Dear Perrie,
My mom was recently diagnosed with metastatic, stage four bone cancer following a brutal car accident. The diagnosis came from a scan that was done because she broke her pelvis in the accident. She was five years from having “recovered” from breast cancer. My biggest question, besides the “why” that everyone grapples with, is: If the doctors were doing their job and following up with her and doing check-ups to make sure the cancer wasn’t coming back, how is she already at stage four? Why weren’t they looking? Why didn’t they check? What could they have missed? Do we sue? Can I talk to her “care providers”
These thoughts are all-consuming, and I do believe there is someone to blame. Thoughts?
Dear Looking for Answers,
First, I want to say how sorry I am that your family is facing this. Receiving a metastatic diagnosis five years after a previous cancer diagnosis is devastating for patients and the people who love them, especially when it comes completely unexpectedly. It makes complete sense to me that your brain is searching for a “why.”
When something traumatic or unexpected happens, our brains often search for reasons, answers, and patterns in an attempt to understand what happened and keep ourselves and the people we love safe. Sometimes anger can become part of that search too, especially when something feels unfair, preventable, or impossible to make sense of.
I name that because you mentioned these thoughts are all-consuming. I want to make some space for why your brain may be returning to these questions over and over without dismissing the concerns underneath them. It may be helpful to get curious about what feelings or fears are sitting below some of these thoughts. Are you afraid someone failed your mom? Are you angry that this happened after your family thought cancer was behind you? Are you trying to understand whether anything could have changed what is happening now? Those questions may help you better understand what you need as you continue to support your mom.
As far as the medical questions, I absolutely encourage you and your mom to bring these concerns directly to her care team. You deserve space to ask, “What happened?” and “What do we know now that we didn’t know before?” Her providers are going to be the people best positioned to explain her individual history, what they were monitoring, what they saw over time, and what they understand about her cancer now.
It may help to write your questions down before the appointment so everything doesn’t disappear the moment you walk into the room. You could ask what her follow-up plan had been after her original breast cancer treatment, whether there were any earlier findings that look different in hindsight, when they believe the current cancer may have developed, and whether there is anything about her previous records that they want to review again.
If your mom wants you involved in those conversations, she can also ask her medical team what they need from her so they are able to speak openly with you about her care. Sometimes having another person in the room to take notes, remember questions, or simply listen can be really helpful when everyone is overwhelmed.
If, after talking with her providers and reviewing her records, your family still has serious concerns about her care, you can seek a second opinion or ask another qualified specialist to review her case. It may also help to bring a trusted advocate or family member to appointments, take notes, and write down questions in advance.
In the meantime, I really want to encourage you to give some attention to yourself, too. You were just thrown into a completely different chapter of your mom’s cancer experience without warning. Fear, anger, grief, and uncertainty can take up an enormous amount of mental space, and you deserve support as you carry all of this. That might look like joining a caregiver or co-survivor support group, seeking individual therapy, or connecting with a breast cancer or caregiver community. You do not have to navigate this alone, and you are worthy of care and support, too.
Living Beyond Breast Cancer offers resources for people living with metastatic breast cancer, as well as for their family members and loved ones. They also provide support and opportunities to connect with others who understand the emotional challenges of breast cancer. Elephants and Tea offers writing workshops for caregivers, along with magazines and articles focused specifically on the caregiving experience.
You don’t have to stop asking questions or searching for answers. I just hope you can give yourself permission to recognize that you may be searching for two different things right now: information about what happened and a way to make sense of something that feels profoundly unfair. The first may come through conversations with her medical team. The second may take more time, support, and care.
Sending you and your mom so much care as you navigate what comes next,
Perrie
Ask Perrie is Cactus Cancer Society’s advice column for the questions that young adult cancer doesn’t come with instructions for. Community members submit anonymous questions, and Perrie offers thoughtful guidance, perspective, and practical ideas for navigating life during and after cancer.
