In 2022, the latest data available, about 20 million people around the world will be diagnosed with some type of cancer. As is often the case in these cases, a figure cannot reflect the emotional burden of 20 million unique cases. 20 million personal stories hidden behind the cold statistics. Dramas in some cases, stories of improvement in others. Happy endings. Fatal endings. But there are some common elements in all of them. First, the vital change that this disease represents. It is difficult for someone who faces it and ends that journey being the same person they were before. Cancer puts you on the edge. It punishes you. But sometimes it also gives life lessons. It makes your priorities change and things that seemed important go to the background and always stay there. The public examples are numerous: “I have learned to look for the beautiful things in life,” said Julia Otero after overcoming it. “The best advice I can give you is to run for your dreams.” Words by Sara Carbonero.
When cancer comes, it turns everything upside down. Not only in the field of health. The shock wave can affect the family and even other social aspects, such as work. According to the Spanish Association against Cancer (AECC), almost 30% of patients who suffer from this disease of working age claim to have subsequently lost or left their job. Among other things, due to the difficulty in meeting schedules and maintaining the pace of work. And when that happens, it is not easy to re-engage in the labor market. The risk of unemployment in patients who have overcome cancer is 34% higher than that of the rest of the population. It is the experience that Valladolid businesswoman Raquel González is experiencing right now, forced to leave her restaurant to face the disease, without knowing what will become of her after it, at 61 years old. The AECC studies also conclude that work problems extend to the patients’ families, who have many difficulties reconciling care with their jobs. Almost 7% of them lose them, either because they resign or because they are fired, and more than 2% are forced to change to another, more compatible job. And they do it because they know the importance of help that is not always easy to provide. That is why the AECC works with families to ‘teach how to help’. So that they learn to communicate when delicate topics have to be addressed, such as the end of life. “Or to give information to the children that mom or dad is sick and their hair is going to start falling out,” explains AECC psychologist Inés Ruiz.
Raquel González (lost her job in hospitality after tonsil cancer): “I can’t work in hospitality because the treatment burned my taste buds”
Before she was diagnosed, Raquel González already suspected she had cancer. She had had a sore throat for months and could open her mouth less and less, to the point of having great difficulty eating. But in her first consultations, her doctor told her that it was nothing serious. And she, somehow, clung to that diagnosis, even though she didn’t believe in it. «Even the biopsies were negative and, on the one hand, I didn’t want to look anymore; but, on the other hand, I knew it wasn’t like that, because I felt the lump, it hurt… », she says.
His suspicions were confirmed when a lymph node appeared. A new biopsy confirmed that he had tonsil cancer, although he was not given the result until a month after the definitive test was done, in July of last year. The blow was brutal. “It’s like a stone falls on you, it scares you tremendously,” he remembers. Raquel didn’t even know that tonsil cancer existed, but she had to learn what it was all at once. “It’s like entering a totally unknown world that you think will never touch you,” she adds. But if. She plays. And when one least expects it. She felt alone despite being surrounded by many people. She alone before chemo and radiotherapy. She began to lose her hair and a lot of weight after spending two months eating only shakes. After 33 sessions, “the maximum that can be received”, her physical impact was so great that standing in front of the mirror was a difficult pill to swallow.
The consequences also extended to the workplace. Raquel has almost always been linked to the world of hospitality. In fact, she worked in the kitchen of a cider house in Valladolid of which she was co-owner, and she had to leave to focus on her recovery. Something normal in all patients, but, in this case, she has many doubts that she will work in this sector again because the treatment burned her taste buds. “I am not able to differentiate flavors and, therefore, I have no criteria for food,” she explains.
The uncertainty about the future of work is absolute, because he is aware that at 61 years old it is not easy to retrain or find a job. And even less, with his medical history. “I’m honest, if I were in the employer’s place, I wouldn’t hire a person in my situation either,” she concludes.
Natalia de la Puente (breast cancer patient): “There have been people who have asked me how much time I had left”
August 24, 2023 is a date that is marked in the mind of Natalia de la Puente. That day she was told that she had breast cancer to confirm her worst suspicions. The disease entered her world at a time that, in theory, should have been one of the happiest of her life. Only nine months before she had become a mother and there were just a few weeks until she was to get married.
It was precisely during the pregnancy when the first suspicions came that something was not right. “I started having secretions from one nipple and the doctor told me that I was probably starting to generate milk,” she remembers. With the doctor’s message she became calmer, but not completely. After giving birth, in November 2022, she began to notice a lump in her breast when she was breastfeeding the baby. She thought it could be a consequence of the initial breastfeeding period, but, seeing that it did not disappear, she returned to the consultation. From there she was referred to the Hortega River, where, according to Natalia, they told her that there was no reason to be scared. “But I didn’t trust it and decided to go to the Recoletas clinic, where they told me that they didn’t see anything strange either, but that I had to look at it, and when I looked at it…”
Upon looking at him the fateful news arrived. “The first thing I felt was a lot of anger, against everything and everyone, I don’t know why,” he remembers. Instead of crying, he started screaming, thinking that he was only 32 years old and had a newborn baby in his care. “It’s like the world is ending in a matter of seconds,” he says. The anger gave way to another stage of crying, but both did not last long before Natalia climbed onto the back of optimism to face everything that was to come. No matter how terrible it was, like losing a breast whose reconstruction she is still waiting for. Now, almost at the end of the process, she says she is immersed in another stage. The “maximum depression” that comes after the ‘euphoria’, mixed with the fear that the tumor may reproduce.
The support of his family has been fundamental, although the reactions from those close to him have been a double-edged sword. «It’s nice to have people waiting for you, but there have been people who haven’t spoken to you for years and now they do it every day, as if they wanted to say goodbye, and several people have asked me how long I had left, I don’t know how they come up with it… », he ends. However, he emphasizes the importance of “surrounding yourself with ‘vitamin’ people.”
Inés Ruiz (AECC psychologist): «The question of why it was my turn appears in all patients»
Cancer treatment usually has a very important impact on the patient’s physical appearance, but the psychological consequences are no less important. From the moment the patient receives the news until he finishes assimilating it and getting used to a life that always changes. Inés Ruiz works as a psychologist at the provincial headquarters of the Spanish Association against Cancer and, from her experience, she recognizes that the first moments are marked by uncertainty. “From the moment the first signs are seen in the tests until they confirm that it is cancer and how serious it is, there is a very complicated period in which the patient becomes worst,” she explains. These are the “most complicated” days of the process. Later, when the worst news is confirmed, fear appears. “He doesn’t know how it will affect him, how he will cope with it and what side effects it will leave him, in addition to the fear of death, even though the prognosis is good,” she adds.
Then begins chemotherapy or radiotherapy and the devastating effects it has on the physique, such as nausea, joint pain and vomiting. «In that phase we work a lot on anger, rage, sadness and the feeling of injustice, because patients wonder why it was their turn, despite taking care of themselves and having done everything right… the question of why “It appears in all patients,” he asserts. And there is no answer to it, simply because there is no why. “Illnesses come and at that point the only thing that needs to be addressed is how we are going to face that moment.” That is, we work on accepting a process that will have better and worse moments.
Although many people think that facing the disease with optimism generates medical benefits, there is no scientific basis for this. “For years we have generated a problem on an emotional level, it seems that we cannot allow ourselves to be bad because being bad means getting worse and then, if that happens, it will be our fault… this is a mistake,” he says. What depends on the patient is to eat well, rest and listen to the doctor. “Whether the disease goes badly, despite doing that, does not depend on him, nor will having bad days make him have a worse prognosis.” That is why it is “very important” to free him from that burden and teach him to deal with the disease in the best possible way.
Carolina González (cancer researcher): “There are currently techniques in development that will arrive in the next 25 years”
Carolina González is immersed in research on the search for blood biomarkers that help personalize treatments for liver and bladder cancer patients. In the case of liver tests, she seeks to replace biopsies, which are more aggressive for the patient, with blood tests.
Despite his youth, he is clear that research is essential to find new treatments and improve existing ones, along with prevention. According to her, it is the safest way to stop the increase in mortality that is expected for the coming years. In this sense, he advocates developing “more personalized” treatments, which avoid generics, “which sometimes do not help patients.” Although sometimes it is necessary to work without knowing the deadlines, because in research it is always an uncertain factor. “It is difficult to estimate the deadlines, because sometimes it seems that advances take a long time to arrive, but when they arrive they can represent a revolution and that everyone starts researching it,” he says. Despite everything, he considers that “in 25 years there are many things that can advance”, although he is not clear that it will be to stop cancer “in a radical way.” The advances that may give better results in the coming years have to do, according to González, in immunotherapy and techniques with CAR-T cells. In this sense, he remembers that “25 years ago certain types of treatment that exist now did not exist, nor were they considered,” which is why he opens a door to hope for what may happen in the next quarter of a century.
Of course, everything has to be accompanied by the corresponding financing, which “is not the same in all types of cancer.” For example, the research for breast and colorectal cancer is superior to that of others. In this sense, the role of the Spanish Cancer Association stands out, “which in recent times has dedicated more funds to the types of tumors that are less researched and have more needs.” However, she is in favor of increasing the budgetary effort.
González considers that the increase in incidence in recent years is due to the increase in early detection programs, although environmental factors and changes in lifestyle habits, “which have worsened,” also play a role.