I first heard the word “cancer” applied to me 22 years ago this week, in a radiologist’s room as she peered at the grainy images on her screen during a breast ultrasound scan.
That was a lifetime ago, on the other side of the globe, in Boston, America. In the intervening years, so much has changed.
I am often in a pensive mood this week in March, at the anniversary of my cancer diagnosis. I feel a mix of emotions – sorrow at the past suffering; empathy for those living with cancer and other life-limiting conditions; relief that I survived; gratitude for the health I enjoy today; and often, a residual guilt at being a survivor of something that kills millions each year.
Cancer remains a leading cause of death worldwide. According to the World Health Organisation, in 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths. The estimated number of people who were alive within five years of a cancer diagnosis was 53.5 million.
I was among the lucky ones who survived cancer. I was diagnosed in 2002, at the age of 33. I was in Boston doing my master’s, and had access to very good care and experimental treatments that turned out to be successful. Otherwise, I don’t think I’d be alive, writing this. Such is life.
Two decades on, I have integrated the cancer experience into my growth journey. I am quite a different person because of it. I do not wish cancer on anyone; but I would go so far as to say that while being a cancer patient was difficult, going through cancer can have many positive outcomes. It can even offer gifts.
While I use the somewhat controversial g-word in relation to cancer, I am in no way minimising the suffering and disruption that the disease can cause. Many people die from cancer, painfully. Some recover and never want to talk about it. Others make a career out of it – cancer survivors who enter the caring or medical field to take care of other cancer patients. Many others, like me, move on after cancer, but accept it as part of our lives that changed us. As a friend P put it, going through cancer taught her to be ready to support others in need. Lessons learnt are to be shared.
Here’s what having cancer taught me.
Accepting one’s limits
A cancer diagnosis stops you in your tracks.
I had quite a Type A personality back then – driven, controlling, impatient with delays and slowness.
Cancer strips you of a sense of control and makes you feel extremely vulnerable. You lie exposed in multiple scans and invasive tests. The treatment is debilitating. You lose your hair, you have weird-coloured pee, ulcers erupt everywhere, your energy levels plummet. You have no choice but to accept your physical limits.
Post-cancer, I made conscious decisions to step away from high-stress career roles. I chose to work on the features and commentaries desks, rather than the news desks. I was fortunate to have bosses who gave me roles I could do well in, but did not push me to take on more than I could handle. Meanwhile, I managed my own ego and ambition, and focused on being happy in the roles I had.
A friend, C, went through a similar transformation. “I adapted to a less stressful life as my world view shifted to treasure the time I have, invest in meaningful work and relationships and live life with no regrets.”
On accepting physical limits, she put it this way: “Cancer taught me to listen to my body – rest when I am tired, be kinder to myself and know it’s okay to not oblige or please people. Health is wealth. I have come across too many people who shared that they had symptoms or signs prior to seeing a specialist or being admitted for some condition, but they ignored it. I think it’s important for us to listen to our bodies. I am now much better at tuning into my body. I will ‘obey’ and rest when my body sends me signals.”
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Learning to face your own fears
Cancer – or any serious illness – forces you to face your fears of pain and dying.
As you feel angry at the way your body has betrayed you, your mind may go into overdrive, sussing out how to cheat death, how to outwit the illness, how to beat this new enemy. I often fight uncertainty with knowledge – and so I read up a lot on breast cancer. But reading about the worst-case scenarios, and knowing the details of how breast cancer can metastasise and kill, was too harrowing. This was not just head knowledge; I was reading about my possible future.
Despite my insatiable intellectual curiosity about life, I realised that there were some things I didn’t want to know, at least not at that point. I had come face to face with my own mental limitations. Many nights, as my active mind careened ahead of me into a catastrophic future, I would make myself stop thinking, wrestling the galloping mind to a halt.
The tools I used to bridle my mind were the time-tested ones used by generations of spiritual teachers. Meditation helps you silence the mind – sitting still and becoming aware of the breath brings your mind down from its self-induced terrors, back to the body, to be centred. Contemplative exercises like yoga and swimming were also useful. Practices like journalling, and talking to a therapist or empathetic loved ones, can also help.
When life’s terrors loom large in front of you, you can turn away in fear; you can rage and hope to bash your way through; or you can learn to turn towards the terror and face it. As you sit face to face with the fear, you may see its contours better. You see through the smokescreen that the monster of fear casts a bigger shadow than is merited, and that what you thought was a Woolly Mammoth is in fact a small puppy of whimpers that needs to be hushed by nurturing, not battled and bludgeoned to death.
After I found out the cancer I had was stage 2, and there was a good chance I would survive after five years, my mind went on to the future. What if I survived this bout of cancer, only for it to recur and spread?
Some nights, the terror solidified into a knot in my stomach that kept me awake, and I would lie in bed cold with fear. And then, one day, I decided to practise what I had read about, and do the counter-intuitive thing of leaning into fear, not running from it.
I methodically imagined myself being sick, having cancer again, and dying, painfully. I breathed through the rising sense of panic. I observed the thrashing of the heart, and the way the mind tried to skitter away from the thought of death. I gently – if one can be gentle when imagining oneself dying – observed my emotions and tried to keep calm. Over time, I could spend more time thinking about dying before the terror struck.
Eventually, I learnt to live with the fear of dying from cancer, and the fear of recurrence, holding it lightly without clutching at it, and without flinging it away. There is still discomfort – as I write this, there is a quaver of the heart. But it is not front and centre of my thoughts.
Death after all is part of the experience of living. Every day, 1 per cent of our cells die and are replaced. Scientists call this “turnover”. Tiny cells in the blood live three to 120 days. Cells lining our gut typically live less than a week.
In 80 to 100 days, so many cells die and are replaced, it is equivalent to being a new person.
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Midlife transitions – moving to that second mountain
When the past is over and the future is uncertain, you have only one option, which is to focus on the present and live in it. The Buddhists are wise in teaching the importance of living mindfully and being attentive to the here and now.
There’s the story of a boy caught on a mountain, with a tiger behind him and a tiger ahead of him on the path. He steps out onto a ledge, to find a peach hanging from the tree. He plucks the fruit and eats it with relish. Life is good. The past and future may be littered with tigers, but here at this moment, life is delicious and sweet. And when he finishes his peach and walks on, he may find that the tiger on the path ahead has wandered off, leaving the way clear. There is no point in dreading the future or letting the past trap us; the only reality is the present, and the key to happiness is to live in the now.
Over time, these practices I began during my cancer journey – of meditation, letting go, living in the present – became integrated into my daily life.
Moving on from cancer
Cancer is such a big experience, some people want to forget it and never talk about it again. Others stay stuck with it and remain a victim, or patient, long after the disease is gone. They stay in crisis survival mode, and may become over-vigilant about avoiding cancer risks. Family members may continue to mollycoddle the cancer survivor.
It takes discipline and courage to break out of that victim trap, and to reclaim your identity as a whole, healthy person (albeit living with limitations) in the land of the living.
One milestone event for me was the year I turned 50, when I overcame my limiting beliefs about my own physical fitness to take the Camino de Santiago trail. Together with a group of five friends from school days, we walked the last 120km of the famed pilgrimage trek in Spain. It took us six days through incessant rain, through verdant fields, up and down some hills, on cobblestones, through cow-dung-riddled villages. It was tough for me, but I made it. Since then, I’ve been leading a more active life.
This morning, on the 22nd anniversary of my life post-cancer, I am out on the nature reserve trail by 6.30am. The Australian summer is giving way to autumn. The air here in Perth is chill and crisp, a welcome respite from the 35 deg C heat of previous weeks.
My mind goes back to a lifetime ago, on the other side of the world, when I first found out I had cancer. I send my 33-year-old self a loving embrace. The cancer journey will be tough, but you will be fine, I say, adding a prayer for all others on this journey.
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