After Breast Cancer: A Common-Sense Guide to Life After Treatment - Softcover

Schnipper LICSW, Hester Hill

Softcover

ISBN 10: 0553381628 ISBN 13: 9780553381627

Publisher: Bantam, 2003

Synopsis

As women quickly discover, their life when treatment ends is very different from what it was before their diagnosis. Often exhausted, anxious, and emotionally volatile, they are beset by physical discomforts, fearful of intimacy, afraid for their children, worried about recurrence. Anticipating a return to “normalcy,” they discover that the old version of normal no longer applies.

There could be no more knowledgeable guide for women embarking on this complicated journey than Hester Hill Schnipper, who is herself both an experienced oncology social worker and a breast cancer survivor. This comprehensive handbook provides jargon-free information on the wide range of practical issues women face as they navigate the journey back to health, including:

•Managing physical problems such as fatigue, hot flashes, and aches and pains

•Handling relationships: your children, your partner, your parents, your friends.

•How to regain emotional and sexual intimacy

•Coping with financial and workplace issues

•Genetic testing: why, whether, when

•How to move beyond the fear of recurrence

•And much more

This indispensable book will help you rediscover your capacity for joy as you move forward into the future—as a survivor.

About this title

About the Author

Hester Hill Schnipper, LICSW, brings a unique expertise to her subject: not only her many years as an oncology social worker and the creator of a highly respected support program for women with breast cancer—but also her own experience as a breast cancer survivor. A member of the Oncology Social Work Department at Beth Israel Deaconess Medical Center in Boston, she lives outside Boston with her husband, the distinguished medical oncologist Lowell E. Schnipper, MD.

From the Back Cover

"Although countless books and pamphlets have been written for women recently diagnosed with breast cancer, little exists for women who have finished their treatment. In this volume, readers will find a guide that might help them better understand their infinitely complex circumstances and find hope.
--Publishers Weekly

“If my book is the one you buy when you are diagnosed with breast cancer, this one should be the one you purchase as you finish treatment. Schnipper is a terrific guide on the rocky road to recovery. This book will help you transition from the last chemotherapy/radiation treatment and help you reclaim your life!”
--Susan Love, M.D.

Reviews

Although countless books and pamphlets have been written for women recently diagnosed with breast cancer, little exists for women who have finished their treatment. While many outsiders assume that the end of treatment brings only relief, women who have had breast cancer know that the post-treatment chapter in the breast cancer experience is one of the most difficult. Schnipper, a breast cancer survivor and an oncology social worker, helps prepare women for life after breast cancer by imparting information and advice in an intimate and direct manner. She covers all aspects of the experience, including physical recovery, coping with family members who expect everything to go back to normal immediately, fertility and fear of recurrence. The idea of transformation underlies the book, and she devotes a moving chapter to the different ways some women have gained or regained a sense of spirituality. As Schnipper writes, "Our lives have been changed in many ways and we have tried to be understanding and flexible about our possibilities.... Our hearts and souls, however, need time to catch up." In this volume, readers will find a guide that might help them better understand their infinitely complex circumstances and find hope.
Copyright 2003 Reed Business Information, Inc.

Excerpt. © Reprinted by permission. All rights reserved.

1

My Personal Journey

As hard as it is to remember, there was a before. I had lived for forty-four years and thought of myself as having been lucky. I had been a daughter, a sister, a wife, a mother, a lover, and a friend. I ate right, exercised, got enough sleep, and in general took good care of myself. I had been working as an oncology social worker for more than fifteen years and had recently fallen in love with a wonderful man who happened to be a medical oncologist. It usually seemed a good thing that we shared so much of our work lives and could help and understand each other. Spending our days in the midst of cancer, as we both did, we recognized and appreciated our own good health and good fortune.

I had lived through the death of my beloved father, my mother's aging and increasing needs, the loss of too many patients and friends to cancer. I had come through a divorce and was hopeful that my daughters and I were moving forward toward better times. My older daughter was clearly thriving in college, and my younger girl was a typical twelve-year-old, wondering about boys and friendships and whether I could drive her to the mall on Friday evening.

When I try to remember who I was and how my life was before breast cancer, I think especially of my work. My hospital, Beth Israel Deaconess Medical Center in Boston, has always been a well-known and respected center for breast cancer treatment. When I began to work there in 1979, it was one of only three institutions in the country where some women with certain forms of the disease were regularly offered the choice of a wide excision (lumpectomy) and radiation therapy rather than mastectomy. Many women came from distant cities to avail themselves of this breast-conserving option. The diagnosis and treatment of breast cancer was an institutional priority and quickly became my passion.

In the years since then, I have developed a wonderful and well-respected psychosocial support program for women who have breast cancer. With the overarching goal always empowerment and community, I have met with women and their families for counseling, facilitated countless support groups for women in all stages of breast cancer, developed a model peer-support program called Patient to Patient, Heart to Heart, and offered many special programs. I have been active in many national breast cancer and professional organizations and have lectured widely. I have been on the faculty at the Harvard Medical School and the Boston University School of Social Work. Additionally, I have written numerous professional articles about psychosocial aspects of breast cancer and, following my own diagnosis, about my dual perspective and experience as patient and clinician.

Through the years, I have known and loved hundreds of women with breast cancer. I have spent thousands of hours with them and with their families as they learned to cope with their disease and its treatment. I have kept watch by too many bedsides as women died of this illness, and I have grieved later with their husbands and children. I have always had an enormous respect for the power of breast cancer and never underestimated its strength and guile.

My style with my patients had always been one of relatively few rigid boundaries and of shared human relationships, but my own diagnosis of cancer shattered any lingering walls between us and set up a new paradigm of truly working together. Whether in individual sessions in my office or in groups, we together, sharing our strength, turned to face down the tiger. We rebuilt our lives and we eventually came to appreciate the clarity that cancer brings. My own vision gradually expanded to include a life lived in parallel: therapist and patient, caregiver and care recipient. My strongest alliances shifted to stand with my patients rather than with my professional colleagues. I live a double life.

We who work for long years in oncology learn the lessons that our patients have to teach. We know that life is fragile and fleeting. We know that there is no true safety, that our insistence on healthy diets, exercise, and stress management are illusions of control. We understand that there are no real differences between our patients and us except that they have already received a diagnosis of a life-threatening illness. One of my surgeon friends tells his patients, "We are all pre-op." Unlike most people, we spend our workdays immersed in illness and death and keenly appreciate the fact that life can change or end in a moment. Denial is not an option.

There is something else. We who work long in oncology, whether we are doctors or nurses or social workers, believe at some subconscious magical level that we have struck a bargain with the gods. Of course we understand intellectually that this is not so, but in our hearts the pact has been sealed. We take on seemingly endless loads of sadness; we carry others' hope; we give and we do and we know that one person can make a difference. We spend our days trying to heal others. This is supposed to buy us, and those whom we love, protection.

For years, in both my professional and my personal lives, I had said, "When I get breast cancer . . ." When asked by my patients if I had been through the experience, I always answered, "Not yet." I sometimes sat with my breast cancer support groups and wondered how each of the women there had first discovered her cancer and how I would someday find my own. Why did I feel that way? My mother had breast cancer in her mid-sixties, was treated and stayed well, and no one else in my family had breast or ovarian cancer. Hardly anyone in my extended family had ever had any kind of cancer at all.

No one would have considered me to be part of a high-risk family. Being the daughter of a woman who had postmenopausal breast cancer does not appreciably increase one's risk. Why was I so certain?

During the fall of 1992 and early winter of 1993, I felt vaguely unwell. There was nothing that I could pinpoint and not even anything I could describe. There was only a certainty that something was not right. Following a number of years in a difficult marriage, a separation, and a subsequent divorce that had been very hard on me as well as on my children, I was in love. For the first time in a decade, I was truly happy and felt that my life was working out. Being superstitious enough to be concerned about bringing my good fortune to the attention of the fates, I wondered whether my diffuse malaise was a defense. Was I trying to trick the heavens into thinking I had already had my share of troubles and needed no more? Could I possibly have believed that each of us is required to contend with a set amount of pain?

Sometimes I would look in the mirror and think, Well, I am getting older. That is why I look and feel this way. But I knew that was not it.

I have a vivid memory of stepping out of the shower on a cold morning in January 1993 and stating: "There is something seriously wrong with me." My fiancé, a medical oncologist and professor at the Harvard Medical School, tried to tell me I was wrong. He suggested that most New Englanders feel that way during the depths of winter. He told me that I was probably not getting enough sleep and certainly was working too hard. I knew he was wrong.

A few weeks later I knew the reason for my sense of foreboding. Early in the morning, still half-asleep in bed, I stretched and my hand went straight to a lump in my left breast that had never been there before. I had been compulsive for years about breast self-examination, had yearly mammograms, and I knew the landscape of my naturally lumpy breasts. This was different. In that first instant of blinding recognition, my brain and my heart and my stomach reacted as one. I knew.

Since then, I have listened as many women have told me that they knew that something was wrong before their breast cancer was detected. They simply did not feel right. Many of us know our bodies well and our instincts are apt to be correct. One woman told me of being aware of an odd odor in the months preceding her diagnosis; it disappeared when her tumor was surgically removed. Another told a story of dreaming that she had found a lump. She awakened in a panic and touched the place on her breast where the dream lump had been. There was a real lump there and it was cancer.

I wonder now whether I always had heard these stories but dismissed them. Certainly many women describe exactly the opposite situation. They say, "I had never felt better in my life at the time that my breast cancer was found." We are all different, but I now have a deep and abiding respect for women's instincts about their bodies. When someone tells me that she is sure something is wrong, I listen carefully. Often she is right.

Having spent so many years working with women who have had breast cancer, I was well educated about the issues and the impact of the disease. I knew about treatment options, side effects, statistics, and recurrence risks. I understood that breast cancer is a family disease and that everyone in the family is affected. I knew about work-life struggles, concerns about insurability, and changes in professional roles. I knew that friendships often changed, that marriages sometimes faltered, that sexuality and sense of self were always touched. I understood that fear and sadness became permanent companions. I thought I knew all about it.

The diagnosis of breast cancer brought me to my knees.

The first, the very first lesson for me was that I knew nothing about what it was really like to have breast cancer. Working with other mothers was no preparation for having to tell my own daughters of my diagnosis. Talking with other daughters was no preparation for having to tell my own mother that her worst nightmare of seeing breast cancer extend into another generation had come true. Talking with other wives wa...

Edition details

• Publisher: Bantam
• Publication date: 2003
• ISBN 10: 0553381628
• ISBN 13: 9780553381627
• Binding: Paperback
• Language: English
• Number of pages: 320