A breast cancer survivor shares hard-won tips for overcoming depression — and guilt

A portrait of Ruth Kaminkski
Ruth Kaminkski Photo by Robert Hood / Fred Hutch News Service

The way this whole thing started out was I wanted new knees: I had really bad arthritis in my knees and lower back. It had been getting more and more painful, and I thought I should get ready to have a knee replacement in about a year. The way to start off was to get a physical. So in November 2014, I did. And then we stopped right there. The mammogram showed “some concerns” in my right breast.

This was right after my 60th birthday. I was so calm. I thought, “This is nothing.”

I went in for an ultrasound with the radiologist, who found two spots of concern. She did two biopsies. My daughter-in-law and her 2-year-old identical twin boys came over to my house. My son had said, “My mom’s going to get the results today, so you need to be there.”

The radiologist called and said the first spot was benign. The second spot was invasive ductal carcinoma.

As she said that, I looked across the room at my daughter-in-law, who was trying to keep the boys quiet. So I repeated: “It is cancer, and it is invasive.” And Allie, my daughter-in-law, started crying. And I said, “Allie, stop crying, I need to get through this call.” When I got off, we both had a good cry.

My husband and I went to the Seattle Cancer Care Alliance on the eastside, Evergreen Hospital, to confirm [the diagnosis]. We met with the radiologist, the oncologist and the surgeon. We were just looking at these people like they were Martians. Their mouths were moving, but they were not saying what we wanted to hear. We were pretty much in shock.

So I had a lumpectomy. You have to make these decisions that are so hard to make: lumpectomy or mastectomy. I went back and forth, back and forth.

I had my surgery on Jan. 14, 2015. I started my radiation Feb. 16, about a month later. I had to do the daily 35 treatments, Monday through Friday.

Probably within two weeks of starting radiation, I realized I was in trouble emotionally. I kind of fought admitting how bad it was. When you’re stage 1, you think, “I shouldn’t be depressed, I’m fine. It’s OK.” But it still gets you down, it drags you down. People kept saying, “If you’re going to have cancer, this is the best cancer to have.” But no cancer is the best kind to have.

Early on in the treatment, I went to one counselor. She really didn’t help. She was a talk counselor. I was looking at the bad side. She was just kind of agreeing with me: “Yeah, cancer sucks.” So I changed to another doctor, who was a psychiatrist. He went through this trial of medicine. The first one just made me rage and be angry. So I gave up on him.

I held everything together and acted normal all through the surgery, the radiation. Nobody could tell from the outside that I was slipping further and further. Except my husband knew, he could tell. But I couldn’t talk to him because I was so worried about him being worried about me. You try not to put more strain on the people you love.

My daughter-in-law knew I was in trouble, and she tried to help. But I started isolating myself. I wouldn’t see friends because I knew I wouldn’t act the way they expected me to act. I felt guilty in support groups. I guess because of the general populace telling me I should be fine, I couldn’t open up there either.

One day, I broke down with my oncologist. And that’s where I got Jesse.

My first appointment [with Dr. Jesse R. Fann, director of psychiatry and psychology services at SCCA] was after I was completely done with treatment. Jesse understands cancer patients, and I can’t tell you how much of a difference that experience made in how he treated me and allowed me to express myself without feeling like I was whining.

I would say for anybody who’s going through something like this: Make sure you try to see a therapist or psychiatrist who has a lot of experience with cancer patients. You need to find the right therapist, one who’s going to work with what you need. No matter how supportive family and friends are, sometimes you need a professional to drop your barriers and tell them things you can't tell those closest to you. Like: I hate being treated so fragile or I wish I could cry and be angry without someone trying to fix it.

Part of the whole cancer thing is just accepting that you’re not going to feel like yourself. You become a different person after the experience. That has to be OK with you because you don’t really have any choice. For a while, I wanted a choice. I wanted to be able to say, “I don’t want to do this anymore.”

The tips and tricks Jesse told me helped me get through this. Like, not minimizing my experience because it’s different from others—that’s where a lot of my guilt was coming from. And I shouldn’t be so concerned about whether other people can handle what I need to say.

He encouraged me to take baby steps. He said don’t let the fear of getting overwhelmed stop you. He said celebrate the little accomplishments. If you go out to dinner and you feel OK, celebrate that you can do that. You couldn’t have done that two months ago.

You learn also to let go of the people who don’t give you energy or who aren’t there for you. I let go of most of the people who said, “Why aren’t you acting like yourself? It’s just stage 1, you’re going to be fine.” It’s OK to let people go.

And get a puppy: Puppies help. I have a Goldendoodle. His name is Hunter. He’s almost 6 months old now. He’s awesome. He always understands. If I’d known, I would have gotten a puppy sooner.

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