The Emotional Battle Beyond Chemotherapy
I sat cross-legged on my sofa, fighting waves of nausea that threatened to overwhelm me. Several rounds into a brutal chemotherapy regimen, I had managed to prepare a simple lunch of plain white pasta—the only food I could possibly consider eating. Yet now, I found myself locked in a mental tug-of-war, knowing I needed nourishment but struggling against debilitating sickness. Just as I gathered the willpower to take that first bite, my phone shattered the fragile concentration.
Glancing at the caller ID, I expected to see my oncologist's office, the hospital billing department, or perhaps my health insurance provider. Instead, a friend's name illuminated the screen. With relief, I answered the call.
"Emma!" my friend announced brightly. "I hope I'm not interrupting, but I just read something online about pasta. Did you know it actually feeds cancer growth? I wanted to warn you immediately so you can avoid it!"
I stared at the food before me. Mere moments ago, it had represented my only possible sustenance. Now, according to this well-meaning friend, it had transformed into what amounted to cancer fuel. This devastating moment occurred during the evening following my first round of chemotherapy in December 2018, marking just the beginning of what would become a pattern of unsolicited opinions about my illness.
The Burden of Explanation
When I received my diagnosis of aggressive breast cancer at age 29, I never anticipated how many people would feel entitled to share their theories about my condition. Friends, family members, and even complete strangers began posing confrontational questions: Had I consumed excessive red meat? Too much sugar? Was I—heaven forbid—chronically stressed? Each inquiry carried an unspoken implication: if only I had avoided certain behaviors, I might have prevented this life-threatening disease.
Initially, I rationalized that people didn't intend to hurt my feelings. Perhaps they simply sought tangible explanations for why a seemingly healthy young person would suddenly face such a devastating diagnosis. I, too, wrestled with self-blame, wondering if I had somehow caused my own illness. However, my oncologist provided crucial reassurance: nothing I had done could have directly caused my cancer.
We understand that certain risk factors correlate with higher cancer probabilities, but only some fall within our personal control. Environmental hazards and genetic predisposition significantly influence cancer likelihood. Despite our deepest wishes, avoiding known lifestyle risks cannot guarantee protection against cancer development.
The Social Judgment Intensifies
Nevertheless, maintaining perspective grew increasingly difficult while enduring what felt like widespread social judgment. I began avoiding social situations altogether, fearing questions about my occasional glass of pinot noir or scoop of chocolate chip ice cream. The unwanted commentary extended beyond me personally—one acquaintance asked my mother if I had eaten excessive meat. Upon learning I had been vegan for years, the woman completely reversed her theory, declaring I must have consumed too much soy instead!
During a visit to my parents in England, a neighbor waved us over for conversation. "You look well, Emma!" she remarked before turning to my mother. "This is all your fault, you know, Jane! You must have passed down those problematic genes."
Another pervasive theory suggested cancer stems from unresolved trauma or suppressed emotions. Countless individuals recommended I read "The Body Keeps The Score" by Bessel van der Kolk. While not specifically focused on cancer, the book argues that trauma and chronic stress can weaken immune systems and elevate stress hormone production, potentially increasing illness risk. This perspective proved particularly challenging to dispute, both with others and within myself, given my history with antidepressants and mental health struggles.
Questioning Treatment Choices
Judgment extended beyond cancer causes to treatment methods. I received emails attempting to dissuade me from chemotherapy, with claims it was unnecessary. Former college acquaintances—people I hadn't spoken to in years—slid into my direct messages, casually inquiring about my health before promoting their miracle herbal supplements or antioxidant mushroom powders.
It wounded me deeply that individuals sought to profit from my illness. Rather than feeling supported, I expended my already-limited energy trying not to offend misguided advice-givers and modern snake-oil salesmen. Once, while hospitalized with a fever, a nurse attempted to convince me against radiation therapy. "Just research it," he warned. "I had a girlfriend who underwent radiation, and it made her breasts rock hard. You definitely don't want that at your age." Barely covered by a flimsy hospital gown, I felt completely exposed—especially since radiation wasn't even part of my treatment plan!
Understanding the Psychological Drivers
Victim-blaming represents an unfortunate byproduct of the just-world fallacy—a widespread cognitive bias leading people to perceive the world as fundamentally fair, where good behavior yields positive outcomes while "bad" behavior brings negative consequences. Our typically chaotic existence drives us to seek order and predictability as psychological Band-Aids.
I gradually realized people weren't solely concerned about my health but their own as well. They seemed to believe—consciously or unconsciously—that if they could determine why I became ill, perhaps they could avoid similar fates. Since my diagnosis, I've spent years organizing meet-ups for other young breast cancer patients. Time and again, I hear my experiences echoed among peers. I've lost count of how frequently I've reassured newly diagnosed individuals that they bear no blame for their illness.
The Tragic Reality
Tragically, I've lost several friends to metastatic breast cancer. These were women who did everything possible to treat their diseases—consuming healthy, home-cooked organic meals, exercising regularly, avoiding alcohol, participating in support groups, attending spiritual healing retreats, taking supplements and vitamins, and enrolling in clinical trials. Each underwent every available medical treatment. Now, whenever I hear someone parroting tired cancer myths, I feel profound anger on behalf of my friends and all those who've lost their lives to cancer.
If prevention were as simple as limiting risk factors, my friends would still be here. Statistics reveal young adults face higher cancer diagnosis rates than ever before. Cancer among young women has skyrocketed particularly, with diagnosis rates in women under 50 now 82% higher than their male counterparts. Several theories attempt to explain this alarming increase—including modern diets, antibiotic exposure, microplastics, and artificial light—but currently, no definitive answers exist.
Some oncologists observe that cancers affecting younger patients seem to defy explanation, striking individuals far more health-conscious than previous generations. Researchers at Memorial Sloan Kettering Cancer Center even explore whether environmental exposures present since the mid-20th century might bear partial responsibility.
Limited Individual Control
If rising diagnosis rates relate to our progressively toxic world, the sad truth is we possess limited power as individuals. We cannot protect ourselves from every environmental exposure, many not yet fully understood. You might eliminate all sugar and plastic containers, but you cannot change your hometown's air quality.
My community work has taught me that cancer patients' emotional needs vary as widely as people themselves. If uncertain what to say—or not say—to someone with cancer, I believe simply asking what support they need represents the best approach. If they want opinions about staying cancer-free, they'll likely request them. Otherwise, please trust their oncologist has matters covered.
Moving Forward with Resilience
My cancer now remains in remission, and I've developed thicker emotional skin. I've learned that not everyone knows how to communicate with sick individuals, and even the most misinformed advice typically comes from people who genuinely believe they're helping. Still, I wish people had spent less time policing my plate and more time providing emotional support.
I long for the day when newly diagnosed individuals don't find themselves suddenly responsible for explaining their illnesses. When, instead of hearing "Why did this happen to you?" they only ever encounter "How can I be there for you?" So please, don't ask me if I still drink wine. You probably won't appreciate my answer.
