Five Tips for Surviving Cancer Abroad, Alone and in Your 20s

When I received a call from the hospital the day before Halloween asking me to come in tomorrow, it now seems stupidly naive to have assumed that I was being invited for a routine appointment. I wasn't ready psychologically or practically to be told that I had cancer.

1. Be prepared. After visiting the doctor for a routine repeat prescription, I didn't expect to leave with a referral for an ultrasound of my thyroid, which apparently seemed unusually large. Whether out of kindness or genuine belief, everyone remained positive - the ultrasound technician who stated that the nodules on my thyroid 'were not necessarily cancerous' and the doctors at the biopsy who were only concerned by the size of the nodules. When I received a call from the hospital the day before Halloween asking me to come in tomorrow, it now seems stupidly naive to have assumed that I was being invited for a routine appointment. I wasn't ready psychologically or practically to be told that I had cancer. As the doctor unloaded this information and asked if I had any questions, I didn't have a rational and emotionally calm person accompanying me, who would remember the important details and be ready with a useful response. Always expecting the worst is clearly not a healthy way to live life, but if a friend asks whether she should come along to your appointment, say yes.

2. Be understanding. After my cancer diagnosis I didn't turn down the offer of company during hospital visits. For those early appointments I was fortunate enough to be joined by my closest friend. She even stayed for hours in a cramped waiting room while I lay unconscious in surgery. My parents flew over from the UK to Montreal, Canada with just a week notice of my surgery date. But when the operation was done and I was supposedly recovered, people returned to their own lives and I found myself uncomfortably alone. My cancer treatment unfortunately came at a time of job and immigration-related insecurity, and my troubles began to feel like a burden too big to bear. When I lay still for hours wrapped in linen like a mummy in a CT scan tomb, a camera claustrophobically close to my head, there was no one waiting to ask how the scan went. Another friend later told me that we each carry a bucket with us, and this bucket can only hold so much of our own troubles or anyone else's. As devastating as cancer is, it can be easy to forget that there may be others struggling with their own over-flowing buckets.

3. Be imaginative. When you meet a friend or worse an acquaintance at a party or another purposefully upbeat occasion and they ask how you are or what you've been up to, you're probably not going to want to reply with 'well today I discovered I have cancer' or 'today I cried after being told again that I can't have the treatment I need'. Even if it took all of your energy to come to this party and you really don't think you have anything positive to say, use your imagination. Tell someone you're going to Hawaii next week if it will prevent another public display of tears.

4. Be patient. Having my thyroid removed and taking a new prescription meant that my body was going through some changes. Despite the intense fatigue, it became impossible to sleep at night. Heat intolerance made me sweat in a most disgusting way and forced me to open up my windows on a frigid winter evening. Feelings of fear, frustration and irritability finally culminated in an anxiety attack that brought tears so intense they shook my entire body with an alarming profundity. My heart felt as though it was trying to escape my chest in search of a more worthy body. Monitoring my weight each day and the amount of hair left on my comb after showering was a way to feel somewhat in control of the situation. Discovering new, unanticipated symptoms, like the dark hairs slowly staking claim of my chin and the skin tags appearing around my eyes, only intensified the feeling that I had become the occupier of a body I no longer recognised. It took a while to feel better. Before my surgery I ran at least three times a week. My first major solo outing after the operation involved trudging in the snow a few blocks down the street to a bookshop, and it seemed like the greatest achievement I had ever made. Even now, a year on, I'm still waiting for my thyroxine dose to be optimised. But I'm running again, maintaining a stable temperature and only experiencing insomnia some of the time.

5. Be accepting of uncertainty. Removing my thyroid drastically reduced the chance that the three cancers growing on it would spread elsewhere. I was fortunate, or perhaps not, that the cancers were discovered just before my Quebec health insurance expired along with my work permit. My experience with cancer might have been entirely different had I not also been dealing with the uncertainty of whether my work permit would be renewed and of how long I would be without health care. Despite continuing to work, I was told that I couldn't have the whole body scan that I needed following my surgery. Months later, when the scan was finally done, the doctors discovered remnant thyroid tissue. Unable to say whether this tissue was healthy or not, the doctor asked if I thought I should have radiation. With no idea of how to respond, I turned to him for the answer. If I was going to be followed by a good doctor for the next 25 years, he was happy for me to be monitored every six months and to hold off on radiation for now. I still don't know if there are cancerous cells left inside me. I don't know where I will be for the next 25 years. I don't know when I will feel completely myself again. But I do know that I am stronger than I imagined, and that sometimes you have to roll with life's punches. Although it might not seem the case, things do have their own funny way of working out.