Q: What was your relationship with your body before being diagnosed with cancer?
A: Right from my teenage years, I’ve been more tomboyish than girly. I look petite and dainty, but mentally I’m more one of the guys. Makeup, skirts. . . all of that was never something that I was interested in. But I was happy with my body in the sense that I wasn’t overweight, I wasn’t unhealthy, I was fit, I was running around, I looked okay. I never needed to use any products.
Q: The treatment lasted a couple of years. How did that change your body in terms of your energy levels, the things that you could do? How did it affect other things about your body that you like?
A: Cancer is hereditary in my family. At the age of 37—I am 45 years old now—I tested positive for the BRCa gene. While it was a shock, I also knew that lots of people have it and that I would be fine. So, it wasn’t earth shattering. My kids were three and six years old at the time, so I also didn’t have the luxury of being devastated.
With the treatment, the first thing that happened immediately was the surgery. They took the left breast out completely. Within about six to eight months of the mastectomy, we realised that the only sure way of dealing with this was to completely neutralise every single risk of getting cancer. Because of the genetic propensity, I was in the 85% bracket where it could go into my right breast, my uterus, ovaries. It could spread anywhere, and it would just mean that I would have to keep going for surgery and getting chemo, every few years.
I got my right breast, my uterus, ovaries, and everything else removed too. The doctor kept saying that while having them did pose a health risk, these were healthy body parts. I told him, “sure, they may be healthy now, but not healthy three months down the line. I don’t want to finish 36 sessions of chemo and then realise that now I have to do this all over again.”
I got my right breast, my uterus, ovaries, and everything else removed too. The doctor kept saying that while having them did pose a health risk, these were healthy body parts. I told him, “sure, they may be healthy now, but not healthy three months down the line. I don’t want to finish 36 sessions of chemo and then realise that now I have to do this all over again.”
It wasn’t even so much a discussion, but more about me marching into the doctor’s office and saying, “I have thought about this long and hard. I have read up what I can and I need you to do this. If you’re not going to do this, I’m just going to go to the next available surgeon and get it done.”
So, for the first year, it was more about doing the chemo, doing the radiation. It was about eating healthy, getting my strength back, keeping your mind occupied. Life kept me busy and the pain was being managed. I was on really high steroids. I was a patient.
Intimacy and sex with my husband obviously took a backseat. There were a couple of times when we attempted it, but I was not comfortable in the sense that it was painful. I was also just not ready. He was fine with it too. We put it on the back burner and went on with life.
Q: Did you discuss the surgeries and the effects of the therapy on your body and intimacy with your partner?
A: To be honest, it wasn’t done simply because it wasn’t something that I may have read about it in passing when I was taking off your fallopian tubes and your ovary that affects your hormones. I knew that my hormones would be affected whatever I do. The doctors told me that it would put me in a forced menopause where I would never have my periods at all and that kind of has a cascading effect on hormones again.
I did realise that hormones will be affected. I didn't realise to what extent and how much. I'm only finding that out now.
For me, the surgeries meant that I would atleast be alive, as opposed to being tied to a hospital bed and having to keep doing rounds and rounds of chemo and watching each body part being taken off every few years.
And so, at that time we (my husband and I) weren’t in the headspace to talk about intimacy or sex. It wasn’t a priority.
Q What do you mean when you say you’re only now understanding how much your hormones would be affected?
A: The radiation, for example, blew up my thyroid gland. Now I have thyroid on top of everything else.
The thyroid gland has complicated the whole hormonal imbalance. Now, the sex drive is at a bare minimum. There is no desire left anymore, there is no energy left anymore. There are body image issues.
At the time of the surgery, I didn’t have medical insurance. So, I thought “it’s all cosmetic, who cares, I’ll live without my boobs”. Now, every time I look at myself, I wish I had gone ahead and got my reconstruction surgery done because I don't like it now. Now, I actively really don't like my body. I don't want it anymore.
I wear a prosthetic. It's annoying, heavy and it’s giving me a bad posture. I can never wear loose tops any more.
Yesterday, for the first time in my life, I used a toner because my skin has lost all elasticity. It’s just become so dull. I'm very careful about the kind of clothes I buy now because nothing that has a V-shaped neck can happen.
The worst part is when I need to go do a facial, I can no longer go for a massage. Because they put their hands near my chest. There is no flesh there to massage and it hurts. I don't like anyone touching me there. I still can’t feel my armpits. There is no sensation anymore. So, the body has just become an open wound, a war zone.
The other thing is the mind fog. No one ever tells you about that. But the chemo really gives you brain fog. The thyroid is not helping either. There are vast spaces in your mind that are now completely blank. As a journalist, words used to be my forte. And now I just struggle with simple things. Just remembering. The good thing is that now I have pens everywhere and I have chits of paper all over the house like okay- remember this, remember this, remember this, do this, do this.
So, mentally it's kind of slowed me down. Physically it's definitely slowed me down in terms of emotionally connecting and having a healthy relationship with my husband.
And I feel sorry for the guy because it's been years since he's had a good round of sex and I'm sorry that I just don't know what to do. Because, one, it’s super painful. Secondly, I just can't be bothered. I don't feel good. I don't want to have anything to do with anything. And it's just difficult. It's a struggle. The couple of times we managed to have sex it was hugely painful afterwards. And I just don't think I want to do this again. He says it’s okay, that we don’t need to, but it's not fair to him. So, the guilt is also there. Everything that I have gone through, he's been on the sidelines. He may not have carried the scars, but he is feeling the same shit. He's carrying the burden as well.
There is painful vaginal dryness because mentally, you're not really stimulated, because your hormones just don't exist anymore. The few pleasure points that used to be there have also been screwed up.
Q: What are the moments of tenderness or love, that can come in a relationship at times like this, then?
A: I can’t take squeezes anymore. Even if my husband has to put his leg over mine it’s fine for three seconds. After that I tell him it’s too heavy.
Earlier we used to have really good fun in bed like playing, kicking, and laughing, it used to be fun. And now he attempts even one little thing out of all those crazy things that we used to do. It’s just hurting, hurting all over because the bones have lost the capacity to take the weight.
So, for moments of tenderness, yes there are a lot of hugs. For the longest time, it’s been this one thing that he started doing ever since I got my stitches removed and recovery has been happening. The last four, or five years, it’s been a massage. He’s the only person who can give you a back massage without any flinching, so legs, back, he will sit.
But I can’t bear him coming to the front of me. I also refuse to let my husband see the surgery scars. I refuse to let him get close.
It’s completely off-limits. The chest, the stomach, the front part of my body. I just can’t bear touching. It’s something that I’m uncomfortable with. So, that is where tenderness comes in right now. For us, it has become just that massage. Like head to toe, the back, the head, the legs. And I’ll sit there and massage him as well of course. It’s nowhere close to a massage but that’s about it.
Q: What were the things that your partner did or things in general that made you feel supported or made you feel loved in those situations where everything was falling apart and scary?
A: The one thing that really helped was no matter how tired he was or I was, he would just sit and press my legs every day. It started with that because at that time I couldn’t even sit straight after surgeries and all, even my back or, I couldn’t sleep on one side.
Things like making sure my water bottle is filled so I don’t have to get up in the night. He’s taken over the kitchen sort of space, he’ll do the cooking now. For a while, it was just him switching to coffee.
In that sense, I think I have kind of won the lottery in terms of support and a caring and loving partner. But there are days when I just want to fling a pillow at him—especially now, as time has gone by and slowly, slowly things have kind of become normal.
Every once in a while, he’ll ask why can’t we have sex.
I’ve thrown some literature at him; I’ve told him how I feel and he says all that doesn’t matter to him. “It doesn’t matter if you have your breasts or not”. But it’s not the cosmetic part of it. He doesn’t understand hormones.
So, we’re okay as we are in every other aspect of life but in terms of a sexual relationship, it’s just not there. That’s what cancer took away.
Q: You mentioned reading some literature, etc. all in. Are there other books, or other people that you’ve spoken to who sort of helped you perhaps understand this experience a little bit more?
A: I've had a lot of conversations with people and read a lot of stuff on cancer in general. But now five years down the line, why isn't anyone discussing how this leaves you?
The fact is that the chemo drugs are crazy and they take years to get out of your system. Why is it that nobody tells you that simple radiation well it's not simple really but radiation can literally throw up in your thyroid? I've never had thyroid in my life and now suddenly it's hypothyroidism.
I know a lot of people who've been through similar breast cancer experiences who have had hysterectomies and they're all in a slightly older age group or in a slightly different place in life. There were women who said that they wanted the breast reconstruction done there and then. This is something that I found, especially abroad.
I remember, the doctor didn't even ask me once if I would like to go in for breast reconstruction. It wasn't even an option on the table and at that point again it wasn't something that occurred to me really, but I remember that when I went again for something else to another doctor and he asked, “But why would you not consider a reconstruction surgery at the same time? That's a decision you should make in advance.”
How come nobody told me? Why would they not counsel women when they are diagnosed and say these are your options? It’s as simple as that. Why is this not made part of the treatment process? Why are you leaving women to deal with this on their own?
Q: It’s terrible to have to go through it so blind not knowing yeah what you're going to encounter next.
A: One of the side effects of the hormone replacement drug that I was supposed to take for five years, was that you could just die of heart failure. And the doctor said, “No, no, that’s a very extreme 0.01%.” I corrected him. It’s like 4%. And, considering the odds of me getting cancer at 36, I think I would have liked to know the odds, even if they were 4% and not 44%. So, I refused to take it.
I just stopped that medication. The doctor said he couldn’t continue my treatment if I behaved like this. I told him that I took the chemo, I completed the radiation, I’d taken two years of hormone therapy by then. But it was making me sick, I cannot do this.
There was no alternative therapy. So, I thought, considering I’ve gone into all of this so blind, I might as well just stop this and I’ll deal with the consequences as and when they come up.
Q: Post-treatment, were you able to find a new meaning or discover new ways to love yourself?
A: This is where the struggle for now is that the treatment part is over. This is the next bit of the struggle that I'm realising I'm in the middle of—coming to terms with the body that I am now left with, the limitations of this body and how to make it work for me. And so, this is something that I am slowly making my way through. I don’t have answers. I don't know.
So, there might be a good day when I might walk from my house to the station and then there might be a day when walking from my bed to the kitchen is a lot.
In terms of body image, it is at its lowest. I don't think I have ever felt this bad. So again, because of the thyroid, because of the hormones, it is now overweight. So, the day that I walked into the hospital for my diagnosis and the nurse weighed me before my surgery, I was at a very cool 52. And, it was comfortable. I was happy.
I’d be picking up jeans off the rack. I would fit into a small. I now fit into a large or an XL. I have never even been through the medium stage. I just kind of bypassed it completely.
I used to love swimming. I used to love being at the beach. I used to love being in the water. Now I’m just constantly worried if my fake boobs falling down.
I don’t want to put on my prosthetics. I want my body back for God's sake. And I’m not even talking about the strength . . . at least make it look normal. I can't wear certain clothes. I can't go in the water until I'm prepared five levels down where I have a second bra at home, which has the inserts. I have waterproofs. I have a swimsuit that basically is up to my neck. And even then, I'm extremely conscious of them sagging. I am wondering if they are hanging down? Are they moving to my waist? I mean, where is my little so-called boob? It’s not fun anymore. It’s not happy. I can’t just pick up a whim and go travel anywhere. I have to really be careful.
That is where I'm stuck at because I don't like this thing I have become and cancer treatment, while it may have given me my life, it has taken a collateral that was just too much and it wasn't with my knowledge or my permission. But take the hand you get.
*Amulya is the pseudonym of a cancer survivor who shared her journey with Agents of Ishq in an interview with Div Rodricks
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I Thought I'd Be Too Cool For Vanity. But, It Was A Struggle.
Author Shormistha Mukherjee on struggling with self-image and reconnecting with intimacy during and post her breast cancer treatment
Q: When were you diagnosed with cancer?
SM: I am 50. I was diagnosed when I was 45 in March 2018. I had breast cancer. I had a mastectomy and reconstruction at the same time. And then, I had around 16 rounds of chemo, and 20 rounds of radiation. And I think I finished my treatment at the beginning of December.
Q: What were the physical and emotional changes before and after the treatment? What was your relationship with your body before the diagnosis. What did the diagnosis change?
SM: I never expected to feel so strongly about the way I looked. I always thought I’ll be fine even if my hair falls off. Those were the least of my concerns, really. When it did happen, and when I buzzed my hair, I was fine. I thought I looked so GI Jane.
But, between the chemo sessions, the hair would grow back and then I would go in for a round of chemo and then it would fall again and I kind of looked like a porcupine most of the time. You have patches. In the movies, they show people ekdum bald, but that’s not true. I think it was very eye opening for me that vanity is, I guess, part of all of us. I thought I was above vanity but I wasn’t. I think it was a very big realisation for me.
Also, the way I looked started to change because of the steroids and the medicines. My face really puffed up. I got this hump in my neck, because of the steroids and big dark circles and stuff like that. And I just started looking like a very different person.
I didn’t even know who I am anymore. For 45 years you see yourself every day and you have a way you look in your own head. Now suddenly what you look like in your head, and what you see in the mirror is so different. It was an awful struggle. And I’ve always thought that that would not be the struggle. I’m just way too cool for this. But no, it is a very big struggle.
Q: Did you feel disconnected or like you lost a part of yourself in a way?
SM: In 2018, I had just about started getting my act together about working out. When I felt sick, I had thick long hair. I was very fit. When I went to the doctor, before my surgery, they needed to take tissue to do the reconstruction. They said there was no fat in my body. I was that fit. I was lean and it looked really good. I think it became very hard to suddenly realise that it’s gone one day.
I didn’t know who I was in terms of all the things that were happening to me. I’ve always been friends with my body. I asked myself how to reestablish this friendship with my body. With cancer, with medication, every day is different. Some days you’re feeling nauseous, some days your stomach is not good. Every day is different.
Chemo medicine gives you constipation. It’s killing all your gut cells and everything. It’s very difficult for the body to process that medicine, which is why they keep checking on your kidneys and stuff like that. The medicine is obviously toxic for all your organs, so constipation is a very big part of it. I would go to the loo and would strain. Then I got an anal fissure. I didn’t know what it was but it was so difficult I would have tears in my eyes and I found it so difficult to tell my family because it’s just robbed me of all my dignity. It’s robbed me of everything.
Q: What were your concerns and fears when it came to intimacy?
SM: I had a mastectomy and so they had to remove my breast and they had to reconstruct the breast and they had to take away my nipple. The funny thing is that even after my treatment got over, I was talking to somebody. . . and they told me how being handicapped is not always visually handicapped the way we see it. You know, not having a nipple is also being handicapped. I do feel like sometimes that I am a freak. I’m very strange in that when my hair fell, I could have worn a wig but I never did. I thought it’s too hot I’ll be sweating. I just went through all this trauma. Now that I think about it, I should have just worn a wig instead of being so traumatised by it.
Similarly, when they did my surgery, I had stitches everywhere. When they reconstruct your breast, they use tissue from your back and it’s just like a lump. It could have been a lump of clay, plastic, or anything. It doesn’t feel like anything. It was just like this thing that’s stuck there. It’s very weird and you have like one OG breast, and one this guy. And it’s strange and then you don’t have a nipple.
Even now sometimes, I like not to wear clothes and sit in the house. I’m fine with it. I’m married, so I’m okay with my husband seeing it, but I don’t think I’m okay with anyone else seeing it.
Q: You mentioned that you were comfortable with your partner seeing your body, but were also afraid of how your partner would perceive you.
SM: I don’t think it’ll go away. You’re always thinking, “Hey, what does it feel like to him? Does it feel different to have this person now who has one breast that doesn’t have any sensation? That you have to be very careful around, that doesn’t have a nipple?”
What does it feel in his head? I’ve never asked him because I know he’ll say, “are you mad?” and stuff like that.
Q: Are there things he does that make you feel supported and loved and a little bit better in all of those heavy emotions?
SM: He was my primary caregiver when I was sick. When they let me out of the hospital, I had a band-aid on my breast. What they do is they take out all the tissue from inside your breast, like, like think of it like a coconut scraper, they just scrape everything out. And then they stuff it with this tissue. When they scrape everything out, they really scrape everything out. It’s just your skin there. It’s like the flap of your breast is still there and then they can stuff it back and stitch it up. So, the skin is just very thin, it’s been scraped so much. And so, when they send you back home, because you have bandages and you have to take out the bandage every morning and then you have to put this ointment and then you have to put the bandage back.
It was traumatizing for me. I would always be scared that if it bleeds, I would have to go back to hospital. I could not do that myself. I would be so scared of it. He would do it. He would take the bandages out. He would put the ointment. I couldn’t have a bath. I used to have a sponge bath for almost a week because you can’t wet that side and your back. He was the only person who could give me that bath. He was he was basically my rock through it all.
Q: Did you notice changes in how you experience or perceive your gender? Did you sense of femininity get affected?
SM: Anytime you tell anyone, I have breast cancer, they look at your boobs. Okay, they can’t help themselves.
A friend of mine said “Oh my God, anyway, your boobs are so small. Nobody will even notice that it has gone”.
That is not what you’re supposed to be telling me. I told them that it did not feel funny when they said this, right? And I hope that they introspect and realise it. I learned that not everybody has the capacity and the capability to understand what you’re going through.
I guess, somewhere, the way you look and having hair on your head and all those things are tied with your own self-image, with your own feeling of being feminine. And, while I never felt less of a woman in my head or less feminine, I felt I just looked strange.
Initially, with my hair gone, I would wear these big bindis. Whenever I went for my chemos, I would wear all my lipsticks and everything and go for it. And I don’t think I felt less feminine, but I felt like others perceived me as looking strange, less feminine, less of what I used to look like. Sometimes you could see it in their eyes.
Q: Did you have a support group that you could talking to about what you are facing?
SM: I was vocal about having cancer. And, I have a strong circle of family and friends. I think they all just took me through. I had two female friends who were with me all the time.
But support groups in terms of groups with other people, no.
There was one group because I met somebody who had been through breast cancer and she had just recovered, a year and a half, two years before me. She became like a sort of guide for me. Then somebody else who had it and then she also, we made a little group- five, six of us, that’s it.
Q: How did you meet them?
SM: One day, I felt that I should do something, may be yoga, to be friends with my body. It’s not like my body has turned against me. It’s me and my body together on this journey. So, I need to feel that connection with my body a lot more.
So, this friend I used to go for yoga with before, said she had a student who had been through breast cancer two years back. But it was fabulous because that girl was like, just the most calm person, who did a lot of research. And then another girl whose sister lived in my building, we went to the same doctor, same hospital. So, then we got friendly. That’s how I met these 2-3 people and then we just connected.
I felt like it was a bus and everybody was on this bus with me. And now I’m going to ride through this very rough territory together. But I was very lucky to have a very strong support system. I always feel like people who don’t have that, that is very rough. That way I always felt I was lucky. You always think like when you die, that’s when you really realize how much you’re loved. But it was quite something to feel how much you’re loved when you’re alive.
Q: During the treatment and now, did you experience a loss of desire for intimacy? And if you did, how did you find ways to regain that joy for intimacy? And maybe in different, newer ways than before?
SM: I definitely did lose the desire. I feel more sexy with my clothes on than with my clothes off now, which is definitely strange. I mean, I had no issues with my body ever. I think I just grew up in this way of being very not self-conscious. But now, I do feel like I’m different, physically. And breasts are such a big part of being a woman.
I don’t know what I wanted to do about the intimacy. I think I still struggle with it, honestly. I don’t have an answer. I’m still struggling with it.
I’m very conflicted about it. I feel okay and then not okay. I think I’ve gone past a lot of stuff, but this yeah I’m struggling with.
Q: You mentioned that you like this character of the supportive husband in the book, Bangalore Detective Club. Is it also because of the support you got from your husband during the nine months of the treatment?
SM: I think I’m very lucky to be married to the man that I married to. I got married very young at 23. Weve grown up together and it’s just been the two of us through everything. It’s also hard being married because it’s difficult. I don’t think human beings are made for marriage actually. You know, it’s hard not to be attracted to other people. It’s hard not to sometimes feel like I’m done with this person, So we’ve had all sorts of things between us where we thought that oh we’re never going to be able to live together anymore, but we’ve always made our way back to each other.
Shormistha Mukherjee is the author of the book ‘Cancer, You Picked The Wrong Girl’. She spoke to Agents of Ishq in an interview with Div Rodricks