When I was diagnosed with brain cancer at 19, I wasn’t really concerned with my mental health post-cancer treatment. I just wanted to live.

A few weeks after my doctors discovered a tumor, I underwent brain surgery and then spent several weeks in the ICU recovering. My recovery from brain surgery, of course, included pain management. 

Doctors have been increasing access to pain management in recent decades. Unfortunately, increasing access to opioids for those suffering from chronic or incurable illnesses comes at the expense of increasing the risk of addiction in patients who are prescribed these medications. This expansion also raises questions about how to approach pain management for those recovering from addiction. This is what we now know as the Opioid Epidemic

Many people aren’t able to manage their pain without opioids, and cancer survivors who recently finished treatment are twice as likely to use prescription opioids than people who have not experienced cancer.

I had full access to opioids in the days I spent in the ICU. I knew that opioids could cause addiction, so 48 hours after my brain surgery, I stopped taking them and began using only NSAIDs to treat my pain. Many people aren’t able to manage their pain without opioids, and cancer survivors who recently finished treatment are twice as likely to use prescription opioids than people who have not experienced cancer. 

While I’m glad I decided to take a different route with my pain management, I wish my doctors would have provided me with more resources for understanding how my cancer experience would negatively impact my mental health before giving me such unrestricted access to an addictive substance.

Some months later, I was fortunate enough to become one of the 17 million Americans who will have survived cancer in their lifetime. Making sense of my cancer experience was difficult though. The mental toll of cancer — survivor’s guilt and the existential dread that followed me — meant turning to alcohol to cope despite the risks. 

I believed that my cancer experience ended when the treatments ended and that I should just move forward to a new normal because my doctors told me I would still have a long life. Although I didn’t know it at the time, I was suffering from PTSD.

I didn’t even know it was possible to develop PTSD from cancer. But doing so is pretty common, I found out. Twenty-one percent of survivors experience PTSD six months after their initial treatment ended. Cancer survivors are also twice as likely to have problems with mental health than adults with no history of cancer and are at an increased risk of suicidal ideation even years after their cancer treatment. 

Additionally, PTSD, which can be caused by the trauma of experiencing cancer, increases the risk of developing an addiction. In one study, 53% of substance use disorder (SUD) patients said they have previously experienced a life-threatening situation, while only 33% of people who are not experiencing illness said the same (source). The trauma of a diagnosis coupled with making sense of a post-cancer life can leave cancer survivors especially vulnerable to addiction, and I was no exception.

My cancer experience brought much more than the fear of death with it. My entire life, right down to my train of thought, has been totally transformed by my experience. I worried about money. I often found myself confused or mentally foggy as a side effect of my treatment. I wondered how long my cancer would stay gone and if it was irresponsible to make long-term goals when I wasn’t confident I would be here a month from now. 

All of these stresses are common among cancer survivors who often must deal with “chemobrain” or the cognitive impairment that is a side effect of chemotherapy, financial stress, and the fear of a recurrence after recovering from their treatment. Living with that mental burden was incredibly tiring, and I felt like no one could understand what I was going through. I was the one who almost died, not my support system. 

I just wanted to feel good in the present moment, and alcohol gave me a false sense of security.

Drinking became the means I used to forget. I drank alone while reading at the end of the day. I drank with friends on the weekends. Eventually, I woke up every morning and asked myself if I would decide not to drink that day. I didn’t want to think about my future. I just wanted to feel good in the present moment, and alcohol gave me a false sense of security.

After drinking alone to ease my anxieties one too many times, I made the choice a few months back to cut out drinking altogether. I just had my 23rd birthday and I’ve been cancer-free for three years now. Now, I use writing as a tool to spread awareness about intersectional issues, like the relationship between mental health, cancer survivorship, and addiction. 

My experience woke me up to the growing need for mental health access among cancer patients and survivors. There are more cancer survivors than there ever has been, and we need to start advocating for the mental health of those trying to move forward with their lives after spending months or even years fighting to stay alive.