October is ‘pinktober’ – Breast Cancer Awareness month and activities are in full flow. You do not need to have breast cancer or any cancer to sense that such cancer awareness times can be complex, helpful, annoying, divisive and frightening. Having been treated for cancer, I have to be careful for this month not to raise my cancer anxiety too high.

For many it can be a difficult time, when memories, current health realities, campaign misrepresentations, commercialisation of the cause and disagreements among people with breast or other types of cancer can be exhausting.

Breast Cancer Awareness month was never high on my radar – not before my diagnosis and not after my treatment for breast cancer.

Cancer has become part of who I am. It has shaped me, but it does not define me. @KarinSieger (Click to Tweet)

For me, breast cancer is not just about breasts. On balance, I have always tended to think that I have been treated for cancer, first. In my case, it happened to appear in my right breast, first. If or when the cancer returns, it can be in many other parts of my body like my bones, my liver and my brain.

For me, breast cancer is also not about pink fluff. I appreciate that up-beat, motivating and cheerful messaging will get a better response to awareness and fundraising events. But it just does not sit comfortably with me. The reality of breast cancer and any cancer for that matter is stark and brutal.

Breast Cancer like any other type of cancer is complex. The incidence among women is high. Men get breast cancer, too. While survival rates up to and beyond five years are comparatively high, this is not to say the cancer will not return and become terminal.

Cancer is a waiting game. The word ‘never’ does not exist.

Social media campaigns like #BreastCancerRealityCheck on Twitter challenge what is described as sugar coating the truth of breast cancer by sharing less known or talked about realities of being treated for, living with and dying from the illness.

Questions are asked like what kind of research is the fundraising used for (prevention, primary, secondary treatment or cure)? What are the health ethics of campaigning companies and organisation during the rest of the year? Is the language and imagery a reflection of the cancer reality or at best an innocent glossing over of difficult facts or at worst an irresponsible headline grabbing attempt in the name of corporate social responsibility?

It is a twitter campaign I have chosen to participate in by focusing on the emotional impact of cancer (not just breast cancer). Cancer impacts our bodies, minds, hearts, souls as well as our pockets. While every aspect of our life is thrown into crisis, treatment and care rarely integrates our mental health needs.

Anxiety, depression, loneliness, relationships problems, anger, guilt, loss, bereavement, religious and spiritual void are just some of the issues we will be dealing with, if we are affected by cancer (including relatives and friends). And this does not stop with treatment.

While other charities for other and rarer types of cancers, or those with lower survival rates may not achieve the same levels of awareness, fund raising and participation levels as Breast Cancer Awareness does, a lot of the worries, questions and concerns apply across the board.

While ‘my’ cancer may not be ‘your’ cancer, ultimately we all are in the same boat of uncertainty, where death from cancer is real. I do not want to compete for attention, concern, investment in treatment or cure.

Another aspect of cancer difference is the grade or stage of our cancer diagnosis. I am in remission, which I interpret as currently not undergoing any treatment for noticeable symptoms of primary or secondary (ie terminal) breast cancer. The occasional sense of guilt does creep in, especially now during Breast Cancer Awareness month with its high volume of stories and messages of what others already go through and what may lie ahead for me.

I have ‘remission guilt’. Others may call it ‘survivor guilt’.

In the world of cancer words matter, and words may not have universal but personal meanings.

I do not see myself as fighting or bravely battling. My body developed an illness called cancer. For me, battling that would mean fighting my body, which I cannot and will not. Neither will I demonise the disease, which would make me feel even more helpless and lacking control. While my treatment left me with life changing side effects, was terrifying and debilitating, I have been given time, for which I am thankful and which I try and use wisely.

Hearing others’ stories, I wonder whether I have made the right choices for my treatment, whether I asked the right questions, and whether there is anything else that I should be doing now or instead of what I already do.

Ultimately, we need to find the right measure of engagement with our own reality, our story, our wound, whatever that may be.

For my cancer reality this means taking special care at a time when the messages can be overwhelming in volume and tone and lead to even more fear and other difficult feelings.

I for one have noticed an increase in my cancer anxiety, which is unhelpful at best and harmful at worst. Given the pressure of uncertainty in my life, and having lost some trust in being able to read my body, trying to separate irrational from rational anxiety and limiting the physical impact of anxiety on my body has become constant in my life. Even more so during the month of October.

Karin Sieger is a psychotherapist and writer. She specialises in supporting people through anxiety, bereavement and life-changing illnesses like cancer. Her blog is Between Self and Doubt. You can follow her on Twitter and  can sign up for her newsletters here. For more information visit KarinSieger.com.