How To Live With Cancer

We have come a long way from cancer as death sentence to 70 percent of cancer patients living at least five years after diagnosis. Over 18 million cancer survivors live in the United States today, and there are estimates that the number will grow to almost 22.3 million by 2030. That's a lot of people. While there is still plenty of "slash, burn, and poison," as patients refer to their treatment, cancer treatment has made huge strides. Treatments have become more targeted to the cancer and individualized. Chemotherapy, surgery, and radiation are becoming elegantly sophisticated and innovative. As a society, we are speedily moving from "dying from cancer" to "living with cancer" when it comes to treatment.

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Knowledge Is Power

My intent is not to cultivate doubt in medicine but to inspire you to expand your awareness. In your journey with cancer, you have yourself and your knowledge that you have accumulated over time to draw from in your attempt at optimizing your health, and you have collective knowledge accumulated over centuries. When you are diagnosed with cancer, that moment in time constitutes one point on your life continuum embedded in the ocean of many continuums. The more aware and knowledgeable you are about yourself, the more likely you will be able to distill from the vast and endless ocean of contemporary available knowledge what is relevant to you and to find the right people to help you with it.

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Thought Stacking

I propose that you use this processing speed (or rather processing slow-ness) to your advantage by crowding out stuff that you don't want to think about. And not just crowd it out but slowly dismantle its neuronal structure.

There is another style of thinking in addition to "thought seizures" for which that works. I call it "thought stacking." Rather than random thoughts popping like corn in the pan, they build momentum off one another like a runaway train. One negative thought stacks onto the next.

We're dealing not just with a series of negative thoughts but with thoughts the next of which is worse than the one before. "I did not present myself well during the interview" is followed by "I will never get this job" is followed by "I will lose my house" is followed by "My wife will leave me." Some people call this thought sequencing catastrophizing.

 If you are someone for whom every thought is worse than the previous one, you probably get plenty of advice about not catastrophizing. This style of thinking is very common with distress. But rather than get disappointed that you don't seem able to follow the well-meant sapient advice of your family and friends, try any of the exercises in this book and interrupt the thought stacks. Not catastrophizing might be a tall order, but crowding out the cascade of thoughts is something you can do.

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How Do We Find A Balance?

How best to stay in balance is a hot topic these days (in the Western world at least). Many people in our society have an overly active nervous system.

 They are irritable, exhausted, have difficulty finding restful sleep, and have difficulty staying balanced. We have known for many years that pushing ourselves to perform will yield results, but if you increase the push and the stress to a breaking point, your performance will actually suffer. If you think of balance as the balance between the parasympathetic and the sympathetic nervous systems, things get a little clearer. It is the Yin and Yang of the Western world.

In my experience, people tend not to be aware that they are chronically sympathetically overactivated. They might not notice that their muscles are tense, that they don't sleep well, or that they are irritable but still go about their daily business. It isn't until they go on vacation, totally removed from their circumstances, that they might notice a change. But even though they might sleep a whole lot better and feel more chill chilling on the beach, they rarely come to the conclusion that they should change their lifestyle after they return from vacation. They simply assume that their "regular life" is normal and how they feel on vacation is a rare luxury or privilege.

Does this sound like you?

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Staying Healthy

It might come as a little bit of a shocker that half of the cells in your body (that you want to keep happy) are not even human but bacteria. That's right.

And many of those bacteria reside in the gut. I did not want to devote a whole chapter to the gut, but since it talks to the brain the same way that the heart and lung talk with the brain, I did want to mention the connection. As we are talking and thinking about cells and you are getting rid of sick cells with your treatment while keeping the healthy ones happy, the detour is hopefully worth a moment of your time. It is as important that we listen to the gut as the heart, even if what (or who?) is talking when the gut speaks to the brain is not always human! You want to treat your insides with respect. They are closely linked to the brain's well-being.

I encourage you to reflect on cellular healing and use guided imagery for that purpose. While you are working on eliminating cells you don't want— the cancer-mutated cells— you want to make sure that you don't forget to treat the cells that you do want very well. Send some gratitude and energy to the cells that are working hard to stay healthy for you.

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Positive Psychology

For a very, very long time, Western medicine focused on fixing illness rather than maintaining health and preventing illness. I am happy to witness during my lifetime the trend toward paying at least as much attention to wellness and illness prevention. I consider positive psychology part of wellness. You have heard about positivity and negativity throughout the book. The brain's affinity to negativity as described early in the book as negativity bias and the suggestions to promote positivity at times seem at odds and I want to revisit a few important points, while adding new ones.

Generally, I will support positive psychology with a few caveats. Many authors write inspirationally about positive psychology. It is an important focus of my work with cancer patients to assist them in discovering strategies to focus on emotions and thoughts that they experience as healthy and desirable. I will, however, always remind you that we are individuals and that some approaches work better for some and other approaches for others. There are data showing that people with a negative self-image get worse if you force them into positive thinking.

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Clashing Needs

Two needs I often see clash in cancer patients are quality and perfection.

As a cancer patient, you want the highest quality of care, but often that gets confused with perfect care. The former is important, the latter doesn't exist. If you are unhappy with your care, ask yourself if you are, in fact, getting low-quality care, which demands a change, or is your expectation for perfection arising because your life is at stake? The wish for perfection is fully understandable when one's life is at stake, but you will also be chronically disappointed. Mathematics comes close to perfection, not medicine. Medicine is as much an art as it is a science.

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The End Of Life

While it is true that a majority of people, even towards the end of life, behave in their own particular way, what matters is that there are vast differences between us. As I've said before, we are all unique and fit somewhere on the bell curve of our respective differences. We have to stay open and in-the-moment to be able to capture what matters. As we have reached the end of this book, I want to emphasize a statement I started it with. The same way you want targeted precision medicine for your body, you also want it for your soul. Coming towards the end of your life doesn't mean it has to be full of despair; it can in fact have serenity in it.

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How To Handle Cancer Now

I hope this book will add to the "cancer now" experience. I have come across brilliant and eloquently written books about stress, communication, meditation, philosophy, health, positive psychology, and even cancer. But I have not encountered a book that effectively addresses stress and distress management for cancer patients and brings these different disciplines under one umbrella. A book that describes cancer patients' needs systemically and systematically from the time of diagnosis until after treatment and beyond. A book that also offers practical solutions to maintain some sense of normalcy and well-being while going through the experience of cancer. A book offering information about the physiology of that experience.