The side effects of cancer treatment go beyond losing your hair

If someone asked me at this point in the year, which happens to be nearly the end of my first one, what I liked most about medical school, it would have to be the patient’s stories.

I could do without the hours of science classes and my utter lack of motivation to learn any subject that I am told is important. I could also do without the people who need to tell me how awesome they are at school and how they budget their free time performing hours and hours of shadowing and sucking up to physicians.

However, without the special lectures where patients share their stories, the kind of privileged story that only a doctor would be allowed to hear, I would completely forget why I was at all interested in being a physician in the first place.

Besides having to talk to a child, within our clinical rotations we also had to listen to a patient talk about the “psychosocial aspects of illness” day. Our patient was young, she had children, and she had cancer.

Cancer is an illness that we hear about what seems like every day on the news. We donate money, we walk for Relay for Life, and we even donate our hair to Locks of Love. We also typically know someone who has died of or survived cancer, and often we know both. I am no different, but that does not mean this woman’s story was “old news.” It definitely did not mean I wasn’t moved to near tears listening to her story of her struggle with breast cancer.

What was most unique about this woman’s struggle with cancer was not the effects of the disease itself, but the words that she used to describe it. Her observations were almost poetic and in one great example she explained how she waited in a plastic surgeon’s office to get reconstruction and as she sat next to beautiful women getting Botox or facelifts, and listened to them gripe about their little problems, all she wanted to do was unbutton her shirt and show them “real ones.”

This almost caricature of this waiting room experience puts into perspective her sense of isolation, her feelings of being different, and most of all, her perceived loss of womanhood. It made me want to call every plastic surgeon up and tell him or her that they need a separate waiting room for “those who really need surgery.” There really is nothing worse than feeling not like a woman, around women who just wanted to improve upon themselves for vain purposes.

In addition to this image, which will never leave my head, I had never thought about the side effects of cancer treatment beyond losing your hair. Yet, she had arthritis and she had severe depression. In fact, she described herself as having PTSD. Having also just listened to a PTSD patient describe in vivid detail the day-by-day, minute-by-minute activities of himself as a young soldier in Vietnam, at first I was confused by this comparison. This man had explained how no one wanted to hear from him when he got back from war, and no one even supported the war, so that when he came back, he was supposed to just be quiet and suffer in silence. Without people to talk to, over time he lost that feeling of emotion and he could describe in detail gory, horrible images as if he was passively involved in them, instead of an active participant.

He was damaged and his disease ruined a lot of his personal relationships with his family. How, then, could cancer, be like this for this woman who was smiling while she told us her story and still very much supported by her husband and children, a fellow student asked?

Politely, the woman replied, “You may not see my wounds with my clothes on, but I am wounded … and because of cancer, I will never be the same.”

That statement will stick with me forever.

Jessica Gold is a medical student.

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  • http://secondbasedispatch.com Jackie Fox

    What a wonderful post. I dare say you’re going to be one heck of a doctor. Thank you for sharing this story.

  • http://www.alexbarthe.com/blog Alex

    Wow, that was a really great post. Prior to going back to school to finish my pre-req’s, I worked as an oncology nurse tech. It’s true, people suffer more from the psychological aspects of having cancer than the cancer itself.

    The disease does change you in both good and I don’t want to say bad, rather uncomfortable ways. Always in the back of their minds, the patients wonder if the cancer is going to strike again if it goes into remission. But on the flip side, they learn to put life into another perspective where they appreciate it more than most people.

    Thanks for sharing your story :)

  • Diane D’Angelo

    A wonderful post. BTW, it’s important for med students (and others ) to know that PTSD is NOT restricted to the military. It occurs with great frequency among victims of childhood sexual abuse, rape and domestic violence, as well as traumatic illness such as cancer. Too frequently it is misdiagnosed as a personality disorder or generalized anxiety.

  • http://www.lodewijkbos.com Lodewijk Bos

    Jessica,
    Thank you for bringing this to everybody’s attention. After my cancer (a rare NHL) I was so taken aback by the lack of attention to what was happening to me after the chemo, that I decided to re-name myself from cancer to chemo patient and started my blog about my experiences in the now almost 5 years.

  • Finn

    “The disease does change you in both good and I don’t want to say bad, rather uncomfortable ways.”

    Just say bad. Permanent peripheral neuropathy is bad. Chronic chemo-induced insomnia is bad. Chemobrain is bad. Loss of body parts is bad. Perpetual risk of recurrence is bad. Increased risk of other cancers is bad. Yes, many of us find new strength, purpose, and perspectives through surviving cancer, but the good changes don’t make the bad changes any less bad.

  • Ginger

    I understand why Physicians don’t warn cancer patients about how long it takes to recover from treatment.  They don’t want their comments to become self-fufilling prophecies and anyway everyone is different. It’s been my personal experience that it takes several years at a minimum.  That’s a huge surprise for many people. 

  • Ginger

    I understand why Physicians don’t warn cancer patients about how long it takes to recover from treatment.  They don’t want their comments to become self-fufilling prophecies and anyway everyone is different. It’s been my personal experience that it takes several years at a minimum.  That’s a huge surprise for many people. 

  • http://www.facebook.com/people/Andrea-Paine/611964255 Andrea Paine

    I’m a breast cancer survivor, and it’s been 3 1/2 years since I finished chemotherapy. I had a double mastectomy and reconstruction. I have had to go in for several minor surgeries since then. As a result I have spent many hours waiting in my plastic surgeon’s office. To be honest, I never felt bad, or out of place. I was doing what I needed to do for myself. There will always be people around you that complain about their medical issues. Some have to go for routine blood tests, and lament about how they hate needles. As breast cancer survivors know, this is nothing compared to what we had to go through. I think that we need to be mindful, though, that we are not martyrs. Yes we went through a huge battle, and have the scars and the medals to prove it. But we don’t need to belittle those healthy people around us who have not had the experience we have had. Their feelings and fears are equally important. So leave us all in that same waiting room. Those who feel uncomfortable will catch up eventually.

    Andrea

  • Anonymous

    Great post, Jessica.  Please don’t forget what you learned today in the years ahead!
    A cancer caregiver for 25+ years.

  • http://twitter.com/ddwebster Dana Webster

    After 2.5 years in remission, my HL is back, and I’ll be having an autologous Stem Cell transplant in a few weeks.  No one, other than another cancer patient, knows what the lingering side effects are, and even within the Survivor’s Club, we each handle our diseases and treatments so differently. 

    This article was excellent because it focuses on the patient, not the disease.  It affects us as people in a different way than it affects our bodies.  Everyone assumes life goes back to normal – NORMAL has a new meaning while you have cancer and once you become a survivor, and you’re never the same.

    For me, my anxieties about a recurrence finally came true.  I just had a feeling it wasn’t the end of cancer for me yet.  I’ve offered for a filmmaker at my company to document my progress through the stem cell transplant and recovery.  I’d like to make it available for everyone to understand the extent it affects me, my husband, our kids…..everyone.

  • Jessi Gold

    Thank you all for your great insights and for sharing your personal stories of survival. I feel honored that you would share them with me