Understanding Survivor’s Guilt

This year, I will celebrate seven years of being cancer free. Diagnosed with stage 2b invasive ductal carcinoma breast cancer in 2014, I remember that day like it was yesterday.

That day, I was sitting on the exam table, swinging my legs listening to the white paper beneath me crinkle as I moved. My daughter was sitting across from me and we were having a nice chat. She was doing her best to keep my mind off what we knew was coming, a cancer diagnosis.

Within a few minutes, and after a slight rap on the door, the oncologist walked in. His hands held my chart and the look on his face was solemn. I knew he would confirm what I already knew in my heart, I had cancer. I was sure of it the day I felt the lump in the shower. As my soapy fingers traveled over a hard mass in my chest, I knew my life would be forever changed.

But when I heard the words aloud, I felt like I’d been branded. Each word forever seared into my heart and mind – “You have cancer.”

The words hung in the air with such palpability, I expected a guillotine to drop at any moment. They seemed to shout, “You won’t be here long!” but I was determined to live.

The doctor gave me a treatment plan. I went home and talked with my husband about each part. I prayed over each decision associated with my care and came to the decision to forego chemotherapy based on my Oncotype DX score. The doctor wasn’t happy about that but said it was my body and I could choose what I wanted to do. He also added, without following his exact plan of chemotherapy, radiation, and anti-hormone therapy, I might make it five years.

That news was unacceptable to me. I was bound and determined to live. I did a lot of research and decided to go a non-traditional route. I wanted to follow a holistic approach.

At the same time, a dear friend of mine received the news that she also had breast cancer. Our cases were almost identical with the same diagnosis and stage.

We chose different paths to fighting cancer. While I chose alternative therapy, she chose a more traditional route: chemotherapy, radiation and anti-hormone therapy.

At the onset of our diagnoses, we began keeping individual blogs and would often compare notes. It was a good way to stay in touch since we didn’t live close to one another, but as time passed, our roads took different turns.

My cancer journey was fairly smooth and easy, although I say that tongue and cheek because who can ever fight cancer and have an easy battle? It does a number on a person both mentally and physically.

I lost both breasts and eight lymph nodes to cancer. I’ve endured two surgeries and countless tests, scans and exams. Though I’m doing well, I’m still under surveillance and will be for the rest of my life.

As time went on, my friend’s path became increasingly rocky and more difficult. To date, she’s living with metastatic disease and is on the brink of death while I continue to thrive.

How does one make sense of such a debilitating disease? It’s like trying to put together a 10,000-piece jigsaw puzzle with no preview photo. And just when you think you’ve found an edge piece and have started to form the framework, a cat walks across the table and wrecks it all.

Why was I the lucky one? Why am I doing so well on my cancer journey while she suffers day in and day out?

Some would say survival has a lot to do with genetics or hereditary traits. Others might argue attitude plays an important role, but truth be told, I don’t think there’s a simple answer.

I am extremely thankful to be looking forward to my 7th “cancerversary.” I plan to celebrate big, but I can’t help but feel a twinge of survivor’s guilt. Am I an anomaly? Sometimes I wonder.

Knowing my friend’s death is imminent breaks my heart. I’ve tried to talk about it with family and friends, but they don’t understand. I don’t think those who haven’t been personally affected by cancer can grasp the concept of survivor’s guilt.

“Why would you feel guilty that you’re living?” my daughter asked recently. As I tried to explain the guilt I was feeling, she shook her head. She didn’t get it. But do any of us get it? Cancer doesn’t make sense.

Survivor’s guilt usually affects those who’ve survived a traumatic life-threatening situation. It’s a feeling of deep remorse some survivors experience when they live, and others die.

The term “survivor’s guilt” was originally used to help describe feelings Holocaust survivors experienced, but it may also be applied to many life-threatening situations, such as car accidents, wars, or natural disasters.

Survivor’s guilt, according to medical coding, falls under the umbrella of post-traumatic stress disorder (PTSD), but it is possible people can experience survivor’s guilt without having PTSD.

Survivor’s guilt can affect a person both mentally and physically. Some common psychological symptoms may include:

• An overwhelming feeling of helplessness
• Having repetitive thoughts about different scenarios and how certain actions could have produced different outcomes
• Flashbacks of the traumatic event
• Questioning why they survived, and others did not
• Irritability, mood swings or anger
• Fearfulness or dread
• Suicidal thoughts

Some common physical symptoms may include:

• Loss of appetite
• Insomnia
• Headaches
• Nausea or diarrhea
• Heart palpitations

Survivor's guilt is real. It can seriously impact a person’s life and cause debilitating side effects.

My friend currently fights for her life while I plan my summer vacation. She just had a tube inserted into her lung to draw off fluid so she can breathe. Her body grows weaker by the minute. As I think of the pain she’s enduring, I struggle. I am overwhelmed with survivor’s guilt.

Shouldering the burden of guilt is a problem none should carry, especially those who’ve already suffered through the trauma of cancer.

For those who have survived cancer, feelings of guilt may come and go. At times those feelings may be overpowering. There is help available. Many cancer treatment centers have counselors on site.

More than likely, we will never understand how cancer picks and chooses its victims. That’s why it’s so important to treasure each day of life we’ve been given. None of us are promised tomorrow.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.