Dealing With Grief After Cancer
- Actor Matt Damon, 53, says he would experience flashbacks to his childhood amid his grief over losing his father, Kent, after a long battle with cancer.
- Losing a loved one to cancer is an incredibly emotional time. The grieving process comes in stages: denial, anger, bargaining, depression, and acceptance.
- These labels help us frame and identify what we may be feeling, and these stages can occur in any order. Grief looks different for everybody.
- New York-based clinical psychologist Dr. Marianna Strongin says it may be helpful to remind yourself that these feelings are “meaningful yet temporary.”
- Damon’s father had multiple myeloma, a rare type of blood cancer that hinders the body’s ability to fight infections. It can cause weakness, dizziness, bone pain, and confusion, among other symptoms.
View this post on InstagramRead More“After my father passed away in 2017, within that year, I had this crazy dream. He came to me [and] embraced me. And the feeling that I got was the feeling that I had, which I think is like my first memory (of him) — which was the feeling of what it felt like to be held by him,” Damon explained to Stephen Colbert while appearing on the “Late Show with Stephen Colbert.”Damon’s father was diagnosed with multiple myeloma in 2010. His cancer journey has been described as a long and arduous one. Shortly before his passing, Damon made comments explaining that his father’s health was deteriorating and asked for prayers from supportive fans.
WATCH: Understanding multiple myeloma.
With multiple myeloma, a person’s white blood cells in the bone marrow grow out of proportion to healthy cells. White blood cells, called plasma cells, are needed to make antibodies and fight infections. Without the appropriate number of healthy cells, infection can overtake the body and spread to other parts. This type of cancer can cause symptoms such as weakness, dizziness, bone pain, and confusion.
How to Manage Grief and Cancer
- ‘Acknowledging the Grief’ – Losing Your Hair During Chemotherapy
- Dealing With Grief Related to Health Problems
- Tools To Navigate Grief And Shame: Dr. Marianna Strongin Addresses These Topics In Her New Column 'Strong In Cancer'
- Mental Health and Cancer — The Fight, Flight or Freeze Response
- Mental Health and Cancer: New Survey Shows Over a Third of Patients Aren’t Getting the Support They Need
How to Cope After Losing a Loved One to Cancer
Damon took some time to mourn the loss of his beloved dad. It’s key to remember that grief may look different for everyone.
The stages of grief are denial, anger, bargaining, depression, and acceptance. These labels help us frame and identify what we may be feeling. These stages can also occur in any order.
The time it takes to navigate these stages can also vary, so giving yourself grace and patience is essential while navigating your feelings.
WATCH: Dealing With Grief Related to Health Problems
“It often gets better over time, but on certain days, it can look like depression, and on other days, people look perfectly normal and can function,” Dr. Scott Irwin, a board-certified psychiatrist and Director of Supportive Care Services at Cedars-Sinai Medical Center, previously told SurvivorNet.
Dr. Irwin added that grieving people are coming to terms with “the change in their life; the future they had imagined is now different.”
SurvivorNet spoke with Megan Newcomer, who lost a close friend to metastatic cancer in 2018. She shared her unique way of coping with grief. Her friend was an athlete and soccer player, so to help her cope, she embarked on a marathon race in his honor.
Newcomer advises others grieving to first “acknowledge your feelings.”
“Then, think about a way that you could honor the person through a mechanism that is meaningful to you. So that can be artwork, music, or developing a financial fundraising project. It could be something very simple, but I do think having it be intentional is what you’re doing to help honor this person,” Newcomer adds.
In a column for SurvivorNet, New York-based clinical psychologist Dr. Marianna Strongin wrote that it may be helpful to remind yourself that these feelings are “meaningful yet temporary.”
“If you approach them with compassion, kindness, and eventually acceptance, you will come away from this period in your life more connected to your resilience and strength,” she wrote.
Understanding Multiple Myeloma and Treatment Options
Multiple myeloma is a notoriously difficult cancer to diagnose. “The reason is because sometimes the symptoms are non-specific,” Dr. Nina Shah, a hematologist at UCSF, told SurvivorNet. This means that its symptoms are so generalized and subtle that they could be a variety of different complaints, and your physician won’t immediately check for cancer.
WATCH: Multiple Myeloma diagnosis.
“In general, having blood cancer means that your bone marrow is not functioning correctly,” Dr. Nina Shah, a hematologist at the University of California San Francisco, explained to SurvivorNet.
Sometimes, doctors find multiple myeloma while doing a blood test to look for another condition or when trying to find out what’s causing a patient’s unexplained symptoms.
Doctors use blood and urine tests and imaging tests, such as X-rays or MRIs, to help diagnose multiple myeloma and to guide treatment options. Ultimately, a bone marrow biopsy will confirm the diagnosis.
Multiple myeloma can be divided into categories that help physicians determine the best treatments and approaches.
“We tend to [divide them] based on how risky the myeloma is, whereas other cancers will be staged based on how far the cancer has spread,” Dr. Shah said.
High-risk multiple myeloma exists when a patient’s cells contain missing segments of DNA or switched segments.
Intermediate-risk multiple myeloma is when some of these DNA changes are absent, but a patient has elevated levels of certain proteins in the blood.
Low-risk multiple myeloma exists when a patient has none of these changes.
WATCH: Advancements in multiple myeloma treatment give patients added hope.
Multiple Myeloma Relapse
When your multiple myeloma comes back within about a year, your disease is generally classified as “high risk.”
When multiple myeloma returns after treatment, “It usually means that there were residual cells, even in very small numbers. They were either resistant to the treatment from the start, or they acquired resistance as the treatment was growing,” Dr. Kenneth Anderson, Director of Dana Farber Cancer Institute’s Multiple Myeloma Center, told SurvivorNet.
In other words, not every myeloma cell in your body is precisely the same. Some start with a set of mutations that can give them resistance to treatments and make them more likely to relapse, whereas others develop mutations as a result of treatment.
The Signs of a Multiple Myeloma Relapse
Signs of relapse may include:
- Increased levels of monoclonal antibodies: Myeloma cells are cancerous plasma cells in the bone marrow that overgrow and produce abnormal proteins. These abnormal proteins are released in the blood and can be detected by physicians. When the levels of these increase substantially, that can be a sign multiple myeloma has relapsed.
- Increase in plasma cells in the bone marrow: Oncologists can use magnetic imaging, like MRI or PET scans, to see if there are a greater than normal level of plasma cells in the bone marrow, typical of overly dividing myeloma cells.
- Bone fractures and lesions: Myeloma cells activate the cells that break down bones and deactivate the cells that build up bones, which can result in fractures or small holes in bones. Oncologists can use X-rays or CT scans to detect bone damage indicative of relapse.
“Just because myeloma returns doesn’t mean it can’t be effectively treated with many years of quality life,” Dr. Anderson said.
Among multiple myeloma patients who are doing well include veteran journalist Tom Brokaw, who was diagnosed in 2013. He found success with the chemotherapy drug Revlimid (generic name lenalidomide), which has been shown to improve survival for multiple myeloma patients.
WATCH: Journalist Tom Brokaw’s multiple myeloma journey.
Myeloma cells that have survived after undergoing multiple rounds of various treatments to cause relapse are typically the most resistant. This occurs because relapsed myeloma cells have over twice as many mutations as when the disease previously appeared. This meant they had twice as many ways of resisting previous treatments.
To treat this highly resistant form of the disease, second-generation drugs are an option. These are more recent adjustments and improvements to existing therapies.
For relapsed patients, the second-generation treatments include:
- Kyprolis (carfilzomib) – is a proteasome inhibitor.
- Pomalyst (pomalidomide) – 2nd generation immunomodulatory.
- Dexamethasone – a mainstay of myeloma treatment in both relapsed and initially diagnosed patients.
Daratumumab, an immunotherapy, is also added to the mix. More specifically, Dara is a monoclonal antibody that ‘tags’ cancer cells for quick and efficient recognition by the immune system.
In myeloma patients whose disease has returned repeatedly, oncologists may turn to therapies approved only for clinical trials, namely CAR T-cell therapy.
“We’re using the CAR T-cells now literally in patients who have no other options,” Dr. Anderson said. CAR T-cells are immune cells harvested from a patient’s body, genetically modified to target specific cells (like multiple myeloma), and then reinfused back into a patient.
For more options following multiple myeloma relapse, clinical trials may offer a solution.
Questions to Ask Your Doctor
If you are facing a multiple myeloma diagnosis, here are some questions you may want to ask your doctor.
- What stage is my multiple myeloma?
- What are my treatment options?
- What are the possible side effects of your recommended treatment?
- Who will be part of my healthcare team, and what does each member do?
- Can you refer me to a social worker or psychologist who can help me cope with my diagnosis?
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