Not actually a pain in the neck: how cancer took me from patient to psychiatrist

Today is World Health Day, and this year the focus is depression. Here Tom Grew discusses the challenges he faced following successful treatment for Hodgkin Lymphoma, and how his experience has motivated him to tackle depression both personally and professionally.

It was 09:45 on the 26^th of February 2004. I was 18 years old. And I’d just been told that I had cancer.

I certainly hadn’t thought about cancer much when I was growing up. My only experience was that of my grandfather who died when I was 12. He had smoked all of his life and died of lung cancer. It was very upsetting, of course, but it sort of made sense.

I’d moved to Sheffield in 2003 to study History at university. It had all begun so well. I was making so many new friends and literally having the time of my life. And I thought that I was invincible.

This meant that despite having had a lump in my neck for about 18 months I kept putting off going to see my GP. I had no other symptoms and so was quite surprised when told that it was cancer, Hodgkin lymphoma, on that Thursday back in 2004. My parents were very upset. That’s how I knew this was really serious.

When I got back that day I went on the Cancer Research UK website and looked up everything about the illness. It was clear for me right from the beginning that knowledge and understanding were the key to how I would deal with my illness.

This was particularly important once treatment had begun. Health professionals that I had never met before wanted to give me chemotherapy drugs that would make me sick, feel exhausted, and put me at risk of infection. I struggled to get my head round this – all those side-effects just to rid me of a painless swelling in my neck? It didn’t seem fair!

The only late effect that was mentioned to me at the time of diagnosis and treatment was that chemotherapy could affect my fertility. I’m glad this was mentioned as it meant that I could preserve samples of sperm.

But nobody mentioned the potential psychological challenges I might face.

‘I found life much more difficult after treatment’

6 sessions of chemotherapy followed my diagnosis, but luckily I managed to stay on at university, spending about a week at home after each treatment and then a week back in Sheffield.

After chemotherapy I had a CT scan and luckily it showed that there were no further signs of cancer.

However, I then went on to receive radiotherapy once a day for 4 weeks to maximise the chances of the cancer not recurring.

Tom’s return to university wasn’t easy.

So what next after radiotherapy?

Back to normality?

Back to having a good time?

It wasn’t as simple as that.

I was able to continue at university but I actually found life much more difficult after treatment. I can look back and see that I always had a pre-disposition to feeling anxious, and that my illness brought it out in me.

I became incredibly fearful of the cancer returning. I began to start checking my body for lumps, often multiple times throughout the day.

This reached a critical point about 18 months after treatment had finished. I started booking emergency appointments, I couldn’t sleep and generally just couldn’t function properly.

I went to see my GP who diagnosed me with depression and an anxiety disorder.

‘It was at this point I decided to make a change’

Following this diagnosis I began taking antidepressants, and had Cognitive Behaviour Therapy, which did help a great deal.

Although the cancer and my mental health problems are linked, for me dealing with the depression and anxiety was more difficult than coping with the effects of the chemotherapy and radiotherapy I received for cancer.

It was at this point I decided to make a change.

Both during and after treatment I had been particularly inspired by my doctors, and so by the end of my history degree I had already started thinking about the possibility of studying medicine.

After graduating in 2006, I successfully applied for a job in a hospital pharmacy as I wanted to get experience to see if medicine was really for me.

I made sure to get a job in the hospital where I had chemotherapy – a place that simply thinking about made me feel sick. I was determined to get over my fear, and not let the cancer continue to control me.

The pharmacy role really cemented my desire to study medicine and so I returned to Sheffield in 2008 to begin the course.

There is no doubt that if I had not had cancer I would not be where I am today.

‘The one person in the world who can empower me more than any other is me’

During medical school I went on to represent young people with cancer, on a local, national and international basis. I began to meet other people who’d had cancer at a young age. For many years I thought I was the only young person in the world with cancer.

Dr Tom Grew

Now 13 years after diagnosis I’m pleased to say there has been no evidence of relapse. But one of the most difficult aspects to deal with has been the discovery of the potential long term implications of the therapy that I received.

Recently I have been found to have low levels of testosterone. Hormone replacement therapy has given my energy levels and mood a much needed boost.

As for the future, one area of my survivorship that still needs to be resolved is my fertility.

I’m pleased to say that I finished medical school in 2014, and I’m now working as a core psychiatry trainee in Sheffield, inspired by my own mental health issues after cancer.

Helped by the encouragement of those who treated me, the most valuable realisation I had was when I discovered that the one person in the world who can empower me more than any other is me.

The impact of cancer on my mental health was huge. I cannot underestimate the importance of recognising the link that can exist between the two.

My experience has taught me that I am not going to be here forever. But that doesn’t mean that I’m going to forget about cancer.

I have accepted that it happened, realised that it will always be a massive part of my life, and then started to make the most of all of the opportunities that it can bring.

Tom

• If you or someone close to you have been affected by cancer and you’ve got questions, call our nurses on freephone 0808 800 4040 or contact them via this online form