Articles with #cancersurvivor

Cancer: Legacy

Cancer: Legacy


 When a disease confronts you with your mortality, you may start to wonder about your legacy — how you would like to be remembered when you have passed on. Everyone’s hopes and expectations about legacy differ. We all write our own unique life stories, like chapters in our book of life. Cancer may influence the direction of the story, but it cannot control our narrative. 

We all strive to leave behind a footprint when we are gone. The question is how. People have different ideals for their legacy. On one end of the spectrum, some people may prefer to focus all their time/energy/love on a select few people, while others may choose to invest in an activity that would leave a larger footprint in the world. 

Everyone is different and preferences, hopes, and ideals may change. There is nothing wrong with that, as long as you are aware of what drove that change. A healthy self awareness is good for life in general. I found the movie The Fault is in Our Stars, which shows two teenage cancer patients exploring their own perspectives on legacy, to be a great example of this concept. 

We leave a legacy in one way or another by just going about our lives. It’s hard not to. However, all we can do is shape our legacy, realizing that how we made people feel will be remembered more distinctly than our actions. We all touch other people, make an impression on them and impact their lives in a manner that we may not even be aware of. This is the so-called ripple effect which allows us to continue to live on indefinitely. 

It’s important to strive for connection, purpose, and meaning in life. Building towards your idea of a legacy will foster this pursuit and may allow distraction, healing, and channeling of your inner energy into an external target that helps both you and others. But more than that, it may allow you to get a sense of calm and peace, knowing you are working towards building a legacy that fits with who you are and where you stand in life.

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Cancer: Why Me? Why Now?

Cancer: Why Me? Why Now?

Many of my patients understandably wonder and ask, “Why did I get cancer?” I do not necessarily have a medical or scientific answer. I wonder if the question behind the question is, “Why me?” From that question comes others: “Why now? Can it happen again? What can I do to prevent that?” 

There are certain risk factors that predispose one to cancer. These factors (including genetics, environment, and lifestyle) are also associated with poorer outcomes for certain patients. However, there is not always a cause-effect relationship. 

My late mentor taught me a simple way to explain the different levels of cancer risk; it can also be applied to those who carry a cancer diagnosis. On the one end is the general population for whom gender/age appropriate cancer screening guidelines apply. On the other end are those whose families transmit the cancer gene. For this group, we have proactive and comprehensive approaches to try to decrease the risk. Lastly, is the in-between group whose cancer risk is unknown. These are people who have had one cancer diagnosis. This puts them at an undefined higher risk than the general population to get another cancer, but at lower risk than those who harbor the cancer gene. (Unfortunately, data is lacking for those “in-between” individuals, so we resort to general population guidelines). 

Even though we are in the 21st century, nature and our bodies remain a mystery with many unknown variables. Sometimes we just really don’t know why cancer happens to you or why it happens when it does. Questions that probe the why are good, though. Our why questions reflect how we cope with our diagnosis and try to make sense of it. They indicate our curiosity to try to understand the mystery of life. This is healthy as long as we acknowledge that life’s mystery is one that likely won’t be unraveled entirely for another few generations, if ever.

A cancer diagnosis never comes at the right time. (If not now, when?) It can happen to anyone. (If not you, who?) As the current pandemic teaches us, we are not invincible or immortal. Life is not fair. Embrace your curiosity and let it empower you without letting it overwhelm you. 

Be kind to you and others….

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Cancer – Embracing Our Emotions

Cancer – Embracing Our Emotions

Many of you may feel like being in the midst of this pandemic has you stuck between a rock and a hard place. What’s worse — delaying cancer testing/treatment or risking Coronavirus exposure? Having to choose between two evils, you must try to anticipate and minimize your risk. 

Medically speaking, this is unknown territory, so I strongly recommend that all of you make decisions about your personalized cancer care with your medical oncologist. Here is a resource that may help to facilitate your communications. 

There is a reason we have a spectrum of emotions that can range from fear, sadness, anger, and sorrow to happiness and joy. There is no need to put up a facade and deny any of these feelings. Doing so may make things worse and make us feel fragmented. Allowing all these feelings to coexist and being in touch with them will facilitate integration, healing and inner peace. I had previously outlined a few examples of mature coping styles, but only you know what will soothe you most. If emotions are causing you or your loved ones debilitating pain or dysfunction, please reach out for help! 

I think the trick is not trying to keep the joys and the tragedies apart but you kinda gotta let them cozy up to one another, you know, let ’em coexist. And I think if you can do that, if you can manage to forge ahead with all that joy and heartache mixed up together inside of ya — never knowing which one is going to get the upper hand — well life does have a way of shaking out to be more beautiful than tragic.

Dr. Nathan Katowski (by Gerald McRaney) in This Is Us.

When you are aware of all your feelings, you can choose how to approach and act on them.  Embracing fear without letting it paralyze you, but allowing its energy to cautiously propel you forward can help you to express the best version of who you can be so you can love and honor yourself and the world. The hope is that a new (and better) normal will be born out of the Coronavirus tragedy — at global, national, local, and personal levels! 

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Cancer and Intimacy

Cancer and Intimacy

Sexuality plays an important role in society, facilitates reproduction, and helps us to feel connected to our partner as well as to ourselves. When you are told that you have cancer, it can affect the desire of either or both partners. For some people, desire decreases (as they are distracted and not in the mood), while for others physical intimacy may sooth or provide welcome distraction.

Cancer therapies can affect sexuality in many ways. Qualitatively, your routine sexual act may need to be adapted due to anatomical changes (e.g. pelvic or breast surgeries) or functional changes (e.g. erectile dysfunction, vaginal dryness or scarring). Quantitatively, the frequency and duration of sexual acts may change, usually lessening. Reasons for the latter can be due to the experience of pain, discomfort, shame, or guilt, but also because one’s desire may be decreased when going through premature menopause/andropause, anxiety, or depression.

Oftentimes, I see couples, whether in brand-new or long-lasting relationships, in which I sense that both partners are longing for a connection but are not communicating about this out of concern for disrespecting or hurting the other. Finding a safe environment for this communication may help healing to begin. Also, it may encourage a cancer survivor to feel confident enough to talk with a health care provider to find if there is anything that can be done to improve matters.

There are medications and devices that can improve, if not resolve, anatomic/functional deficits. (As a gentle reminder, hormone replacement therapy is not an option for those who are survivors of tumors that are fueled by hormones.) Talk- and/or pill-therapy can emotionally support partners.

However, at the end of the day some things may not be fully restored to the pre-diagnostic state. Some emotional and physical scarring may be permanent. In these situations, partners may have to work harder and be more creative in finding ways to connect with each other in ways that are enjoyable, pleasurable, and satisfying for both. In addition to intimacy, identity and security can also be altered by cancer. Therefore, even couples who have been together for a long time may need to reset and rekindle their relationships. Keep in mind that sexuality is one form of physical intimacy. You may want to explore other forms of physical intimacy, such as sensuality and eroticism.

There are many other ways of being intimate that can enhance or compensate for the impaired ability to connect physically. Examples of these alternative forms of intimacy are emotional (connecting with someone else in spoken or unspoken ways that express your love), intellectual (participating in communication about a topic that both parties are passionate about), and experiential (sharing activities and making memories together).

Enjoy connecting!

Thank you for visiting me. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn & Think, Live & Feel:

My family decided to go all in. For years we have held ourselves back due to various issues including active or anticipated medical issues. Recently, we decided to get some more love in our house. A month ago, we expanded our family to include our beloved cat, Melky. In another month, we will be expanding again with a dog, Cookie. We are fully aware that having a pet may bring more responsibilities, worries, and expenses, so we have backup plans in place, but we do not want to miss out anymore on the therapeutic joy pets can bring. Stay tuned for our adventures!

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“Sibling” Rivalry Amongst Cancer Survivors

“Sibling” Rivalry Amongst Cancer Survivors

Working with cancer survivors, I have noticed a trend in which we support each other as peers, but sometimes hurt and isolate each other. Cancer survivors may feel a sense of commonality and connection to each other that they may not find with the general population — validation, a sense of physical vulnerability. This sense of comradery is crucial for guidance, role modeling, fitting in, and feeling hope that others made it through and survived, and hopefully, thrived. 

However, at the same time, a cancer survivor may desire recognition, approval, or praise. They may seek to stand out by comparing themselves in terms of cancer types, stages, or intensity of and types of cancer therapies. Inherent to this pursuit is often unconscious competition. (My cancer was worse. My therapies were worse or lasted longer or had more post-treatment effects. I had less support or finances.) This competition amongst cancer survivors may lead to hurt one or both parties and is very similar to a kind of sibling rivalry. The perpetrator may do this to redefine their identity, stand out, get attention and support, or be recognized for their unique victory. The victim may feel bullied and isolated, but should not take it personally. 

However, at the end of the day it’s important to accept the reality that none of our journeys are lighter or heavier, they are just different. Smaller tumors may require intense therapies when their behavior is aggressive. Simpler treatment regimens can still cause a great deal of bodily damage depending on their location and the patient’s ability to tolerate them. We all try to go about our travels the best we can. 

Comparing and hearing others’ stories can help but also hurt. When you tell your stories, please think about why you are sharing — to scare the other person by showing off your hardships or to help the other person by providing support, insight, and (realistic) hope. And if someone tells you a story that makes you feel upset, you should feel comfortable letting that person know in a calm and respectful manner. If communication does not help end this unhealthy dynamic, you may want to ask a neutral third party to intercede. If you still find yourself at odds, a (hopefully temporary) distancing may be needed. In tough times, it’s crucial to remember that all cancer survivors may have been scarred emotionally and try to focus on what keeps us united rather than divided. 

Thank you for visiting me. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

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Meditation and Cancer Survivorship

Meditation and Cancer Survivorship

Meditation, if done on a regular basis, has been shown to be able to provide many emotional and physical symptom-relief benefits for cancer survivors. I don’t know about you, but I have tried a few meditation activities and they don’t always make me calmer. When I sit quietly and allow vague fragments of thoughts, feelings, and images to pop up in my mind, sometimes I feel more confused, overwhelmed and stressed. I frustratedly wonder, “Why can’t I seem to relax?!” 

But, let’s back up. What does meditation mean? The dictionary states:

intransitive verb. 1 : to engage in contemplation or reflection (he meditated long and hard before announcing his decision). 2 : to engage in mental exercise (as concentration on one’s breathing or repetition of a mantra) for the purpose of reaching a heightened level of spiritual awareness.

transitive verb. 1 : to focus one’s thoughts on; reflect on or ponder over (he was meditating his past achievements). 2 : to plan or project in the mind: INTEND, PURPOSE (he was meditating revenge).

There are many (sub)types of and ideas about meditation, depending on who you talk with or what you read. To me, meditation describes a state that allows you to pause and reflect on your current situation and life’s journey from a distance to see the bigger picture, feel less overwhelmed, and regain clarity about where you are going. 

One school of thought I like is the, so-called, philosophical meditation:

“A practice whose premise is that a decisive share of the trouble in our minds comes from thoughts and feelings that haven’t been untangled, examined or confronted with sufficient attention. Ordinary life goes by far too fast for us to process events properly in real time – and we suffer, accumulating unthought thoughts and unfelt feelings which make for anxiety, anger, depression, addiction and misaligned goals. 

So we need, according to the theory, regularly to return to the contents of our minds and listen to their garbled signals, picking this or that object of consciousness and submitting it to the beam of reason. Our confused feelings and ideas are not to be pushed aside, for they are – in appallingly muddled and enervating ways – trying to tell us something important about the course of our lives. 

Lying in bed or sitting by a window. We’d ideally have half an hour without interruption, with paper and pen to hand to seize ideas and feelings as they emerge from the mental undergrowth. With the patience of ornithologists, we would be out to catch the mind in its most fleeting, tentative, furtive moments. Key to all this are well-angled questions that we must put to ourselves to extract the full picture. At the heart of a Philosophical Meditation, there are three: – What am I presently anxious about? What am I presently upset about? What am I presently excited about? These are the clues for directing the mind to search its recesses with acuity.

However, if you are facing a life and death situation like cancer, and you feel like your boat has capsized in the middle of the ocean, then your thoughts and feelings may be so intense that meditation alone may not be able to provide relief. In fact, it may make things more intense as all these thoughts and feelings come to the surface. In this situation, it may help if you also go and talk to a professional who can help you untangle and restructure your thoughts and feelings so that you will feel less confused and overwhelmed by them. 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Live and Feel:

  • Meet our newest family member – Melky!

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You Cannot Always Win – Cancer Survivorship Apps, The Biggest Little Farm

You Cannot Always Win – Cancer Survivorship Apps, The Biggest Little Farm

Dear Fellow Traveler,

Sometimes my life feels a bit complicated, like a chess game in which I’m always trying to anticipate and strategize. I guess everyone’s life is like this, but dealing with a chronic health issue adds another layer of complexity. If your health causes you to have less energy at the beginning of your day, if that energy is drained faster because your body is less fit and if you have extra tasks to take care of your health (e.g. doctor’s appointments, medical tests, paperwork for e.g. leave/disability/accommodations), life can become overwhelming. At times it may even feel like you’ve been checkmated!

Most of us try everything we can to control our quantity of life to the degree that quality of life may suffer. For instance, many things we do because we think they’re healthy may turn out to have downsides (e.g. vitamin intake may be associated with lesser survival,  calcium pill intake may be associated with heart disease and Zantac may contain a carcinogen). Please note that all of these observations do not imply cause/effect, but reflect associations requiring further investigation. 

It can sometimes feel like you can’t win. You take two steps forward and one back, or one step forward and two back. It may help to remember that life is a marathon, not a sprint. When you find yourself spinning your wheels without clear purpose, stop and breath. Be kind to yourself. Rest, sleep, watch a movie, anything to allow your brain and body to rest and gain a new perspective. We’re not the only ones who have a hard time making sense of life. Even though we live in the 21st century, the medical community still has a lot to learn about our bodies, this ‘black box’ in which many systems are closely balanced and interrelated.

The internal tension you may feel forcing you to ‘fight for your survival’ after you have faced a traumatizing diagnosis like cancer is (in most cases) a normal and healthy response. You may need to find ways to distract from your own thoughts and feelings and navigate your internal energy outwards into more productive channels. I have listed a few examples to get you inspired! Please note that I intentionally did not list exercise, sleep, and diet, since they can become more a source of stress than relief in cancer survivors. Also, I did not list much about relaxation techniques (e.g. yoga, meditation), because when you have so much inner energy boiled up, it may be quite difficult to relax. First try blowing off some steam by actively doing any of the following:

  • Invest time each week in creating a calendar that visually outlines your schedule. This may allow you to recognize conflicts and/or reorganize days that may prove to be rather hectic. Break tasks down into smaller steps and rank them by priority — in terms of what you need as well as what you want! Perhaps ask a loved one to help you plan your calendar so you can identify opportunities for them to support you or join you in social activities that you can both look forward to and enjoy. (Feel free – or better yet – I challenge you to make plans to spend a few hours together doing nothing!) 
  • Absorb nature (even if you only sit) and allow all your senses to be stimulated. It can be a calming and humbling experience! 
  • Distract yourself by getting a new hobby. (What were your favorite activities to lose yourself in when you were younger?) 
  • Express your thoughts and feelings to yourself (e.g. by writing them down or typing them into your phone) or to others. Sometimes it may feel safer to express your worries to people you don’t love (such as a healthcare provider) since you may not want to hurt your loved ones with your worst thoughts/feelings. 

Control is an illusion. Please allow yourself to accept the things that you cannot change, since fighting them only makes your life harder. Life is not only about the destination, but also about the journey. Please be kind to you along the way by acknowledging that no matter how hard you try, you cannot always win! 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

  • A review of publicly available apps for cancer survivors.

Live and Feel:

  • A fascinating movie (The Biggest Little Farm) tells the true story of a young couple who left Los Angeles to successfully start a farm for a barking rescue dog whom they had promised would never change families again. Enjoy going back to nature while you watch this!

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Pity vs. Compassion – Wild Horses, Journaling

Pity vs. Compassion – Wild Horses, Journaling

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Dear neighbor!

How are you today? This week I shared a meal with another cancer survivor. We ended up talking about how we try to carefully gauge when, how, and what we share to avoid becoming a conversation stopper or the object of pity. But not sharing our pain can lead to feelings of ‘self pity’ and isolation. On the other hand, the sharing of our stories can also make us feel worse or even compelled to comfort the other person, in particular when sharing our pain triggers negative judgment (such as ridicule, inferiority, failure, or pity).

The bad press received by pity concerns both what pity lacks, namely, actual assistance, and what it implies, namely, a feeling of superiority and satisfaction with our own position. Source.

And this brings us to compassion. Pity and compassion are two reactions (to seeing someone suffer) that overlap and are on opposite ends of a spectrum that also includes sympathy and empathy. I like the following graphic, which visualizes the relationship between these 4 terms:

inforgraphic
Designed by Robert Shelton.  Source

 

These different terms correlate with different perspectives on life that one may have been born with and/or acquired over time.

Someone who has compassion senses a cancer survivor’s suffering and has an active desire (and ability !) to:

  • Allow one “to just be” (which may take a survivor already quite a bit of energy/effort!),
  • (Often silently) provide company (while respecting boundaries),
  • Universalize the situation (because life is not fair for many),
  • Create temporary distractions from problems (with e.g. silly activities),
  • Allow one to feel less of a nuisance,
  • Take on the challenging task of knowing when and how to help, since a cancer survivor may not always need instant help or a solution. And may even (stubbornly!) prefer to first try to sort things out on their own (perhaps needing you as a listener or a sounding board),
  • Jump in if you see HELP signals, e.g. trouble taking care of oneself, dysfunction in their family or society, posing a danger to self/other,
  • Be comfortable with the unsatisfied desire to help. In particular, if the survivor is not (just yet) open to accepting help (you can bring water, but cannot force one to drink), or if there is no clear solution at this point in time.

Compassion is one of the main drivers of altruism, which in its turn can facilitate well-being. Altruism can be a noble (or even self-motivated) initiative to alleviate suffering, but helping others can also be a defense mechanism in which one distracts themselves from their own thoughts/feelings. The helper needs to also care for him/herself to minimize risk for caregiver burnout.

Compassion for me translates into a few key words and noble goals that we all should aim for: honesty, unconditional love, genuine care, and passionate generosity. But please remember that you are only human – it’s the reaction to and recovery from our unavoidable mistakes and failures that count and allow us to grow!

Won’t you be my neighbor…?

Please…find below a few things for education and entertainment!

Learn and Think:

Its cucumber time, or also a slow-medical news-season. Give your brain a rest!

 

Live and Feel:

  • Enjoy this video of one of the few remaining herds of wild horses – the Chincoteague ponies and Assateague’s wold horses!
  • Visible Ink offers Memorial Sloan Kettering Cancer patients to express themselves in writing with the individual support of an experienced writing mentor. Their initiative has been described in the NYT. Journaling may be one way in which one can write their thoughts and feelings away to facilitate healing!

 

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