Back to Work After Cancer, I Saw Myself Change

On the first Monday of June at 4:30 a.m., I was back to work. It was official: my breast cancer journey was over.

Flying from Calgary to my hometown of Toronto to attend an academic conference felt like an enjoyable way to start working again. I looked forward to the business and buzz of conferencing: sharing coffee with old friends at favourite haunts, catching up with students and colleagues in campus corridors, and even writing up my last-minute speaking notes on the plane.

As my early-morning Uber made its way along the dark stretch of Deerfoot Trail to the airport, I began strategizing: what details should I share with friends about my illness? I didn’t want to share too much and make them uncomfortable. But I also didn’t want to share too little and cause them to worry that I wasn’t OK yet.

Next, I considered what I should tell colleagues who don’t know me well. My email account has been pumping out hundreds of automated out-of-office replies since Christmas. Colleagues know I’ve been away, but perhaps they think I’ve gone on an extended research trip overseas or am holding a visiting appointment at another institution.

I decided that I would answer all questions directly: it was breast cancer, and I’m over it.

We need to get comfortable talking about cancer, a disease that touches just about all of our lives.

We don’t always talk about it, but cancer affects many

According to data reported by the Canadian Cancer Society, 45 per cent of Canadians are expected to receive a cancer diagnosis in their lifetime. In Canada, women have a one-in-eight chance of developing breast cancer.

And some cancers are striking at younger ages. Researchers anticipate that women aged 30 to 59 will account for 36 per cent of all new breast cancer diagnoses going forward.

Last year, the Canadian Task Force on Preventive Health Care released draft recommendations that continue to advise against routine mammogram screening for women aged 40 to 49, which has long been the standard national recommendation.

Provinces like Quebec and Manitoba follow these national guidelines and offer regular screenings starting at age 50.

However, change is afoot. Manitoba, along with a few other jurisdictions, plans to lower the recommended screening age this year. In my home province of Alberta, the government recently dropped the age for regular screening mammograms from 50 to 45.

I was diagnosed with invasive ductal carcinoma of the breast at age 47. My outcome might have been different if I had waited for routine screening.

Even starting at age 45, as is now practised in Alberta, might be too late for some people. Today, the Canadian Cancer Society recommends that women and trans, non-binary and gender-diverse people at average risk begin screening even earlier — at age 40.

In response to public backlash against the task force’s draft recommendations, the federal government established an external expert review, which reported back in June.

Among its many recommendations was a call to overhaul how screening guidelines are developed. This bodes well for possible changes to national recommendations.

Am I ready for this trip?

I drew in a deep breath as I entered the airport, filling my lungs with the excitement of travel. Joining a small security queue, I waited to flash my boarding pass and move forward through the line. Backpack in one bin. Coat and liquids in another. Laptop in a third.

As I passed through a silent metal detector, a security agent stopped me and directed me to a machine for a random hand and laptop swab. The process triggered an alarm. The agent instructed me to spread my arms and legs for a pat-down. Pointing to the beige compression sleeve on my left arm, she asked if it was a “medical device.”

I looked at my sleeve, contemplating — for the first time — its classification as a medical device.

People like me who have had lymph nodes removed during cancer surgery or who have undergone radiation treatment are at risk of developing dangerous and permanent swelling called lymphedema when flying, exercising or hiking at high altitudes. Compression sleeves help prevent this.

Just a few days before my trip, I bought my first sleeve in preparation for the journey. I thought it looked unremarkable — like a bandage an athlete might wear for training. Now I saw it as something that marked my illness.

I returned the agent’s gaze and responded in a voice so small I hardly recognized it: the sleeve was for breast cancer.

Since my diagnosis, I’ve controlled who I tell about my cancer. But now — standing with my arms outstretched in an airport security line — I found myself disclosing this to a stranger.

Just a month earlier, I had lifted my arms for strangers who were preparing me for my final radiation treatment at Calgary’s new Arthur J.E. Child Comprehensive Cancer Centre.

On this first day back to work, I felt like a patient again.

My eyes burned as the agent ran her hands along my bandaged arm, around my new surgical scars and across the rest of my body.

The spectacle of me tearing up at a security checkpoint raised suspicion, prompting a secondary team to search my backpack while the agent pressed me. Have you been to Toronto before? What do you do for a living? Is it your dream job? Did anyone put explosives in your bag?

And then it was over. An agent rezipped my bag and wished me a good journey, while another agent filled out paperwork.

Shaken, I hurried forward and collapsed on the first bench I saw.

Will I be able to talk to people about my cancer? Am I ready for this trip? Should I turn around and go home?

Healing takes time

The previous week, when I slid my return-to-work form across my doctor’s desk, I reasoned that I was ready: I was already answering emails, chipping away at a conference paper and reading my students’ work. As my doctor signed the form, she cautioned that healing takes time. Sitting on a bench in the departures terminal, I was feeling less confident, but I steadied myself and pushed forward to my gate.

When I arrived at the conference site at George Brown College in downtown Toronto the next day, I felt ready, though a little anxious, to present my thoughts on encouraging “deep reading” in the classroom — the theme of the panel. I relaxed at the sight of the friendly and familiar faces of my co-panellists.

Convening at the front of the classroom, we took turns presenting to the audience. I tried to follow everyone's words carefully. It felt like work — to hold on to each new idea and connect it to the next one — but I was keeping up.

When I spoke, I worried that the cadence of my speech was a little too quick, my delivery a little too erratic.

This is not a new worry. In casual conversations with neighbours or while chatting with other parents at my kids’ schools over these past weeks, I’ve found myself trying to outrun the intermittent confusion and pangs of panic that come with post-radiation brain fog: reaching for words that aren’t there, struggling to recall names of people I know and fearing that I’m losing coherence.

I searched the faces of my co-panellists and the audience for clues of unintelligibility. No one looked confused.

Following the panel, I had time to reconnect with a good friend attending the conference — another motivation for pushing forward with this trip. Two years ago, she had lost her spouse, an exceedingly charming, sharp-witted British scholar I also knew well from graduate school, to colon cancer. While we’ve exchanged occasional messages and video calls, I felt terrible for not having seen her in person.

We made our way from the campus grounds to St. Lawrence Market — one of my favourite Toronto spots. Weaving through the market stalls, she described the shock of receiving her spouse’s terminal cancer diagnosis and the impact of his death on their young children.

It struck me that we now share a terrible common language: biopsies, oncologists, surgeries and lab results. We also share frustration with the many delays, long wait-lists and siloed care that come with cancer treatment.

As we walked, we turned over the promise of new cancer research, treatment and care. In June, The New England Journal of Medicine published the results of a study on exercise and colon cancer survival led by Canadian researchers from the University of Alberta and Queen’s University.

The large international study, spanning 17 years and involving 889 patients, showed that exercise programs reduce the relative risk of death by 37 per cent.

I have found exercise to be a critical part of my own recovery through the Alberta Cancer Exercise program, or ACE. Twice a week, I lift weights, do squats and run on a treadmill at the University of Calgary’s Thrive Centre with others who have cancer. Beyond establishing a practice of structured exercise, I’m motivated and heartened by the tenacity and good humour of my fellow participants.

I sent a letter to Cancer Care Alberta detailing my experience and advocating for provincial support for the ACE program. I was discouraged to receive a template reply explaining that the province does not financially support clinical exercise programs for cancer.

This response was surprising given the growing evidence that exercise is indeed medicine. It was even more surprising considering how many public health nurses and physicians had handed me pamphlets promoting the ACE program. It’s clear they see its value.

Following the conference, my journey home to Calgary was uneventful. This time, I left the medical device in my bag until I had cleared security.

As I settled into my seat on the late-night flight, I reflected on the distress I experienced when I found myself unexpectedly disclosing my illness to a stranger at airport security. I also recalled the comfort and catharsis that came with sharing details about my breast cancer with a friend — in this case, someone facing the life-sized hole cancer has left for her.

Setting out on this trip, I was prepared to tell people about something that happened to me in the past: breast cancer was a challenge, but I was over it.

I see now that cancer will remain with me. It will be there every time I move through airport security, check the “cancer” box on a medical form or — and this is a gut punch — help my parents interpret my dad’s oncology reports and join them at his appointments at the same cancer centre where I just completed treatment.

Returning to my everyday working life, I now understand that I won’t always be able to control how I share this new fact about me.

I’ll be gentler on myself, recognizing that healing from cancer will take time. I need the support of my friends and loved ones as I continue this journey, just as I support them in theirs.