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Five stages of (cancer) grief

By Dianne Sibal, The Philippine STAR Published Oct 22, 2020 5:05 pm Updated Feb 03, 2021 11:08 pm

I never expected it to be cancer. 

I honestly—and arrogantly—believed that it couldn’t, wouldn’t happen to ME. I didn’t smoke, I didn’t drink (much), maintained a steady weight, and felt up until that point that I was living a relatively healthy life.

Up until the very last second before the surgeon broke the news to us, I was blissful in the belief that everything was fine.

They say people go through stages of grief before accepting any form of loss in life. I had no idea of the rollercoaster ride I was in for. In fact, I climbed onto the cart ride nonchalantly, unaware that l was going to be screaming and hurtling into the void for the next few months.

Dianne with her best friend Papu Dela Cuesta

Stage 1: Nonchalance (in other words, DENIAL)

I knew plenty of women who found lumps in their breasts that turned out benign. I remember the doctor’s mildly concerned face when she found it during my annual physical exam. “You never noticed this before?” she asked. I shook my head sheepishly and promised to be more vigilant next time, but internally, I brushed it off as nothing.

When I consulted an OB, and then a surgeon about it, I was told I could have the offensive lump taken out — mostly for my peace of mind. No biggie, I thought. I could take a few days’ leave and have it removed easily.

I remember sneaking out for a shopping trip with my best friend Paula two days after the procedure. I bought a pair of nude sandals to reward myself for recovering so quickly and made plans to wear them when I went back to work. While paying for them, I cheerfully confirmed a follow-up schedule with my surgeon over the phone.

I never touched those new shoes for months — I couldn’t bear to look at them because they reminded me of what came after.

I thought: At least it’s me, not my parents, right? I’m young. I can fight it.

The next day, when I went to the hospital for what I thought would be a routine check-up, my surgeon dropped the C-bomb on me and my mom.

My mind whirled and weirdly settled on the most random of concerns, like does mastectomy mean that I’ll never be able to wear tank tops again? or Am I going to need a wig for my brother’s wedding in three months?

Then I glanced at my mom who was struggling to take notes as the doctor continued to discuss possible treatments.

I thought: At least it’s me, not my parents, right? I’m young. I can fight it. Should I have my eggs harvested now? Is it even responsible to even think about kids when I can pass this on to them? How much is all of this going to cost? Can we even afford this? Even as my thoughts turned grim, my mind reached out to worry about problems that had possible solutions — anything, except for the question I didn’t want to think about: Could I die?

We walked out of my surgeon’s office, not registering a single thing he had said, except for the “I had cancer” part. I shook the haze off, determined to focus all of my energy on understanding this illness to beat it. I continued to talk to my mom like we hadn’t just received life-altering news. I had resolved not to fall apart, for her sake.

I texted my best friend as we walked out of the doctor’s clinic.

“Be chill because I need to be chill too, okay? It’s cancer.”

Paula was out of the country then on a work trip, and I knew it took all of her willpower not to react emotionally. She sent back a simple message, “Okay, what’s next?”

Shortly after her diagnosis, Dianne's friends convinced her to do a full-blown photoshoot before her mastectomy.

Dianne's crew behind the shoot: Photographer: Carlo Lina. Stylist: Jodinand Aguillon. Producer: Charissa Pammit.

Stage 2: If I do this, you give me that. Right, God?

Bargaining. If I do this, I’ll surely get better, right?

I guess that was what I was unconsciously thinking during the first few months of my diagnosis, when my coping mechanism was to problem-solve everything to death (I’m allowed to make the pun, okay? LOL).

My family and friends indulged me as I prepared Excel sheets for the pros and cons of different treatments. They let me talk their ears off as I set multiple meetings to discuss the merits of each doctor I met (I saw five surgeons, seven medical oncologists, and four radiation oncologists. Pro tip: Stop at three or else you’ll go crazy trying to pick). They read along with me as I diligently devoured what must have been gazillions of breast cancer articles — from the best combination of treatments to where to buy a post-op bra after my mastectomy.

My pro-active attitude towards my problem quickly morphed into an obsessive attention to detail that began to take its toll on me. I let every single thing stress me out.

I was throwing all of my energy into finding the best of everything — doctor, hospital, treatment — thinking that if I did all of it right, then I’d get the outcome I wanted.

But the funny part about cancer treatment is this: it’s all backed by years of studies and research, but medicine and science can’t make any of the big decisions for you.

Different doctors gave me different opinions. Confusing as hell, by the way, but I eventually understood that their recommendations were based on both data and experience, which meant it was impossible for them to give similar answers.

Friends and family, of course, weighed in and helped me evaluate each of my options; but ultimately, the burden rested entirely on my shoulders.

The enormity of each decision, and how it could possibly mean life or death for me, weighed heavily at first. My obsessive research had its limits. It ensured that I was making informed decisions, but I could never be 100 percent guaranteed that thigs we going to be all right.

It was human to crave certainty, but I had to accept that there were things out of my control.

So, I learned to take things one step at a time. I hoped for the best, tried to be prepared for the worst, and relinquished all illusion of control.

Don’t get me wrong — I still make Excel sheets for everything up to this day, and sometimes still fall down a Google rabbit hole whenever I’m worried about a new side effect or symptom. But at least these days, I don’t lose sleep over it. Much.

Obviously, these stages don’t happen in chronological order. Like I said, rollercoaster. Or maybe more of an “Anchors Away” kind of thing, where I’ll be wildly swinging back from one state to another.

Stages 3 & 4: Alternatives to ugly crying

I rarely felt the need to cry.

I’m usually a big crybaby, but since my diagnosis, funnily enough, I’ve probably broken down only a handful of times.

It didn’t mean I wasn’t affected by what was happening to me, of course.

Was I sad? Sure. I was scared, anxious, frustrated, worried and praning too almost 100 percent of the time. But what I wasn’t was alone.

All throughout this whole ordeal, the people in my life have never, ever let me feel like I was fighting this thing by myself — and I honestly think that’s why I’ve been able to get through this without completely falling apart.

To be honest, I feel embarrassed every time I get called brave or get praised for “handling cancer so well,” because while I truly appreciate the gesture, I sincerely believe that most of the credit should go to the people in my life who have been rallying around me since day one.

I do what I’m supposed to do to survive — because there is no other option.

They, on the other hand, make the conscious decision every day to fill my days with creative, surprising, funny, touching gestures of kindness, big and small, that have made me feel more loved than I have ever been in my life.

So yeah, thanks to them, instead of crying, I smiled a lot and laughed a lot.

Laughed when my brothers offered to help shave my head during my first month of chemo, as we made a mess on the floor and they gave me the ugliest haircut I’ve ever had. Laughed when I was making awkward poses during a full-blown photo-shoot that my bida-bida friends set up so I can “remember my boob” before they chopped it off during mastectomy. Squealed with happiness when friends sent care packages, wigs, scarves, messages of support, random memes, Spotify playlists on nights I couldn’t sleep.

Smiled when caring colleagues offered to take on extra work so I could have days off to rest or when people offered to be my hospital buddy/errand runner/driver/foot massager on the days I needed help. Smiled when friends flew home from halfway around the world to visit or organized fundraising efforts to help me with my mounting medical bills (It’s in the range of millions now SO PLEASE, PLEASE GET INSURED! Cancer isn’t cheap!).

Smiled through tears when I was able to recover in time from an early chemo session and a radiation session to watch both brothers get married just a few months apart. Smiled whenever I remember waking up in the middle of the night at the hospital and seeing both of my parents huddled together just a few feet away, ready to wake up if I needed them. Smiled whenever I realized that cancer is a shitty thing BUT it’s been (cliché, I know, but true!) a blessing, too, because it brought my family, including my two new sisters, so much closer together.

Smiled because I was finally able to take those nude sandals out of storage and now wear them to my treatments. It’s a reminder that life is unpredictable, and bad news might probably be waiting just around the corner, but that doesn’t mean I can’t still enjoy life’s pleasures every now and then, however I can.

That, and I want to look nice, of course.

Dianne with her family and new sisters-in-law

Stage 5: Life goes on

Obviously, these stages don’t happen in chronological order.

Like I said, rollercoaster. Or maybe more of an “Anchors Away” kind of thing, where I’ll be wildly swinging back from one state to another. I could be all Zen one day and be irrationally anxious again the next.

I’d like to think that I’m at the acceptance stage right now — but let’s be honest, just like that day when I walked into my surgeon’s office, unaware that my life was going to change forever, the rollercoaster could take a crazy plunge again.

It’s been a year since my diagnosis. I made it through four surgeries, 16 rounds of chemo and drug therapy, and 30 radiation sessions so far.

Treatment isn’t over yet (I still have four months to go with drug therapy), and really, there’s no saying whether the cancer will fully go away or come back. But while I’ve never been more scared and more uncertain about what the future holds, I’ve never felt stronger or more at peace either.

I guess it’s because I’m slowly realizing there’s no single, right way to dealing with this life-threatening illness. I’m thankful that I’ve managed to find something that works for me so far, and hope that I’ll continue to find ways (and reasons) to keep trying.

As for the people who’ve had my back since Day One — to my mom, my dad, my brothers, my new sisters, my friends, my colleagues — I couldn’t have gotten this far without you.

And thank you for being there every step of the way, and always being ready to ask, along with me, “Okay, what’s next?”

(Editor’s Note: All of author Dianne Sibal’s treatments were completed yesterday. She says her doctors are still monitoring her condition closely but she won’t have to see them in the next three months. “They give you certificates when your treatment is over. My radiation oncologist gave me one back in June, and then yesterday, after my 15-month chemo-infusion treatment, my medical oncologist gave me another one. So parang graduation day ko yesterday!”)

For more information about breast cancer, visit icanservefoundation.org