Paul's Heart

Cancer And Relationships

It is often difficult to go beyond the thought, that a diagnosis of cancer can go beyond that of the patient who has been diagnosed.  After all, it is the patient who is in the race against time to avoid one statistic, death, but become a statistic, survivor.  It is the patient who is going to undergo the testing, and the side effects from treatments.  It is the patient who is going to deal with the never-ending fear of recurrence.

But the truth is, when a patient has a significant other, whether it be boyfriend/girlfriend, spouse, life partner, that person gets thrust into a role that comes as much a shock as the diagnosis of cancer itself, caregiver.  Most likely, neither patient or caregiver has any experience about the path they are going to go down.  From personal experience, this should not be taken lightly.

Relationships have enough difficulty surviving without constant effort.  And when things interfere with relationships on a daily basis, such as money, activities, sex, stress, work, a cancer diagnosis, just as any other illness, can complicate things further, or at the least, create issues.

Non-binding relationships allow the easiest escape, but for those that are married, there is that whole “for better for worse, from church until hearse, sickness and health”, which in spite of my track record (one divorce, one pending), I do believe in.

When I was diagnosed, I was six months away from getting married.  I explained to my fiancé, that I knew from that moment on, I was not going to be able to give her the “fairy tale” marriage that she may have always dreamed about.  I might not even survive.  I offered her the chance to walk out the door, for another chance at happiness.  I would not hold anything against her.  It was my fault that I would not be able to live up to what I thought she might have wanted.

Let’s face it though, if you have a significant other, who is facing a life-threatening and critical situation, any human being with an empathetic heart is going to do “the right thing” and stand by their partner.  No one would want to be labeled an asshole for bailing on someone in their time of direst need.  But the truth is, that might be the best option after all.  Especially if a person is incapable, not on purpose of course, of meeting the needs, emotional and physical.

My fiancé became my wife.  The wedding happened as planned.  The honeymoon was altered because financially, and physically I was not going to be up to the physical needs for the plans we had.  I had just completed my radiation therapy before the wedding and I was exhausted.  Upon return from my honeymoon, I was faced with the news that I would have to undergo chemotherapy.

But through all of my treatments, both radiation and chemo, and during my procedures, she and I never talked about my cancer.  In fact, when I finished my treatments, and received the news that I was in remission, she took that as a release, we would no longer have to hear the word “cancer” in the house, and it pretty much was not to be spoken again.  And if I did, I was often met with “why can’t you just get over it.”  And I tried, but I could not “just get over it.”  This laid the foundation for the eventual failure of my first marriage.  We could not deal emotionally with the scars we wore from my Hodgkin’s fight, so anything that came along on top of that, money, sex, attention, only made things worse.  And when we finally had our first true husband-wife conversation, it was an explosion that neither of us were able to prepare for, and emotionally it was crippling.  That was the end of my first marriage.

I do not blame her, not entirely.  But I did warn her.  I did not have access or knowledge of how difficult dealing with cancer was going to be, like I do today.  Looking back, she lacked attention from me.  Cancer dominated my life, and when I was done with it, I found out, I was never going to be done with it.  But instead of dealing with our issues, and I cannot stress it enough, YOU CANNOT DO IT ON YOUR OWN!, we hid them.  Our relationship suffered, and resentment began to build.  And it was only a matter of time, until that resentment would come out.  I wanted to get help for us, but she did not see the need, until I told her I wanted to file for divorce.  And I even patronized her by going to two sessions before I filed, but during those sessions, I heard the same thing that led me to believe there was no chance of getting her to understand how I felt as a cancer survivor.  All I heard was blame directed at me.

Over my twenty four years counseling cancer patients and their families, this is all just too common.  Pride keeps us from wanting to expose our laundry to any outsider.  But the option of “just getting over it” does not work.

I believe you are totally blessed if you have someone in your life who will be completely by your side, not just through the battle, but help with the scars that grow from within.  And they do exist.  I am a romantic at heart, and I know this can happen.  But I cannot stress, please do not underestimate the emotional toll that a cancer diagnosis and journey can take.  Be strong enough to admit when you need someone to lean on.

Diagnosing Lymphoma – Why Is It So Hard?

Hodgkin’s Lymphoma is considered a rare cancer.  It makes up just 1% of all cancer diagnosis.  Its rarity is what makes it so difficult to diagnose in a timely manner.  Yet, timeliness is critical in treating Hodgkin’s as this particular cancer has a cure rate of over 85%.  Case in point.

At age 22, I was a healthy and fairly fit young man.  I did not contract colds or the flu.  The only time my family doctor saw me was to deal with a seasonal allergy.  But one day, while sitting at my desk at work, an itch on the back of my neck caused me to reach back to scratch at it.  But instead of a simple itch, I was shocked to feel a massive lump.  There was no pain, and more importantly, there were no other symptoms.  As I said, I rarely get sick, but I was not going to take any chances.  I went to my doctor.

He had told me that I probably just had some sort of infection going on, perhaps even a minor cold.  He was not concerned that this was a swollen lymph node because of its location.  He said that if it were located a bit higher he would be more concerned.  He prescribed an anti-inflammatory drug and antibiotic, and told me to get a lot of rest.  This was asking a lot of someone who exercised every day and was heavily involved in sports.  But I did as I was told.

After two weeks, the swelling did in fact go down and I resumed back to my normal activities.  Talk about being frustrated.  I had never been on any kind of injure reserve status before.  I jumped right back to the gym and resumed my workouts right where I left off.  Not smart at all, but I just felt good doing it.

Two days later, I developed a pain under my left arm pit.  When I extended my arm, I felt a pulling sensation.  I thought for sure I had strained something.  A co-worker had recommended that I see his doctor because he specializes in sports injuries.  I have only had two doctors in my life at that point, and though I had no reason not to go back to see my family doctor, I took Steve up on his offer to see his doctor.

Another family practitioner, he questioned why I was seeing him.  And I explained to him that I hurt myself exercising.  He felt under my arm, and examined the shoulder area as well.  Then he asked what I had been doing prior to the injury.  I told him that I was being treated for a cold, took a couple of weeks off and had just gone back to exercising, clearly using poor judgment going full tilt right away.  But as I told the doctor about that, he immediately felt around my neck and found the swollen lymph node I had just taken medication for.  The swelling had returned in just the two days off the medication.

He recommended that I see an oncologist – note – I had no idea what that was at the time, because he was concerned about the lump.  Me, I was concerned about the injury.  Long story short, and six second opinions later, including an oncologist, I was diagnosed with Hodgkin’s Lymphoma.

I hate telling this story, because the first thing that happens when I mention a swollen lymph node, everyone goes into a panic when they have one.  A swollen lymph node is doing what it is supposed to, handling bad stuff, sending it through your body to be handled and disposed.  However, it is when something is too much for that lymph node, everything goes wrong (I simplified that by a mile).

Bottom line, if you develop a swollen lymph node, let the doctor decide and diagnose.  But the trick is, you have to remember everything that you have been feeling up until that visit.  I am certain that I had more symptoms, but in general I am not a complainer.

The Facebook page Lymphoma And Hodgkin’s Disease Awareness And Survivors Club posted a list of symptoms to look out for, to tell your doctor, and to urge you to get the necessary diagnostics done, such as X-ray (although HD did not show up for me on x-ray), CT scans, or PET scan.  The diagnostic tools when looking for Hodgkin’s are much better than they were 25 years ago, but still require the patient to fill in the blanks so that the doctor goes in the right direction.

Here is they list of popular symptoms of Hodgkin’s Disease (and I must stress, having any of these does not mean you have Hodgkin’s – I am a horrible sweater):

1)  swollen lymph node in neck area, armpit, or groin

2)  abdominal pain or swelling

3)  chest pain, coughing, or trouble breathing

4)  fatigue

5)  fever

6)  night sweats

7)  weight loss

8)  itching

9)  alcohol pain following consumption anywhere in the body

10)  loss of appetite

I only presented one symptom to the doctor.  It is no wonder I was misdiagnosed.  But I do not fault him.  Hodgkin’s is a rare cancer, and unlike breast cancer which most family practitioners can at least have an idea of what to look for, most GPs do not, even to this day.