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.
My partner he’s just ultra-positive. He’s the most positive, so positive to the point where it’s “Are you serious? This actually sucks, there are bad things happening here too.” But it’s okay. He’s really upbeat and optimistic and fun and he looks at the best case scenario and is really big on not letting your mind wander onto the "what ifs" which it happens sometimes.
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.
I went once but, they were lovely very welcoming. Probably, well the majority seemed to be in their mid 80s and they had known each other for a very long time and had had this group for a very long time. So they were all “Oh we hope you’ll come back.” Because they realized that they were very insular but they were very complete.
Some women also benefited from professional psychological support and from support groups organized specifically for women with breast cancer.
When I was informed that my cancer had spread to my bones, I was scared. I was really scared. I thought about death. During many months, I had to get use to the idea that death could come sooner for me than for others. That was haunting me a lot at the same time, because the pain was there, it was always there. So this… It intensifies the thoughts when you are in pain.
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.
One thing that I did, I had a friend who was a psychologist and she said if I wanted to that I could come to see her and she would help me with the meditation. She walked me through a meditation to do. I could do it any day but especially to do before I went to my chemo. I did that religiously before my chemo and quite often in between and maybe a shorter version.
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.
One of the other things was I did a lot of visualization and one of the things that I did with visualization was when I had the tumour removed. I actually had visualized that that was all the cancer that was in my body and that was what was coming out. After my surgery, I actually considered myself to be cancer-free.
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.
Ginette: Well I must also say that I am a religious person and at some point in time, it must have been a year and a half for sure, that I was always into this, and then it was the radiotherapy, and in radiotherapy the staff was amazing! (It is at the hospital), the radiotherapy, fantastic! Compassionate! Really…
I’m a very spiritual person so during the time that this whole thing happened, it was very scary. I just prayed a lot. I meditated a lot, gave me a lot of strength. There was a real miracle that I felt that happened to me during surgery. Two days before my surgery I wanted to see my previous doctor. She had been our doctor for almost 30 years, Dr. (name) and she was a wonderful doctor.
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.
I had been away from the church for a long time. I’m a Catholic, Roman Catholic, and I had just decided a few months before that that I wanted to go back to church and I did. I have since discussed that with the man who was my pastor. Not long after that I went to a church near here, and then one even nearer after... which I didn’t know about, I didn’t know about the one I’m at now.
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 I go to sleep I think of it and then I tell myself look just push it away. Push it away from your brain try and think of something else. And I try to think of something else or something nice or my grandchildren what I can do for them and that’s until I fall asleep.
When Melissa found herself dealing with worrisome thoughts she would acknowledge them but then put them aside to prevent them from becoming overwhelming.
I wanted like… not ignore, but like it didn’t exist… Continue to live because… I was afraid that it would take over or unduly… I tried not to panic, not to become hysterical, and mainly, that it didn’t take over, that it didn’t control me, that I do not become only this. It is part of life but it’s not life.
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.
I was in the store one day, I was in the drugstore with my daughter and because I didn’t have any feeling in my fingers I drop things, right. So I got my wallet out and it fell to the floor and I bent over to pick it up and my wig flipped off. And I stood up and just the look on the person’s face that was standing behind me.
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.
I’m a mom. I have a full-time job. I have a spouse who sometimes doesn’t understand things and there’s a lot of other women or other caregivers who are in similar situations and I think that it’s really important that we all understand where everybody’s coming from. Especially because there is a tendency for women to want to do it all, be it all and there’s a... I think it’s a picture.
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.
Oh yes, yes! You have to be patient with the people… because when we are… we have this sickness, we become… I don’t know how, we confine ourselves, we feel like… not alone but angry. We say to ourselves: “Why us?” “Why us?” And it is good to be surrounded. It is good to be well surrounded and that they… Those who harass us with positive thinking, it is what I… This is what displease me a little more, it is when they start to… The people start to say: “No, but you must think positively. You have to be positive!” No, no. It’s all very well saying these things when you are on the other side of the barrier. But when you are really living it it’s normal to think about death, it’s normal to think about relapse, it’s normal to say that I am fed up, to be angry and to be depressed at times. You must not add to it by making the person feel guilty. “No, you have to be… No, you have to be positive.”
Yes… How do they say that, half of healing… 50% of healing is the morale. You can be depressed and pessimistic and heal! And optimistic, you do everything and that’s it! So there is nothing! There is no general rule, everything is… Each person is different; your own cancer, your own response, your own feelings, your own… And look how he is… You must not put everybody in the same boat and say… No, you must be positive. It gets on my nerves.