5 June 2020
Stress Fibers and Microtubules in Human Breast Cancer Cells. Created by Christina Stuelten, Carole Parent, 2011 (US National Cancer Institute via Unsplash)
Everyday Lauren* breaks her isolation to visit the clinic where she undergoes radiotherapy.
She is in her third week of this course of treatment, with a week to go. The radiotherapy uses radiation to target an area of tissue on the left of her chest. The laser is active for 15 seconds at a time, during which Lauren must hold her breath to shift the position of her heart and lungs in order to protect them from the harmful effects of the radiation.
Once the 15-minute session is complete, she returns to the home which she shares with her grandmother. She is six months into treatment for breast cancer. While at first it made her anxious, she tells GroundUp that she now likes going to radiotherapy: “It’s good to have something to do every day.”
Lauren, 30, had been in Dubai for three weeks when she found a lump in her left breast. She had just begun a new job. A visit to a Dubai oncologist confirmed that she had breast cancer. She returned to South Africa in October 2019 and began her first course of chemotherapy in November 2019, four sessions, one every fortnight. Side effects of this treatment were severe and included nausea and queasiness, fatigue, extreme light sensitivity, hair loss, stomach pain, menopause symptoms, and insomnia.
Her second course of chemotherapy involved a session every week for twelve weeks. Side effects included fatigue, carpal tunnel syndrome, hot flushes, nail loss, insomnia, and numbness and pins-and-needles in fingers and toes.
Meanwhile Covid-19 began to stretch out across the globe. When lockdown started in South Africa in late March, Lauren still had three chemotherapy sessions to go, then surgery, and then radiotherapy.
Lauren says that when Covid-19 entered the public consciousness, she wasn’t particularly worried. And when the lockdown happened, she felt something close to relief. Cancer had placed her life on suspension, and it seemed as if the rest of the world had now caught up with her.
But that feeling did not last long. Family and friends could no longer support her in the same way. She couldn’t go for walks with friends. Friends couldn’t visit or help her cope with the side effects of her treatment. And the turmoil that Covid-19 has wrought on society in general meant that people had their own crises to weather.
She has not been able to work because of her treatment and moved in with her grandmother at the onset of the Covid-19 crisis so they could isolate together. They have all their groceries delivered to avoid the risk of shopping.
As the nature of the infection began to be understood, precautionary measures at the clinic changed. One week the windows of the chemotherapy treatment centre were open wide, the next they were closed, each decision the result of a new opinion.
A patient’s last chemotherapy session is normally a moment of celebration. Family and friends come to the clinic, and the patient rings a bell to signal the end of the treatment. But as regulations designed to curb the spread of Covid-19 were instituted in hospitals, and visitors were barred from wards, the bell-ringing ceremonies were much more subdued.
Four weeks after the chemotherapy concluded, Lauren was scheduled for lumpectomy surgery. As hospital admissions dropped with the suspension of surgery which was not urgent, Lauren’s procedure was advanced by two weeks. Her doctors were also concerned that if they waited, there would be more risk of her contracting Covid-19.
Her parents couldn’t take her to the hospital or be at her bedside when she woke up. Instead, they met Lauren in the hospital parking lot and waved to her from inside their car as she was admitted for surgery.
One benefit of the lockdown was that there were far fewer people at the hospital. As she would walk around the hospital parking lots as part of her post-op physiotherapy, she noted how the usually bustling space was now empty.
Cancer patients require close monitoring from the doctors responsible for their care. On entry to the cancer care clinic, Lauren would have her temperature read by a digital thermometer, and nurses would watch as she washed her hands before she entered the chemotherapy clinic. The clinic insists on strict social distancing, and access to the clinic is restricted. Lauren has not needed to go for a Covid-19 test, as she has kept strictly isolated.
A month ago, her usual clinic was shut down for two days after a receptionist’s husband- and then the receptionist herself - contracted Covid-19, and Lauren had to go to another clinic during that time.
Enduring breast cancer meant Lauren had to find ways to stabilise her mind - what Lauren calls “emotional regulation”. Covid-19 removed many of these options - walks with friends, a night out with them, visits to the ocean, or spending time with her parents. She finds comfort in watching videos online, and playing games. The key for her is creating a routine to work through each day. “In the hard times, you’re only as good as your systems,” she says.
“Before Covid, it was simpler to be going through cancer. There was a light at the end of things - the promise of getting back to life, getting to swim in the sea.”
For Lauren, what is scary - cancer and Covid - has become normal, and what was normal - a job, a night out, a swim in the ocean - is very far away.