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Cancer During COVID: One Woman’s Path to Resilience

Cancer During COVID: One Woman’s Path to Resilience

“I’m still here and I have gratitude that I’m still here,” says 34-year old, Tori Gelb.

Updated on December 4, 2020 at 2:00pm EST.

In 2016, just one week after her 30th birthday, Tori Gelb, was diagnosed with Stage 4 metastatic breast cancer.

For about a year before her diagnosis, Gelb experienced back pain she attributed to normal aches or “wear and tear.” But after rolling over in bed one day, she noticed a lump in her breast that prompted her to seek medical attention.

Diagnostic tests confirmed her suspicions. Gelb had breast cancer. She also learned that her lingering back pain was the result of crushed vertebra caused by metastases. The disease had spread to her bones, lungs, and liver.

Over the next four years, Gelb received 10 different therapies to try to quell her disease like a smoldering fire. At least once per week, she made a two-hour roundtrip drive from her home in rural northwest Ohio to Columbus for her treatment.

Still, in June 2020, she was informed that the cancer had also spread to her brain.

When she received the news, she was alone. And when she coded in the hospital due to an allergic reaction to her chemotherapy, she was alone. Precautions to protect patients with cancer, who are more vulnerable to severe COVID-19, have had the unintended result of isolating them during challenging times. Gelb wasn’t able to have a support person with her when she was most vulnerable and scared.

Many challenges in life—though difficult—are temporary. Advanced-stage breast cancer, however, doesn’t usually go away. Only about 27 percent of people survive five years after being diagnosed with Stage 4 metastatic breast cancer. Tori will likely be on cancer treatment for the rest of her life. If she goes off therapy, her cancer will continue to spread and eventually kill her. 

Finding strength amid adversity
Since the pandemic began, millions of people have struggled with loss, the stress and frustration of prolonged uncertainty and worries about infection. Unsurprisingly, rates of depression and anxiety have skyrocketed.

In July, a Kaiser Family Foundation poll found that 53 percent of U.S. adults reported that worry and stress about COVID-19 was negatively affecting their mental health.  Another July poll by the Kaiser Family Foundation found that 40 percent of U.S. adults reported symptoms of depression and anxiety.

After months of warnings about symptoms, travel, social distance, masks and countless other preventative measures, many people have developed caution fatigue. Some who are experiencing burnout have even become apathetic—they no longer care, and they lack the motivation to change that.

One can only wonder how someone who is coping with the mental and physical strain of cancer treatment could find the strength to persevere during this unprecedented adversity?

For Gelb, it’s all about perspective.

“It’s definitely been a struggle. But I’m still here and I have gratitude that I’m still here,” she says. “I always say positivity isn’t going to cure my cancer, but it could really help my mental health.”

Gelb also notes that bad days are inevitable and when they happen, it’s important to simply accept them. And when times are tough, be compassionate and patient with yourself.

“For me, resilience is about being kind to yourself for what you’re going through. It’s not so much the bounce back. It’s more about being self-aware and knowing how to best care for yourself as a whole person,” she says.

“So many of us think that we can’t show a bad day, or we can’t cry. Not everybody is going to bounce back the way we would hope they will,” Gelb adds, noting that everyone must process grief and other challenges in their own time.

Your path may be different
Gelb’s story is a testament to her inner strength. But what has helped her may not work for everyone because there’s not one “cookbook recipe” for cultivating resilience, according to Heather McGinty, PhD, a licensed clinical psychologist who specializes in general mental health and psychosocial issues surrounding cancer at The Ohio State University Wexner Medical Center. 

There are some general strategies to help people become more resilient, McGinty points out. And the first step is to stop ruminating on external factors that you can’t control and start doing the internal work that will help change your mindset.

Practice self-control. While teams of scientists, world leaders and public health officials try to curb the pandemic, it’s easy to feel helpless. But there are aspects of your life that are still under your control, according to McGinty.

“Folks who are dealing with multiple crises at once are generally more successful when they focus on those aspects that they can do something about,” she says.

If you’re having trouble sleeping, for example, you may choose to improve your bedtime routine. Once you tackle some simple things, you may work towards more complex goals, like cultivating a more positive outlook or healthier behaviors.

“Your own response and attitude are things you can control,” McGinty says. “It takes practice and a lot of self-control. But that’s one thing that you get to decide for yourself, even if you can’t control everything else that’s going on around you.”

While she couldn’t alter her diagnosis, Gelb had the power to control her reaction to it. About a year after her diagnosis, she got involved in advocacy work, writing educational articles on breast cancer for other women diagnosed with the disease.

Learn to accept. It’s easier said than done (and it may sound like defeat) but accepting the things you can’t fix can help you build resilience.

One way to do this is to identify the things that you currently have no power to control and give yourself permission not to try to change them, McGinty advises.

“So many things are uncertain right now,” she says. “The hard part is allowing yourself to not feel like you have to change something that you really can’t change.”

This advice may also apply to your interactions with others. You may want to ease the pain of friends and loved ones who are coping with loss or sadness. While this may not be in your power to control, it’s important to remember that your presence may be enough, Gelb points out.

“So many times we see somebody suffering and we just want to make them smile,” she says. “Sometimes honoring the fact that some people can’t smile right now and knowing that you’re there to support them—even if it’s in silence—means the world.”

Focus on overall well-being. At a time when many may be hesitant to go back to the doctor’s office or make a virtual telehealth appointment, McGinty emphasized focusing on wellness and encouraging people to take care of their physical health.

“Anything that impacts your health negatively will make it harder to bounce back when all this is over,” she says. “An important part of resilience is trying to maintain things in a healthy way as best you can, from your physical well-being to your emotional well-being, to your social and financial fitness. Those key parts of our life that let you know that you’re doing okay.”

Laughter is good medicine. The power of laughter isn’t to be underestimated, according to McGinty. And even now, as the pandemic persists and many people are struggling, it’s okay to smile. It’s okay to laugh.

Many people may be grieving little things that COVID-19 has taken away, like greeting passing strangers on the street with a smile or going out to dinner with friends.

“People don’t always realize what little pleasure those kinds of things bring, and how much that maintains feeling healthy. It used to come more easily when we had these more casual social exchanges and those are gone right now,” she says. “Find something that helps you smile and even laugh.”

There is no “one-size-fits-all” solution
These strategies to help build resilience may change over time and be different for each person, notes McGinty. Some people may clear their mind and relax through meditation while someone else may ease stress with high-intensity exercise.

McGinty tells people to allow themselves the flexibility and time to acknowledge their emotions and understand why they feel the way they do.

This advice has resonated with Gelb as she navigates her cancer treatment during the pandemic. “The more people can be honest about what they’re going through, so that they’re not just suppressing things and so they’re dealing with them head-on, the more people will be able to come out the other side and be stronger,” she says.

Medically reviewed in December 2020.

Sources:
U.S. Centers for Disease Control and Prevention. “Coronavirus Disease 2019 (COVID-19): People with Certain Medical Conditions.” Dec 1, 2020.
American Cancer Society. “Survival Rates for Breast Cancer.” Jan 8, 2020.
Salari, N., Hosseinian-Far, A., Jalali, R. et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health 16, 57 (2020).
U.S. Centers for Disease Control and Prevention. “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020.” Aug 14, 2020.
KFF. “KFF Health Tracking Poll - July 2020.” Jul 27, 2020.
KFF. “The Implications of COVID-19 for Mental Health and Substance Use.” Aug 21, 2020.
Northwestern Medicine. “Do You Have COVID-19 Caution Fatigue?”
Queen D, Harding K. Societal pandemic burnout: A COVID legacy. Int Wound J. 2020;17(4):873-874.
Liuyi Ran, Wo Wang, Ming Ai, Yiting Kong, et al. Psychological resilience, depression, anxiety, and somatization symptoms in response to COVID-19: A study of the general population in China at the peak of its epidemic, Social Science & Medicine, Volume 262, 2020.
University of California, San Francisco. “Emotional Well-Being and Coping During COVID-19.”
Mayo Clinic. “Meditation: A simple, fast way to reduce stress.” Apr 22, 2020.
Mayo Clinic.” Stress management.” Aug 18, 2020.

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