Cancer, Stress and the Power to Say No


Stress reduction is a vital part of breast cancer survivorship. Learn how one survivor incorporated the word

One of the most challenging obstacles I faced during my cancer diagnosis and the treatment period that followed was stress. I’d never experienced the feeling of overwhelming stress before and I felt totally out of control. I felt like a tiny surfer trying to master a tsunami wave. No matter how much I tried to stay upright on that massive wave, I’d inevitably get knocked down. Struggling to breathe, I’d rise to the surface, grasp a quick breath of air, only to be submerged again and again. Fighting was difficult and often, and I found myself choosing to give in and give up. I felt powerless to continue. Day after day, I did what I was told, when I was told. It almost felt robotic, but it was the way I coped. I didn’t deal well with stress.

Stress is not beneficial for those fighting cancer. In an article by Medical News Today it explains, “Previous studies have shown that stress is a risk factor for cancer, and for example, that psychological stress is linked to breast cancer aggressiveness. And researchers already know that ATF3 is activated when all types of cells experience stressful conditions that threaten their ability to maintain a constant internal environment (homeostasis). Under normal circumstances, triggering ATF3 protects the body from harm by causing normal cells to commit suicide if there is a risk they have become permanently damaged by the stressful conditions (e.g. lack of oxygen or irradiation). When cancer cells first arise, the immune system recognizes them as foreign agents and enlists immune cells to attack them. In the early stages of cancer development this works. But then things go wrong: one reason is cancer cells start to send signals to immune cells that cause them to misbehave in a way that helps the tumor grow.”

As breast cancer patients face a myriad of daily decisions, stressors can seem magnified with the constant barrage of medical tests, treatments and the after effects of cancer. These overwhelming demands wreak havoc on the body causing maladies such as increased blood pressure, anxiety and depression. That is why some doctors recommend their patients find ways to reduce stress in their lives. Mindfulness, counseling, meditation and yoga are among some of the ways patients have found to manage their stress levels. But for a typical Southern Belle like me, it isn’t always easy to move out from under the cloak of people pleasing. Saying yes is an inbred part of my nature. Managing to utter the little two-letter word, “no,” seems difficult, if next to impossible.

When my doctor gave specific instructions to avoid stress at all costs, I cringed. I knew I was going to be required to say no to some things in my life. A friend gave me a copy of the book Boundaries: When to Say Yes, How to Say No to Take Control of Your Life by Henry Cloud and John Townsend. That little book has forever changed my life. As I read it, I learned it’s OK to set healthy boundaries and in doing so, I’m taking control over my life stressors.

At first, I felt afraid to say no. It felt unnatural and I couldn’t do it. Without being able to say no, I found myself overcommitted and my stress level rising, but as I practiced the techniques in the book, I discovered a newfound freedom. No longer do I feel the need to use my cancer as an excuse. I don’t even use my post-cancer fatigue to wriggle free from obligations. I do, however, allow myself the freedom to say no and feel good about it. I know that when I choose to set healthy boundaries, I’m doing a good thing for my body. By reducing stress in my life, I live a more peaceful life.

While stress can’t be seen, it can be felt. When I’m in a stressful situation, I can feel my body tense. I can feel my blood pressure rise. I am not happy and relaxed when things are stressful. And since I’m currently in a state of NED (no evidence of disease), I want to make sure I do everything possible to keep my body healthy and strong. To do that, I must set protective boundaries over my life.

For some, saying “no” is easy. For others, it’s difficult. With practice, forming that little word is powerful. It is an essential part of my survivorship and I’m going to do everything within my power to use it to eliminate stress from my life. And I don’t intend to apologize for doing it. I hope you’ll find the ability to learn the power of saying no. It’s extremely liberating.

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