14/05/2018 18:16 BST | Updated 14/05/2018 18:16 BST

An Open Letter To Any Woman Facing A Cancer Anniversary

Cancer is not only a date in our past, it is an experience we must take forwards with us

Wenjie Dong via Getty Images

We are the 1 in 8 women who hear, at some point in our lives, that we have breast cancer. Like you, we crossed that invisible threshold into a place where no ordinary person can follow. This is what we want anyone who follows in our footsteps and is approaching a cancer anniversary to hear:

Whether it’s the one-year anniversary of your breast cancer diagnosis, the date you had your mastectomy, or you feel you are finally crossing what we hope is one of those most glorious of all milestones - the five or ten-year mark - there are some dates associated with cancer that stay with us forever.

No one told us that traumatic anniversaries are not easy. We wish we had known that it’s natural and common to have a powerful and distressing reaction to a traumatic anniversary - especially ones that were life-threatening. We wish we had known that this is called an “anniversary reaction” and that research highlights that distress and traumatic-stress symptoms are likely to be at their highest in the month in which the traumatic event took place.

Many women, especially those who have had a recurrence or secondary breast cancer have experienced so many traumatic anniversaries that it becomes impossible to pick out specific dates. Sometimes, we don’t even consciously remember the date, and instead physical or psychological reactions are triggered by a particular place or a change in the seasons (for me it’s the first signs of spring and the Wimbledon Tennis Championships.) And, of course, not everyone will experience an anniversary reaction, but knowing what to expect can help you to cope.

As you approach the date that marks a cancer anniversary, the memories of what you were doing this time ‘that’ year may start to resurface; the voices of all those intense emotions and powerful memories that you thought you had buried deep within yourself start calling out to you. Unwanted. Unbidden. Vivid nightmares about those aspects of your experience that you found most frightening run through your head like a fast train. You tried to suppress your memories of cancer to ‘move forward.’ You tried to forget. It feels like opening a door to a room in your house that you have walked past every day because you have not had the courage to enter.

The build up to the anniversary can be hardest - the planning and expectations about how you should be spending it. Should you get out your gratitude cloak? Be thankful that you are still able to pick up enough of the ‘old’ routine; be grateful that you are well enough to work; maybe you cling on to your loved ones just a bit longer than usual before they rush off out of the front door. You feel relief. After all, you made it. Maybe you prefer to spend the day in quiet reflection. You tell yourself that it doesn’t matter that you are not the person you used to be; that you don’t really know who you are any more. You are alive. You feel blessed.

Then comes the whirlpool of fear... is this your last anniversary? Will there be another one? Maybe you should take the day off and celebrate? What if this is the year, you wonder? The last one I have? Planning what to do and who to spend the day with can take you into a storm of emotions, and, if you are not careful you end up berating yourself because you did not spend this ‘special’ day in the way it deserved.

You will be surprised to find your family, friends and colleagues, whose support you had come to rely on, probably won’t even remember the date. In his book, The Body Keeps the Score, Bessel Van Der Kolk, describes how trauma “cuts us off from a language based on common experience.” Unable to find the words, we experience a “disenfranchised grief” - the pain of a loss we do not share openly and is not publicly acknowledged.

It’s natural to want to avoid painful emotions, to suppress the trauma and forget cancer and all of its associations. If only we could. Our scars, side effects and ongoing check-ups are constant reminders. If we had primary breast cancer, we must be vigilant for signs of recurrence and if we have secondary breast cancer, we are vigilant for the progression of disease. A cancer anniversary has a unique impact. Unlike other traumas, cancer is not only a date in our past, it is an experience we must take forwards with us. Whether we like it or not we must find a way to live with the uncertainty that becomes the background music to our lives. We take with us the myriad emotions of cancer - fear, helplessness, loss, despair, anger - whose voices become louder and louder when we are at our most fragile.

There is no prescription we can give you for who to spend your cancer anniversary with, or what to do on the day. Some people acknowledge the day in their own way. Perhaps they raise a glass, buy themselves a gift. Others choose to ignore it, or forget. There is no right or wrong way to spend a cancer anniversary.

Acknowledging the pain and trauma can feel unbearable. But, if we can greet our vulnerability like an old friend and we can acknowledge the cliff we fell from, we can see - and I mean really see - our courage and perseverance for living in all its brilliance. We can be present - really present in the moment. If we can be self-compassionate whenever we feel guilty, sad, or we take our lives and our bodies for granted, we can find our strength and resilience. Because from our vulnerability comes strength. Because from our vulnerability comes resilience.

With thanks to Anita Traynor for her collaboration and the women at the Centre for Building Psychological Resilience in Breast Cancer.