To have cancer is to change forever. It is a devastating declaration. Each of us copes with the diagnosis differently. How people adjust and move on with their lives are lessons in humanity.
I take care of a patient who explained to me how he deals with incurable cancer. Stan is active and able to enjoy grandchildren, friends and hobbies. He describes himself as happy, despite his terminal diagnosis. The key was both difficult and simple. He said, “that in order to survive with cancer, you need to accept that you are going to die.”
For Stan the obstacle was his struggle against the unstoppable. When diagnosed he responded by attacking the disease. He demanded extra tests, multiple second opinions and became obsessed with an investigation of treatment choices. He threw himself into conventional and alternative therapies. He filled binders with data, radiology reports, tumor markers and medical articles. He cataloged every event. Stan was absorbed in the disease process every moment of every day and with every ounce of his being.
Wherever Stan turned, he found that his cancer was indeed incurable. No matter what he did, he would eventually die. Frustration overwhelmed him. The more time he spent with the disease, the more he became lonely and frightened. He was the prototypic cancer patient…sick, exhausted, isolated and buried in medical care. He fell away from life and started to die.
According to Stan, the answer came as a revelation. In a particularly depressed and forlorn moment, a realization saved him. Stan did not have to fight an opponent he could not defeat. There is no shame in mortal limits. If he stepped back and accepted there were things he could not change, he would be alright. Stan discovered that to be set free, he needed to drop the burden of struggle.
With his family and doctors, Stan put together a basic medical plan. It consists of chemotherapy, nutritional support and exercise. He has set terminal limits. Most importantly, Stan carved out large blocks of time to be away from “health care” and return to his life.
Stan spends most of the days enjoying his family. He has done a little bit of traveling. He has been reading and learning. He is looking forward to spring garden planting. Stan hugs all his grandchildren every single day. He is happy.
Each person needs to find their own way through the challenges of life and those caused by illness. For this man the formula is difficult and simple. Accept what he cannot change and hold on tight to the things he loves. Seize life today, for that may be all there is…but sometimes that is enough.
James C. Salwitz, MD is a Medical Oncologist in private practice for 25 years, and a Clinical Professor at Robert Wood Johnson Medical School. He frequently lectures at the Medical School and in the community on topics related to cancer care, Hospice and Palliative Medicine. Dr. Salwitz blogs at Sunrise Rounds in order to help provide an understanding of cancer.