A remission ‘rollercoaster’: Lymphoma survivor details mental health in cancer survivorship

May 07, 2021
Liza Patterson helps her daughter jump off log on the beach
Liza Patterson, with her daughter at Isle of Palms beach, struggled with mental health issues after completing her cancer treatment and initially had a hard time finding other people who could relate. Photo by Marquel Coaxum

When Liza Patterson, 31, was declared cancer free in September 2019 after a seven-month battle with lymphoma, the news didn’t come as a relief. Instead, Patterson described the experience as a “let down,” as she found herself struggling to reenter normal life.

“I didn’t understand why I didn’t feel good about it,” said Patterson. “I went to therapy. I tried antidepressants. I went to church more. I read more. I basically went on a search for anything that could help make sense of why I went through something like this.”

Amid her search for the purpose behind her pain, Patterson found herself plagued by guilt — guilt that she wasn’t able to be there for her family when she felt they needed her most and guilt that she had survived cancer when so many others do not. Instead of savoring the joy of being a new mom following the birth of her now 2-year-old daughter, Patterson found herself haunted by her diagnosis and outcome.

According to Wendy Balliet, Ph.D., a psychologist who practices psycho-oncology at MUSC Hollings Cancer Center, the feelings Patterson had entering remission aren’t unusual. While Balliet wasn’t Patterson’s therapist, she said cancer survivors, in general, are at increased risk of developing anxiety, depression and social withdrawal due to fear of recurrence, grief over the loss of their pre-cancer lives, issues with body image and guilt that others have died while they survived.

“I didn’t know how to be a mom because I’d had help in caring for my daughter throughout my cancer journey. I was thrown into motherhood and being a cancer survivor at the same time, so I felt like I couldn’t be my best at either.”
— Liza Patterson

“During cancer treatment, there is a sense of ‘doing’ to fight the disease. Although unpleasant, chemotherapy, radiation and surgery are all designed to fight and eradicate cancer, so there is some semblance of control in working toward healing,” said Balliet. “Ending treatment and entering survivorship, while exciting, also means figuring out the ‘new normal’ and affords more time for difficult emotions to surface than when busy with appointments and treatments. Survivors may also feel a loss of control due to no longer actively fighting the cancer.”

When these feelings of guilt, worry and sadness aren’t addressed, they can be dangerous to survivors’ health. Research has shown that anxiety among survivors is long-lasting and can negatively affect quality of life, use of health care and adherence to follow-up visits.

“Ironically, persistent guilt can lead to an avoidance of fully living the life one has,” said Balliet. “Recognizing and acknowledging these feelings is critical in helping us know ourselves, learning to be authentic and connecting more deeply with others.”

From thriving to surviving

Patterson’s cancer diagnosis came just six weeks after the birth of her only child. She became short of breath during her pregnancy and began having chest pain, fevers, a loss of appetite and night sweats after delivery — all of which were attributed to her recent childbirth.

Near the end of January 2019, her mom took her to a local emergency room after noticing swelling in her face and neck, and she was transported by ambulance to MUSC Health to see a cardiothoracic surgeon. The surgeon identified an 11-centimeter tumor in her chest, which was confirmed as stage 2B primary mediastinal large B-cell lymphoma, on Feb. 6. Patterson was admitted and began the first of six rounds of chemotherapy that evening.

Liza Patterson feeds her daughter with a bottle 
With Patterson’s chemotherapy starting just weeks after her daughter was born, she missed out on much of the bonding time that new mothers typically get. Photo provided

“It was pretty shocking,” said Patterson, who noted that her symptoms quickly became so aggressive that she was bedridden only a few weeks after they began. “I was 29. When I was in the ER, I didn’t know if I was going to survive. When they told me that it was cancer and that it had a good prognosis, it was still scary, but I was just ready to fight. I said, ‘This is what I have to do, and I’m going to be fine.’”

Despite side effects from the chemotherapy, the hardest part of her treatment was spending so much time away from her newborn daughter. Patterson had to quit breastfeeding immediately, making her feel like she couldn’t provide her daughter with something she needed, and she missed out on the bonding time most new mothers get to experience during their maternity leave.

At one point, because of Patterson’s weakened immune system, the two had to spend an entire week apart when her daughter caught a cold. The feelings only worsened when she entered remission.

“I didn’t know how to be a mom because I’d had help in caring for my daughter throughout my cancer journey,” said Patterson. “I was thrown into motherhood and being a cancer survivor at the same time, so I felt like I couldn’t be my best at either.”

Because of her stage of life, Patterson struggled to find other young survivors who could relate. She faced the same challenge in trying to find a therapist whom she felt could empathize with her specific situation.

“It’s hard to find a counselor who specializes in young adults recovering from cancer. I don’t think that’s actually a specialty in therapy — it’s too specific,” said Patterson, who recently settled into seeing a trauma specialist after failed attempts with other therapists. “She really delves deep into understanding what I went through and how I can be the best version of myself based on where I’m at in my journey.”

Finding help and hope

Aside from therapy, Patterson has found comfort in connecting with other survivors through online support groups and in exercising more. She feels better about herself physically, knowing that her body could bounce back from the effects of chemotherapy and childbirth so quickly.

She also finds it helpful to read books about others’ near-death experiences, as she has struggled with obsessive thoughts about death after feeling so close to it during her treatment.

Liza Patterson carries her daughter on the beach 
Patterson has rebounded with help from therapy and connecting with other survivors online. Photo by Marquel Coaxum

As someone who struggled with anxiety and depression prior to her diagnosis, Patterson knows the importance of being open about mental health. She wants its relationship to cancer survivorship to be more freely discussed so other survivors might know what to expect when they enter remission.

“I think a lot of support systems don’t understand that when treatment is over, your journey is not over. When you’re physically healthy again, that’s when you’re processing everything that just happened to you. That’s when you might start feeling able to talk about it. It’s a unique experience that I don’t think is looked at enough,” said Patterson, who noted that cancer patients don’t always know how to handle those emotions on their own and could benefit from more guidance.

“I don’t find shame in mental health. I don’t find that it’s anything you need to hide. It’s something that needs to be discussed so we can prevent things like suicide and self-harm. People need to know they’re not alone.”

Balliet added, “As a society, if we were more accepting of painful and uncomfortable emotions, even when they’re expected, like with cancer patients and survivors, we might actually see less severe psychiatric illness.” She reminds patients and survivors that, above all, it’s important to be kind to oneself and to acknowledge the physical and emotional changes that accompany a cancer diagnosis.

Patterson is working on turning her feelings of guilt into compassion by offering support and social connection to other survivors who are struggling. Sharing her experience has helped her to uncover the sense of purpose she felt she was missing.

“I don’t think I’ll ever consider myself ‘past’ my cancer journey. It’s always going to be a part of me,” she said. “But now I feel like I can work through how to use that experience for good.”

Resources for patients, survivors and caregivers

  • Psychotherapy: The Psychosocial and Behavioral Oncology Program at MUSC Hollings Cancer Center offers psychotherapy services for cancer patients, survivors and their families to help to manage anxiety, fatigue, insomnia, pain and distress and to help establish healthy habits. More information can be found here, and appointments can be made by calling 843-792-9300.
  • Support groups: For information on local support groups, visit the MUSC Health Patient Resources website.
  • Additional resources: For more survivorship resources, visit the MUSC Hollings Cancer Center website.

About the Author

Kelsey Hudnall
MUSC Hollings Cancer Center

Keywords: Cancer, Fitness and Wellness