Women used a wide variety of strategies for coping with their cancer experiences. Some of these strategies involved practical measures. Other coping strategies were connected to adopting attitudes and ways of thinking about their circumstances. For some, faith and spirituality were important elements of their journey. Coping strategies could thus involve both support from external sources and/or drawing on their own inner resources.
Changes to daily life
Being in treatment for cancer meant important changes for many women in their day-to-day life and finding a new balance that included living with cancer. Or as Isla said “I could do kids and cancer or work and cancer but I couldn’t do kids, work and cancer.” Women described having to take a step back from certain activities to be able to deal with their fatigue, for example, and the number of medical appointments that had to be attended. This meant that women were spending less time with their children, their work, or for example with their hobbies such as playing a musical instrument. Even though the nature and intensity of activities had changed, women also continued looking for normalcy and alternatives to replace the activities that they could not do anymore. For example, Nalie could no longer stay out late at night with her friends, but could still go out for dinner. And Kathryn spent more time going to the movies.
Support from others
Whether formal or informal, support from others was an important part of many women’s cancer experiences.
Other women drew support from communities they belonged to prior to their diagnosis. For example, Julia had an established mindfulness meditation practice before she was diagnosed with breast cancer. She was able to draw on both the practice and the community for support throughout her experience. While Julia did attend a breast cancer support group one time, it was not the right fit for her.
Some women also benefited from professional psychological support and from support groups organized specifically for women with breast cancer.
Support from others could also take the form of animal companions. Kathryn has a dog that is an important part of her support system. As she explained, having a pet not only provided her with constant companionship, it also required her to stay connected to something outside herself.
A number of women engaged in practices that helped them cope with cancer and restore a sense of wellbeing to their lives. These included yoga, meditation, relaxation and visualization. In addition to reducing stress and anxiety these practices allowed women to have a more positive experience of their bodies and a focus on wellness. They could also become part of a structured routine which many women found helpful. For example Julia found it to be effective in warding off anxious thoughts which tended to surface in the middle of the night.
Visualization or guided imagery was another practice that some women found helpful. Visualization is a technique that uses the imagination to control images in the mind, helping to reduce stress and anxiety.
Wellness practices could also be simple, obvious everyday things. As Margaret pointed out, when she was dealing with extreme nausea following chemotherapy “If you can get outside in the fresh air and walk and do something that helps greatly. I’m a big believer in that, I mean even now I try to walk every day or do something every day to stay fit and stay active.”
Faith and spirituality
While not all women had religious faith or spiritual beliefs, some did and for these women faith and spirituality were an important part of their journey. Several had experiences that made them feel as if someone were watching over them.
More generally, women who had religious or spiritual beliefs were able to draw on these throughout their cancer journey as a source of strength and to help them cope.
Attitude and ways of thinking
Many women found that working to adopt particular attitudes and ways of thinking was an important part of coping with their cancer experience. Maintaining a sense of humour, taking “baby steps,” giving themselves permission not to be “superwoman” and to feel whatever they were feeling, and trying to maintain some sense of a normal daily routine were among the most common strategies.
There were also times when women coped by deliberately not thinking about things, or by choosing to push away negative thoughts.
When Melissa found herself dealing with worrisome thoughts she would acknowledge them but then put them aside to prevent them from becoming overwhelming.
Given that cancer is a serious illness, it might seem surprising that humour was an important coping strategy for many women. However, as Shelley maintained, “It takes so much energy to cry and be angry versus to laugh and say whatever and move on, try something different.” Donna found that laughing at the absurdity of situations provided relief from the side effects and consequences of treatment.
While it was important that other people acknowledged what women with breast cancer were dealing with, such acknowledgement could be unwelcome when it came across as pity. Joanne remarked: “I go to the grocery store you know or to a family function and everybody is pity, pity, pity.” When Joanne’s technician asked her if she had any breast complaints during screening she answered “Besides the fact that I only have one?” to try to make light of the situation.
Another strategy that was helpful for some women was learning to take “baby steps.” Debbra reminded women that cancer treatment is a long journey with many stages. Focusing on one step at a time could make things seem more manageable. Women talked about expectations and pressures to be ‘superwoman’, often times coming from within.
In a similar spirit, several women pointed out that dealing with breast cancer is a genuinely difficult experience. Sometimes it will get the better of you and it is important to remember that this is a legitimate way to feel.