The Dark Side of the Cancer Survivor

There is never a good way to begin a difficult cancer blog topic; unfortunately, there isn’t a shortage of tough moments and sad stories relating to cancer. Patients die way too early. Scan results come back with disease progression. Spouses are widowed. Families look to continue the mission a loved one started before cancer took another life prematurely. The ups and downs of directly dealing with treatments and their results are fairly straightforward, if not always pleasant.

Dealing with unhappiness, though? The mental toll that has been (and continues to be) paid? Maybe depression, or residual… something? That is much more different and difficult essay — ESPECIALLY considering the unbelievable recovery I continue to make. How can a patient articulate internal struggles when so much is going right in their world — cancer and otherwise? How can someone even FEEL that way when so many others did not get the same medical response?

This may have been the toughest blog to pen in three years. Below is an assortment of thoughts pieced together from as far back as last summer, put to paper at darker moments and finally collated into something slightly readable. Call it the Dark Side of the Cancer Survivor. 
[T.J. Side Note: things have gotten markedly better — more on that in a follow up, coming soon]

I should be the happiest person on Earth. And I am not; or, at least, have certainly not felt like it, nor acted like it, on too many occasions spanning too long a time. I have not brought happiness to the ones who should be most overjoyed about my recovery — Jen, Josie, and Tommy. The fuse has gotten noticeably shorter; the patience level is at an all-time low. Little things provoke significant (over)reactions. I am being too tough on the kids, particularly Josie, and worry about how that affects their upbringing. I am driving Jen a little crazy. I have brought tension to the team I volunteer with for A Prom to Remember, needlessly fracturing relationships.

Certainly all friendships and relationships go through trying times. Being Irish-Italian Type-A’s, Jen and I are both a little pre-dispositioned to butting heads instead of standing down. So it is not ONLY cancer that serves as a flint in our marriage. Sometimes, though, I wonder how these three years have taken their toll in ways we cannot understand or explain. You start to worry if the experiences or the medications or the stress, or all of the above, have altered each of you in some irreversible way.

I do smile, a lot. I am able to keep myself mostly focused on the glass being half-full. I haven’t (yet) dwelled on the negative of my medical challenges. But that adversity has seeped into other areas of our lives, a reminder that cancer can be toxic to more than just your cells. It is easy to project positive light in the blog, making each post arrive at the silver lining by conclusion. If only day-to-day lives went that way, all our problems solved and lessons learned in a 30-minute Modern Family-style sitcom.

That’s not how it always unfolds, though. Fights happen. Feelings get hurt. Scars form. Some memories become tainted pictures, instead of beautiful portraits of bonus time granted. The list of good memories* is added to, another chance to create memorable chapters hung with an asterisk.

I’m thankful. Extremely fortunate. Grateful to be able to spend time with my family. Blessed to embrace challenges and tell the tale of survivorship. But happiness? It has become an “event” more than a state of mind too often this fall. I am left with periods — sometimes long ones — of wondering what the hell is happening. Feeling empty. Unfulfilled. In the words of Steven Wright, “Depression is anger without enthusiasm.” I hesitate to put any labels on my last few months, particularly knowing many do suffer from real clinical depression that eclipses whatever I’ve gone through. But there has been a real absence of that something that makes one feel truly alive.

This all sounds almost silly to write, embarrassing even. [T.J. Note: especially after just spending a few days with the family members of melanoma patients no longer with us] Part of the reason — a big part, actually — to publish something so negative is that I can’t possibly be the only one to go through the physical rigors of cancer treatment, only to come up somewhat short on the mental side. I shared this with other patients and found quite a few are in the same boat.

Many had similar stories of projecting happiness to anyone asking, but being conflicted internally. Marriages struggled (and quite a few dissolved). Caregivers shouldered enormously difficult burdens, ones that would constitute unfathomable conduct in “normal” life but are apologized away due to circumstances. The stories come from different ages, walks of life, and treatment protocols (seemingly removing the possibility, however remote, that a checkpoint inhibitor somehow caused mental health issues). In short — no matter how tough you may be, or think you are, staring into the abyss scars everyone, each in their own way.

A friend’s sister battling colon cancer once told me, “It sucks to think about what will happen if I am gone”, a sentiment I have pondered for 42 months. Sadly, her husband and two little girls are finding out right now what this entails, their Mommy a cancer causality at 46 years old.

Fears manifest themselves in a myriad of ways — the criticism of a spouse, the short temper with a child, the criticism of a colleague. The regret of a part of life not appreciated, carpe diem missed. The unspoken worry of future uncertainty, FOMO personified.

Death pretty much sucks. And if that becomes your focus… life can suck sometime, too.

Coming in the next week(s) — Snapping Out of the Cancer Funk.
T.J. Sharpe writes the Patient #1 blog on detailing his three year journey through Stage IV melanoma, along with presenting the latest in oncology and immunotherapy.

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