How many times over the years have patients – not infrequently shaken to the marrow by their diagnosis and its implications – reinforced the very point so feelingly made by Dorothy. As another patient put it to me, “In the early days of diagnosis and treatment I seemed to live in a kind of ‘time warp’. All of those normal ‘markers’ of everyday life upon which I had depended so much just seem to vanish overnight and I was left to manage a state of existence and worry, for which I was totally unprepared”. He readily acknowledged that in the early days of illness he had been “buoyed up” and carried along by loved ones, healthcare staff and “all the ‘to-ing and fro-ing’” of regular clinic attendance. “But none of that” he added “could make up for what now seemed to have gone for ever: then adding, “And when at length my treatment ended, to be honest, at first I felt somewhat abandoned”. In the event – and because his prognosis was good – he did in fact go on to make a real ‘fist’ of things and (to the best of my knowledge) is now working full time, still symptom and most probably symptom free.

It is not uncommon, once treatment and regular surveillance requiring clinic attendance comes to an end, for there to be a void which fears and uncertainties about, so it seems, almost anything and everything are only too ready and willing to fill. Moreover – and such is the undeniable nature of a few types of malignant illness – the disease fan sometimes reoccur, even after prolonged periods of seemingly good health. Thus the psychological pressures on cancer patients and their families, even where treatment has been successful and is ended, are often never very far away.

In reality, there is so much to learn from the “Dorothy’s” of this world and all who like her have had their personal (and sometimes marital, domestic, social and spiritual) worlds turned upside down. For one thing, cancer may well change the way in which people feel about their own bodies. It runs something like this: If I had no idea about my cancer until the searing shock of diagnosis, how can I – even though now symptom and disease-free – ever be sure that it will not return? For another, it can – sometimes favourably, at other times adversely – affect relationships where confidence and trust are of the essence. If all or part of the above is ‘ringing bells’ for you then I would simply say, “Join the club!” (Even although doubtless it is a club that you had no inclination or desire to become remotely associated with in the first place).

Another test comes when people you know to be intelligent, sensitive and caring, come up to you and say, “Sorry to hear you have been ill. Are you better now? As if it were somehow akin to dealing with a severe attack of migraine. Oh, you may very well respond cheerfully enough but isn’t it often all a front? not unlike the “Western set” in an old ‘movie’; you know the kind of thing: a door and window; the fascia of the saloon and sheriff’s office, but behind the celluloid, only prairie! (C) SB.