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October 15 is World Breast Cancer Day. Oncopsychologist Oksana Bulavskaya spoke about how a woman should not miss an illness and how to cope with it.
– Due to the nature of my work, I often have to work with women who are faced with a difficult diagnosis of breast cancer. All of them, like you and me, lived their usual lives, and, as a rule, none of them thought that this trouble could affect them. Either they thought about it, but hoped that it would blow.
According to the patients, most often the discomfort was not obvious. Rather, they were the same as those that occur in healthy women during or shortly before menstruation – swelling, pain, heaviness in the chest, and others. If they had already become mothers at the time of the onset of the disease, then their sensations were also similar to the natural ones that arise during pregnancy and lactation. Moreover, almost none of them attached any importance to these signals of the body, did not undergo examination either by a doctor or on their own.
By the way, I advise you to conduct self-examination regularly every month at the beginning of the cycle. Ideally, this should be done on the same day, for example, on the seventh day after the onset of menstruation, and for women in menopause, on the same day of the calendar month. Most of the sick women who came to me for psychological help did not have an annual mammogram after 40, which is very sad.
So far, in our country, the annual examination is the concern of the woman herself. And, unfortunately, most often the events develop according to the following plot: she completely accidentally finds a ball in her chest or sees in the mirror external changes, often completely painless (retraction of the nipple on one side, a small area resembling an orange peel in structure, a persistent change colors of one area of the chest). And what do you think she does? Going to the doctor? No! She decides that, probably, it is necessary to wait and it will go away by itself … But a month passes, another, sometimes more, and new symptoms appear, a ball or a deformed area increases, and now pain appears. This is where the moment comes when going to the doctor becomes her main concern, fear and hope.
What to do and where to run if something is already wrong
First of all, find a good mammologist. A doctor who will help at all stages of overcoming the disease. You must find a doctor whom you will trust and will be ready to fulfill all his appointments. Someone to whom you can ask any questions without fear and embarrassment, no matter how trivial or difficult they may seem.
In such a situation, the doctor usually already at the very first appointment, even before the results of studies confirming the diagnosis, can with a high degree of probability assume oncology and often turns out to be completely right. Now our woman needs to undergo mammography, ultrasound, puncture and biopsy. She needed all these studies before, even at the first symptoms, to which she decided not to pay attention. However, doctors now need to hurry to prevent the disease from progressing dangerously.
The time at the very beginning of the disease, when treatment would not have been difficult, would be much shorter, had great variability and, unfortunately, a practically guaranteed positive result was missed. Nevertheless, believe me, doctors use all the possibilities of modern medicine to defeat the disease.
When the clinic is found, the doctor is selected (now this can be done not only on a paid basis, but also on the basis of compulsory medical insurance), you must become an obedient, attentive and … very uncomfortable patient. A patient who comes to an appointment is prepared, knowing not only everything about his diagnosis, but also about the methods of treatment, drugs, their action, at least in general terms. All this can be gleaned from the attending doctor even at the first visits, then all the missing information can be found in other available and reliable sources.
Before taking, carefully remember, or better write down your questions about the effect of drugs, side effects when taking them, or about symptoms that have appeared or cause discomfort. Often the doctor needs to hear one such complaint in order to change the tactics of treatment. It happens, and vice versa, the symptom will be a sign that the therapy is working and everything is going well. Unfortunately, it happens that the sensations are so frightening or the woman considers them so “uncomfortable and embarrassing” that she hesitates to say about them. And the doctor often has a very specific medicine that may not cure instantly, but can significantly improve the quality of life. After all, your life is not divided into “before” and “after” the disease. It is here and now and, if possible, should be of the highest quality possible, despite the disease and treatment.
And in order to help you, the doctor just needs to know what happens during the treatment. At the same time, not what happens in general with such treatment, but specifically with you. At the same time, you should remember that the doctor is your assistant and guide, he has knowledge and skills that you do not have. He is ready to share them, but you are being treated! Much will depend on your active position. You should track your changes in the body, the frequency of taking, the implementation of recommendations and examinations, pay attention to the side effects of drugs, if they appear, and in general to everything that happens to you during treatment. Your recovery directly depends on this.
Where do the legs grow from and why is a psychologist needed in such a situation?
– So, the diagnosis has been made. Usually at this moment a woman gets to see me, – the psychotherapist, oncopsychologist continues the story. Oksana Bulavskaya. – As a rule, I see a confused, crying or no longer able to cry adult “girl”, looking for confirmation and conviction from me that everything will be fine and she will certainly recover. Indeed, recently she had a completely different life and plans, which did not fit in with many months of treatment, surgery and diagnosis, which divided her life into “before” and “after”. And even more so it is a very real opportunity to die, if you do not take very decisive actions in the near future.
In my experience with these patients, I have noticed several similarities that are common to most breast cancer patients. A nice, quite successful woman comes to me, as a rule, in the last couple of years she has faced some kind of severe stress (loss of a job, a loved one, the departure of a spouse from the family, a forced move). Such a woman, choosing her priority in life – work, marriage, possibly children, kind of puts everything on this horse. And when suddenly years of outwardly calm life pass and something happens: her husband dies or divorces her, children grow up and “fly out of the nest”, she loses her job or business … The main area of her life, on which the main stake was made, is lost. In her understanding, there is no way out and there is not much to share with either.
It is from the choice of a single priority that her path to illness begins, making her position in life very unstable. What such a woman chooses overshadows all other values in life for her, including herself. She prioritizes in such a way that in her own hierarchy of values she is paradoxically far from being in the first place, and the chosen “main thing” is so huge for her that she makes everything else insignificant or even unnecessary options in her life.
Ideally, you should go to your doctor right away if you have minimal symptoms of changes in the mammary gland.
Her experiences take place inside, there is a clear reluctance to burden others with her problems. But the situation that has been spoken to oneself many times seems to be completely unresolved. The person, as it were, winds up and increases the severity of the situation. Forgive me, but this is a psychological law. Now the piled up experiences becomes too heavy a burden. Under its weight, it changes itself, becoming, as it were, the bearer of this problem. Of course, not all sick women correspond to these characteristics, it happens in another way. I am talking about the most common scenario of life before the onset of the disease. But, one way or another, the situation has already happened, the woman got sick. As they say, trouble has come – open the gate.
– But choose him very carefully, knowing for sure that this person will not begin to groan and lament: “How are we without you, but who are you leaving us with …” – and tell all sorts of horror stories that happened with friends and strangers who are have nothing to do with. Breast cancer is being treated and is being successfully treated! Another thing is that the treatment process is not quick and not very easy. And you need to start it as soon as possible. Keep in mind that there will be people who are so overwhelmed by the diagnosis of cancer that they will move away and will not be able to help you and be close to you.
Try not to be offended and not hold on to them. They are just very scared, and in such a state it is pointless to count on them. Often a good interlocutor turns out to be a person who himself went through a similar test or survived it with his relatives.
Your loved ones, of course, should also be included in the list of trusted persons. But remember, they will experience all the same psychological difficulties that you do. There are studies that prove that relatives and friends living with cancer patients go through the same stages of experiencing stress as patients. Be ready to provide moral support yourself and be sure to learn to ask for very specific help from them. After all, they, like you, first encountered this situation and have no idea what to say and do, how to effectively help a loved one.
Learn to be clear about your requests.
“I would like you to take me to the doctor next Friday, vacuumed the apartment, sit next to me in an embrace and be silent, would say that you will love me without a breast …” Believe me, such a specific request will make your life much easier and your loved one. It will also give you a clear and simple way to get closer and successfully pass this difficult stage in your life. Do not be afraid to discuss with a loved one the changes that will soon happen to you (mastectomy, scars, hair loss during chemotherapy …). You can be clear about your fears and what helps you deal with them. Letting a loved one share their thoughts on this matter, most likely, it will help both of you.
– When we find out about such a difficult diagnosis, we start looking on the Internet for everything related to the outcome of the disease. For example, mortality statistics. Moreover, most often it is unreliable. You should clearly understand that these are statistics in general – like the average temperature in a hospital. It takes into account all women with breast cancer, including very deep old women who could not bear the treatment; women who did not recognize the disease until the very last stage; women who for some reason refused to fight; deceived by would-be healers and swindlers – there are so many losses among those who believed them, so many unsaved lives who simply had to reach the doctor and trust him!
Also, women are simply far from hospitals and for some reason do not consider it necessary to throw all their strength and opportunities to fight the disease. After all, these are women who do not read such articles and do not have a clear algorithm of actions. And all these women are not you! You are the one who knows how to correctly build the nearest goals, if fate has prepared to face you with such a disease. I would even say this: fate gave you a sign in the form of an illness, how important it is to hear yourself and your body, how important it is to be in your first place and accept this not at all as selfishness, but as healthy self-love. After all, only by truly loving ourselves, we will be able to share love with others, near and far, giving support to them, and rely on ourselves.
Many stars have experienced mastectomies at the height of their careers. Now they continue to live happily and continue to act in films. Let us recall at least the story of one of the most beautiful women in the world – Angelina Jolie. In May 2013, The New York Times published a column of the actress in which she admitted that she had completed a three-month course of medical procedures related to mastectomy. The sex symbol, one of the most coveted women on the planet, reported that she removed both breasts of her own free will. She decided on such radical measures for a reason. The actress underwent a series of examinations and found out: she is a carrier of the BRCA1 gene. With such a mutation in the genome, the likelihood of breast cancer is 87%, ovarian cancer – 50%.
Recall that the wife of Brad Pitt began to take seriously her health when, after seven years of fighting cancer, her mother, actress and producer Marcheline Bertrand, passed away. Angelina’s mother has been diagnosed with malignant tumors of the mammary glands and ovaries in different years. Alas, the disease was discovered too late, and the doctors were unable to do anything.
There is only one conclusion from all this: listen to yourself and once a year undergo an examination by a mammologist, which will allow you to identify diseases in time.