Fear and resilience

It is a tumultuous period from diagnosis to mastectomy, a dreadful life-changing journey for some of the hardest-hit breast cancer patients. For them, it requires resilience, a tightly knit support system, and a calm head – steady in faith, and accepting of the outcomes.

It is either that or death. Especially for those patients whose diagnoses came long after the disease had taken root in their bodies, and those whose age and underlying medical conditions may impact the taxing chemotherapy treatments or their ability to cope mentally.

Yet, with the incidence of breast cancer in Jamaica rising, from 43 women per 100,000 of the population in 2010 to to 56.8 per 100,000 in 2018, it is a road many Jamaicans, particularly women, must take. One that changes their psyche forever.

“When you think about chronic illness, the first thing that greets us is fear; and it is fear that paralyses us,” noted Dr Janine Morris, a psychologist at the Cornwall Regional Hospital in St James. “There is a lot of fear and anxiety and because of that, a lot of people tend to avoid screening, rather than face it.

“As women, we know that our appearance has much to do with our self-esteem ... . So first thing is ‘Am I going to have to lose my breast?’ or ‘If I have fake breasts, or if I have implants, how am I going to survive?’, ‘Is my husband still going to find me attractive?’, ‘Am I still going to feel sexy about myself?’”

The psychological problems fester more based on those women’s position in society, and more so if their careers cause them to interact with the public, added Morris, noting that chemotherapy and radiation treatments come with weakness and their own set of bodily changes that will inevitably affect a woman’s self-esteem.

VERY DEBILITATING

“Those are things that are very debilitating as a woman, emotionally and physically,” said Morris, who was speaking at a breast cancer awareness forum put on by the Sarah’s Children advocacy group last week. She said these are some of the factors that push women to stay away from regular screenings and check-ups.

Jannette Kaloo, breast cancer survivor and founder of the Jannette Kaloo Breast Cancer Foundation, said she can attest to Morris’ statements, having battled stage two breast cancer after turning a blind eye to an increasingly painful lump in her left breast 10 years ago.

“Breast cancer didn’t cross my mind and I wasn’t educated about the disease. I was young, I was doing well, and I was living. So when I felt that small lump, I didn’t pay it any mind,” she said, noting that for about a year she remained nonchalant about her predicament.

It was only after a co-worker accidentally hit her on her breast that she fell to the ground in pain. It was then that she was taken to hospital and after a series of tests, she was diagnosed with the disease.

Days later, she was undergoing surgery to remove the breast, Kaloo said.

It took some persuasion for her to tell her relatives and children about her condition as she was fearful of any change in their attitudes towards her. But she said that her support system proved invaluable in the long run.

“The whole diagnosis is like one day you are on your feet, and the next day, your life is flipped upside down, everything around you is just so dark. You are in this room and absolutely nothing is working for you,” she recalled, noting that within a week, she had found a surgeon and was prepared for the operation.

‘I isolated myself ... and cried.’

“By that time, I knew that I was going to lose my breast. The lump was so huge and you could see it even under my arm, and I was in so much pain,” she said. “It was rough. I had just turned 39 and I got diagnosed three days after my birthday. I isolated myself in the room and cried.”

Kaloo said when she woke up from surgery, she was greeted with a room filled with doctors and her relatives, which made accepting herself with one breast a little easier.

“I would tell anyone going through it just to have faith and remain positive. That is the most important thing,” she said, noting that her foundation will embark on a slew of initiatives for October, which is celebrated as Breast Cancer Awareness Month.

In the meantime, Dr Delroy Fray, clinical coordinator at the Cornwall Regional Hospital, noted the prevalence of younger persons developing breast cancer symptoms.

“When I was an intern in 1985, the patients that I saw for breast cancer were in their early 50s, going up into middle age. Now, most of the patients that I’m seeing are in their early 30s – ages 35 going on into their 40s,” offered Fray.

“From January 1, right up to the end of September, I diagnosed 19 patients, and of those patients, only five of them had early disease that you could intervene right away.

“The other 14 patients required chemotherapy before treatment. These patients were presenting locally advanced breast cancer; big mass with auxiliary back end notes. So we had to send them to chemotherapy,” he explained, emphasising that there seems to be an epidemic of the disease and that there was one critical question to ask: “What is causing this?”

corey.robinson@gleanerjm.com