"So, how are you doing?"
Photo credit: Nicholas Kingston
People ask me this question every day. But not often in the usual way, where you're expecting to hear the person respond "Good!", "Not too bad!", or "Busy!" and everyone goes on with their day. When this question is posed to someone recovering from cancer treatment, it takes on a different meaning. What they are asking is some version of "How is the healing going?", "How is life after cancer?", "Are you still dealing with side effects?", "Can you give me some more information about where you are right now so I can figure out how to be there for you?", or sometimes "Are you all better yet?".
The question doesn't bother me at all - on the contrary, I always see it coming from a place of genuine interest, love, and concern. What bothers me is how I never know how to answer it. When I don't feel like figuring out how to answer it, I usually just say some version of "Good!" or "Getting better every day!" - which is definitely true - it's just not the whole truth. For a recovering cancer patient, the answer is often "it's complicated."
So when you ask me this seemingly basic question, here's what's really running through my mind...
I feel AMAZING compared to how I felt this time last year, or even a few months ago. I can clearly see my progress with healing week over week, and know that I am getting healthier every day. I'm going to the gym a few times a week, eating well, and am not feeling sick every day.
I also feel frustrated that I'm not back to "normal" yet. I still get tired easily, I can't do some activities I used to be able to do, and I'm doing the lowest weight, most basic things at the gym.
I feel strong and resilient and beautiful - I'm in awe of my body and how it's healing itself from the sustained, massive assaults it endured for a year. I've gained about 15 lbs of the 20 lbs I lost, my skin is becoming healthier, and I'm not constantly aware of my implants or radiated skin.
I also feel like a bit of a freak with body parts that are "fake" and don't feel or move or function they way they used to. I feel self-conscious in this new body, and sometimes feel frustrated when it doesn't work the way it used to.
I feel motivated and excited to be working, and I'm so excited to have a longer attention span to be able to read and write regularly again.
I also feel overwhelmed because my brain doesn't function the way it used to due to lingering chemobrain. I can't multitask, and there are some days where I can barely work because I can't focus. I'm frustrated because I don't know how long it will last.
I am in a much better place emotionally and psychologically than last year. The amount of dark days I experience are far fewer and I feel grateful for my positive outcomes and optimistic about the future.
I also still deal with anxiety, particularly when the chemo-brain side effects are bad, I get a flashback from a traumatic part of treatment, or I'm experiencing something for the first time since I started treatment.
I am ecstatic to be finished with treatment and able to move on with the rest of my life.
I very much still feel like a patient. I had an echocardiogram this week to make sure my heart is still functioning normally, since my treatment put me at risk for heart issues. I have my 3-month follow-up with my oncologist next week to talk about my progress, lingering symptoms, and advances in treatment to consider. I go to physical therapy weekly and do my PT stretches and exercises every day. And while I have made incredible amounts of progress in healing this summer, I am still living with the physical and psychological aftermath each day.
So yeah, it's complicated.
I certainly am not sharing this to deter you from asking me or any other cancer patient how they're doing. I just wanted to share the reason behind my pause, my short answer, or my long-winded answer to this question and to give you some insight into some of the things your loved one may be experiencing post-treatment.
Checking in with a friend or loved one who's going through or has been through treatment is a great idea and it shows that you're thinking about them and care about their well-being. Just know that sometimes the answer is complicated.
Here are some tips for having the conversation:
Be specific with your question to make it easier to answer. Like, "How are you doing today?" Or "I remember you were struggling with chemobrain a lot last week, how are you feeling now?"
Follow their lead. If it seems like they want to talk or vent, let them know that you're here to listen. If it seems like cancer is far from their minds or they need a distraction, share what's going on in your life or a funny story from the week. Sometimes they may need to/want to talk about it more, and other times they may just want to feel "normal" and not like a cancer patient. Let them know that you're okay with either option.
If you're not sure, check in with them and ask them what they need right now. Do they just need a listening ear? Do they need someone to validate that what they're feeling is normal? Do they need a distraction? Do they need a pep talk? Do they need advice? We get a lot of unsolicited advice and a lot of pep talks as cancer patients - so it's always good to check in to see if that's what the person actually needs at the moment. Sometimes I don't need the person to come up with a solution, I just need a hug and a "yeah, that does suck. I'm here for you."
Don't take offense if they don't want to talk to you about it. Most likely, if they don't want to talk about it with you, they're either not ready to, they already have that need fulfilled, or they just want to focus on other things at the moment.
Remember that it's not over when treatment is over. Some people are on additional medications or therapies for years or decades after their initial treatment. Others deal with side effects for months, years, or for the rest of their life. Some live with cancer for most of their lives. The memories and trauma of what they've gone through can last for a lifetime. Navigating life post-treatment can be lonely for some people, so remember to demonstrate your interest in their wellbeing even after treatment is finished.