tell, cancer-free? It is unfair.

I have not joined any support groups. I am afraid of being faced with people whose experience was a lot harder than mine, afraid that this will invalidate my own story. Afraid of the looks on their faces when I claim being one of them, when I know so little and have suffered a lot less. I feel like I do not belong, because of how easy I had it.

Every time I upload a new blog post, I have this ache in my heart, in my stomach. I worry about people reading this, and feeling like I am cheating. Like I am discussing things that I do not know. I am afraid they are going to see me as a fraud. As someone who is taking advantage. As someone who is claiming distress that they are not entitled to.

I have not spoken of this to anyone before today. Not to my doctors, not to my nurse, not to my family, not to my friends. I was editing a completely different article last night, which I was planning on publishing today, when I typed the title for this one. And then I could not stop writing, the words pouring out of my fingers and onto the page. I finished at 3am, long after the fireworks of Diwali had stopped.

One Step Forward, Two Steps Back

Getting better. That has basically been my only goal since I first received my diagnosis last year. Everything else, life, friends, relationships, work, the future, it all took a step back, to allow me to focus on this one thing. Getting better is the aim, after all.

I always pictured my experience as a hurdle that I would need to pass. After that, life would start again, it would go on, I would be on a clear path to getting better and back to normal.

But as time goes by, and I start having first-year anniversaries of all the significant milestones of my diagnosis and treatment, I realise that getting better is not a straight line. It is full of curves, of hills that I thought I could not reach until I conquered them, of slopes that are too steep, too fast for me to go down safely. It is not an easy path.

There have been milestones throughout the year. So many moment where I thought ‘I have done this, now I will be fine’, only to reach a new low after a few weeks.

There was the operation, on 19th December. The day they told me the cancer was confirmed as Grade 1, Stage 1a, and no further treatment would be needed, on 13th January. The day I was prescribed hormone replacement therapy, on 26th February. The day I received a letter telling me there was no sign of a genetic mutation, sometime in late spring. The day after my first in-person follow-up, on 28th August. On those days, I felt relieved. I reached a new high each time. I felt like nothing could touch me. Depending on the appointments, I had been reassured that I was doing ok physically, or at least that things would start looking up.

But because there are highs, there are lows too. And every time I feel great, I know now that it is not going to last. That no matter what I do, there will be a point where I feel anxious, where I feel low, where I feel down again.

It can be overwhelming, this feeling that whatever you do, there is no progress. I am stalling. I am wary of even thinking things are fine, because I know there will come a time, pretty soon, where I will struggle again. I am afraid of getting my hopes up, because I fall harder every time.

I am at that point again, two months after my latest check-up, and a month before the next one, where I start panicking again at the thought that something might be physically wrong with me. That the cancer is back. I have nightmares about it. I wake up thinking about it. I go about my day, and I think about it every minute. I try to go to sleep, telling myself that I am another day closer to receiving bad news again. It is completely irrational. I know the chances of it happening are very low, but I cannot control it. I have tried CBT, I still try and undo this negative thinking pattern, but it all-consuming.

I feel anxious, and I feel low. Because so much of my energy is focused on this, I feel tired all the time. I feel unmotivated. I do not have the energy to do anything. I try reading a book, and I have to give up after two pages, my brain will not let me focus on it. I will watch a film and switch after ten minutes.

I feel all the emotions, all at the same time. I feel sad. I am downhearted. I feel angry. I am frustrated. I cry. I am mad, and I slam on my keyboard. I swear at myself, I swear at clients, I swear at my friends – but only in my head, and in my flat.

What I thought helped does not anymore. I thought that yoga helped me relax, and now I just cry at the idea of lying down on my mat. I thought medication was working, but I feel worse than I did weeks ago. I started doing crafts again and thought I had found my focus again, but I have to force myself to pick up my knitting needles at the moment. I thought that writing had really helped, that it had allowed me to put words on my feelings, that I was seeing the light again, only to realise that I have taken a huge step backwards, and I am now back where I was six weeks ago.

It is disheartening. I keep feeling like things are looking up, only to be disappointed again. Disappointed in myself, both for letting myself feel like this and having had the hope to think that maybe, it would not be the case this time.

It is a pattern I will have to get used to. Triggers that I will need to identify, and can prevent before I fall into a downward spiral again. What started it this time? I cannot pinpoint a single factor. There are a multitude of reasons, some more personal than others. Cancer anxiety. Family issues. Politics. Workload. Lockdown. Worry about not being able to finally go home at Christmas, and see the family and friends I have not seen for over a year. Watching my friends achieving things, reaching their goals, whilst I am still here, stuck in my post-cancer rut, unable to move on.

Thirty days until my next appointment. I know that if everything goes well, a new high point awaits me on the other side. And it is higher, better, deeper each time. I will feel happy again. I will feel like I am back to normal again. But if you are looking for me in the meantime, I will be hiding under a blanket with a Christmas-scented candle burning next to me.