Last year following a traumatic life event, I was diagnosed by cardiology with “Broken Heart Syndrome”. 

One in six people with broken heart syndrome have been found to have cancer. And these wounded souls were less likely to survive for five years after treatment, according to a study published in the Journal of the American Heart Association.

Broken heart syndrome or Takotsubo Syndrome, occurs when the heart’s main pumping chamber, or left ventricle, temporarily enlarges and doesn’t pump well. It is usually triggered by emotional or physical stress.

When we are experiencing a significant and unusual amount of stress our adrenal glands release high amounts of catecholamines. These chemicals help the body respond to stress or fear and prepare the body for "fight-or-flight" reactions. The main catecholamines, epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine, can result in spasms of the tiny blood vessels that feed the heart, are directly toxic to the heart muscle and can cause heart muscle stunning.

Although the syndrome looks like a heart attack with sharp chest pains, rapid heart rate, swelling of the feet, lower limb pain and shortness of breath, there is no accompanying heart damage and no blockage in the coronary arteries that nourish the heart.

“Patients with broken heart syndrome might benefit if screened for cancer. This may improve their overall survival,” said Christian Templin, M.D., Ph.D., senior author of the study, Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry.

“Our study also should raise awareness among oncologists and hematologists that broken heart syndrome should be considered in patients undergoing cancer diagnosis or treatment who experience chest pain, shortness of breath, or abnormalities on their echo [and not just potential cardotoxicity with drugs and radiation].” Templin said.

One in six is remarkable. And it is another reminder that protecting our hearts is essential in the fight against cancer. While physical stressors can precipitate broken heart syndrome, it’s also an important reminder of the impact of emotional stressors.

I am passionate about working in cancer because it demands a holistic approach. By that I mean, it forces us to think about the many ways cancer impacts the health of the whole person, our family and our community; but just as importantly, when we are thinking of survivorship and PREVENTION, we have to consider how the health of the whole person, family and community influences the risk of cancer!

Despite advances in genomic medicine, cancer cannot be described by a single event. If it could, all smokers would get lung cancer or all victims of broken heart syndrome would get cancer. If those looking for a cure were willing to take a multidisciplinary approach to this worthy endeavor and take into account not just oncology, infectious and immunology but metaphysics, we may yet see a radical understanding of how cancer is a reflection of the whole.

Love is the singularly most dangerous activity we can undertake in our lives. Falling in love, loving a leaving child, leaving a loving parent, losing a loving pet…all of these are a risk. But to not risk is to not live.

Ultimately, when we take our last breaths, the sum total of our existence is how much we loved and are loved in return.

But taking this greatest of risks require us to be vulnerable, to be seen, to need. It requires us to give without assumption of reciprocity. It requires us to receive, sometimes without the ability to give back.

And the loss of the person we loved can bring up the most painful of questions, “Was the person he or she saw in me, worthy of love?”

I will share five life lessons I learned in mending my own broken heart.

There is no way around it, you must go THROUGH it.

Grief and Loss, when ignored or suppressed, become powerful obstacles emotionally and physically. “Going through it” means allowing yourself to sit with the feelings. To allow yourself to fully experience them. 

Try the following. Close your eyes, perhaps diffuse a favorite essential oil and hold a crystal or another sacred object in your hand. 

Breathe IN through your nose for a count of 4. 

Hold it for a count of 4. 

Exhale OUT your mouth for a count of 4. 

Hold it for a count of 4. 

Repeat this 4 times. 

Allow the feeling to enter into your body and mind, hold the space, acknowledge it, like a child that may be acting out. 

Identify where the feeling is showing up in your body: Is it behind your nose? Is it under your breastbone? Is it in your fingertips, your stomach? Let the feeling intensify. Is it giving you any information? Do any thoughts come to mind?

Try to practice tolerance for the pain. Breathe into that physical space the pain occupies and then stretch or move in a way that moves that part of the body. 

Practice this daily. 

The body keeps the score, whether we like it or not. So when we have the habit of allowing ourselves a period of months after a loss, where daily we allow feelings to move through us, the world on the other side will not look like the one we left behind, it will be brighter, richer, deeper, more congruent, and we may avoid health conditions associated with grief.

Move.

One of the most powerful predictors of depression is lack of exercise. Sometimes in the land of sadness and grief, we can get stuck and we start to lose a sense of feeling, the brain adapts to a lower level of function. Get up and move. 

Start with a slow walk for 10 minutes a day outdoors, work your way up. Slowly add on. 

Do not set BIG goals. Set SMALL, attainable goals. 

If you set big goals, it’s like looking at the top of the mountain you are trying to climb, rather than the step in front of you. It’s easy to get defeated or to stop before you start. 

Exercise increases the activity of serotonin in your brain, this is your happy chemical. Further, it fosters the growth of nerve cells and supports your heart. You have a beautiful pump wonderfully designed to send blood flow from your head to your feet, but what brings it back up so it can get re supplied with oxygen? Movement. As you move, the muscles in your body compress the veins which contain one-way valves. In this way, the veins inch the blood back up, or in the case of someone who is mid-movement, flush it back up. This takes pressure off the heart and continues to supply the body, including your beautiful pump, with fresh oxygen.

As you begin to gain competence, exercise is a wonderful way to give you a sense of empowerment and restore trust with your body especially following addiction, disassociation, betrayal or medical diagnosis.

Counseling

It’s important to tell your story. A good counselor is someone who can hold unconditionally loving, non-judgmental space for you to process your thoughts out loud. A good counselor can:

• Be an advocate

• Help you uncover your strengths

• Rediscover your voice

• Restore your joy

• Remind you that a healthy relationship is one where you experience security, consistency, joy, and respect

It’s hard to find therapists familiar with the specific issues that cancer patients and survivors face. We staff our mental health with specialists in psycho-oncology. 

Cancer can exacerbate, trigger or make more intense the experience of grief and loss. We lose so much with this diagnosis. First and foremost, the security of being well and being HERE. Many of us don’t realize this, but the most profound loss associated with a cancer diagnosis is the visceral realization that we do not live forever. 

This, regardless of our age, is not a tangible awareness that we live with on the daily, or we wouldn’t live at all. 

The very act of falling in love, building a family, going to school, starting a business, even getting our nails done, planning a meal, painting a wall, walking our dog, every single act as a human, is underlined by hope.

Hope in a future, hope for the next living moment. 

Cancer scares us and robs us of that hope and it can cause many of us to spend our time trying to predict the future. This impossible task has the unintended result of causing us to die a million deaths before our last breath. 

The primary focus of a good counselor educated in oncology is to help his or her patients live for today. As this moment, is all we ultimately have. 

Massage or Therapeutic Touch

At a time when many of us are “skin starved”, human touch is essential. When trust has been broken, with assault, trauma, a medical diagnosis, betrayal, it’s important to reconnect with the experience of safe, therapeutic touch. 

We are bringing on massage therapists with a high level of integrity, a passion for working with a vulnerable population and we pay for continued training in cancer care. 

It can feel like a challenge to pay someone to lay hands on you under any circumstances, but the act of engaging in that therapeutic relationship is an act of forgiveness for yourself and others, and it’s a willingness to be vulnerable in an attempt to heal.

The American Massage Therapy Association has a nice piece on the known benefits to cancer patients which include:

• Reducing pain

• Alleviating stress

• Relieving nausea

• Reducing depression and anxiety

• Improving sleep and lessening fatigue

• Preventing chemotherapy-induced peripheral neuropathy

• Relieving lymphedema

Love Again. Love Anew

C.S. Lewis once wrote, “To love at all is to be vulnerable. Love anything and your heart will be wrung and possibly broken. If you want to make sure of keeping it intact you must give it to no one, not even an animal. Wrap it carefully round with hobbies and little luxuries; avoid all entanglements. Lock it up safe in the casket or coffin of your selfishness. But in that casket, safe, dark, motionless, airless, it will change. It will not be broken; it will become unbreakable, impenetrable, irredeemable.”

Loving again is a critical piece of mending a broken heart. I use the Healing Trauma guided visualization from Belleruth Napperstek on healthjourneys.com to help me to connect myself to those that loved me and have passed on and to stay open to those that will love me in the future. 

I visualize the kind of love I want in my life and every day I try to keep my little flame of hope alive for a life filled with joy, family and love.

When I take my last breath, I want my husband and my children to be holding me as I walk into eternal life. I want to remember all of you and I want to be remembered. I want my last words to be, “I love you all.”

Dr. Roy