Bladder cancer is not just a condition of the bladder. It is a condition of the spirit. It has ripped away my confidence in the reliability of the universe. It has created a sense of vigilance and a sense of vulnerability that, frankly, have undermined the quality of my life.
Like many people with cancer, I have struggled with depression since my diagnosis. Last year, around this time, I was hit by an avalanche of anxiety. I’ve always contended with depression and anxiety, but after cancer it has been much harder. Sadly, I am not unusual.
In 2013, the National Comprehensive Cancer Network, the group that has developed the gold-standard guidelines for treatments of all cancers, issued a guideline for Survivorship. They have recognized that my bladder isn’t the only thing affected by cancer.
My mental and emotional wellbeing have been compromised, and my sleep has been critically interrupted. Last year at this time, I could sleep no more than 3 or 4 hours at one time, and that was with Ambien onboard.
Sleep problems impact every other aspect of your health, from wellbeing to cognitive function to tolerance of pain.
My concentration has been poor. I have felt fatigued. I am less resilient. I am more anxious. This, my friends, is what cancer does to a person.
Up to 50% of those of us with cancer struggle with sleep. Insomnia and other sleep disruptions can be caused by certain types of tumors, by the effects of chemotherapy and radiation, and by the psychological impact of a diagnosis.
Sleep disruptions, in turn, undermine the immune system, making us less resilient to face our disease and our treatments. A high-functioning immune system is also necessary to defend the body from cancer cells.
And yet, doctors under-prescribe medication to treat insomnia. My GP told me he couldn’t continue to prescribe Ambien, at which point my anxiety just about took me under.
This prompted me to see a psychiatrist who is managing all of my medications for anxiety, depression, and insomnia. I am grateful every night that he understands the importance of sleep to my wellbeing. I see his name on my pill bottle and just say a word of thanks to the universe.
My urologist treated my cancer from August through November the year I was diagnosed with surgeries and medication. He now monitors my status carefully. But, that’s not enough.
Survivorship is about more than surgery and treatment. It’s also about wellbeing and quality of life. Sleep is a critical part of the equation.
Facts in this piece are based on an article by D E Theobald, “Cancer pain, fatigue, distress, and insomnia in cancer patients.” You can find it here.
The NCCN Guidelines for Survivorship can be found here.
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