By Paul S. Anderson, ND
Cancer – The Journey from Diagnosis to Empowerment by Paul S. Anderson, ND
Lioncrest Publishing 2020; © PS Anderson 2020, 2021 all rights reserved
I wrote Cancer – The Journey from Diagnosis to Empowerment after finishing a prior book (Outside the Box Cancer Therapies with Dr. Mark Stengler) and realizing there was a great need in the person who has cancer and their support network to have a framework to process the mental, emotional, and ultimately mind-body parts of their cancer journey. In my practice, and mentoring physicians, I saw this was an area of great need but also often not fully addressed simply because the physical aspects of cancer care are so pressing.
My goal with the book was to write a brief guide for patients and loved ones that normalized the common feelings encountered and gave guidance to their journey. That journey, if accepted, is one which moves from shock and victimhood to a place of empowerment. Empowered patients have improved quality of life and often better outcomes from therapies.
The following are excerpts from the book.
From the Introduction
You, as the person with cancer or the person who cares about them, can be confused or angry because of the loss of control over almost everything you feel— an emotional soup that may be different every day. This confusion (or emotional soup) is aggravated by the fact that nobody wants a cancer diagnosis.
This is completely normal. The combination of emotional responses and confusion can lead to a mental drifting that can sabotage your health. The drifting starts from many thoughts, feelings, and emotions crashing in on you, and you cannot process, sort out, and move past it all. You feel lost because you have seen or heard about so many people with cancer, some who do very well and some who do horribly. You may feel stuck not knowing if anything you do really matters.
How can this book help?
The goal of this book is to use the many years of experience I have had with patients and loved ones dealing with cancer and provide you with the tools you need to navigate this difficult terrain. Why? Because the better your internal journey (mental/emotional or mental/emotional/spiritual—whichever you prefer), the healthier you will be, the better your quality of life will be living with cancer, and the outcomes from any medical intervention will generally improve as well. Yes, the internal journey makes that much difference.
Chapter 2
[A note regarding “Gia and Bob” since you are coming in at Chapter 2: I use the stories of two patients (who are, of course, fictionalized) to illustrate the two ends of the spectrum in “moving toward empowerment” I have encountered through the years. Their stories in each chapter are used to illustrate the concepts in the more linear, “how to” portions that follow.]
“I have cancer—I feel lost, angry, confused, and so much more.” (You just got some of the worst news a human can get, you’re normal.)
Gia’s Next Steps: At this stage, she realized, “I have control over the medical process, to a degree, but what about my internal process?” And then she began to reflect, “What about my thoughts, feelings, emotions, and such?” So, Gia embarked on a journey that day. A journey that would change the course of both her “lives.”
Having cancer divided Gia’s life into a pre-diagnosis “regular life” and the totally unwanted “cancer life.” She realized this was the way things were now. She also saw that she held ultimate control over what she thought, how she felt, and how she processed this new way of being.
She remembered reading about Dr. Viktor Frankl, an Austrian psychiatrist and Holocaust survivor best-known for his 1946 psychological memoir Man’s Search for Meaning. She decided that if cancer was bad, then someone who lived through a concentration camp might have some insights to help get her out of her angry and obsessive thoughts. She found essays by Frankl online and saw that he believed meaning came from three possible sources: purposeful work, love, and courage in the face of difficulty. He wrote about the “intensification of inner life” that helped prisoners in the death camps stay alive: “Love goes very far beyond the physical person of the beloved. It finds its deepest meaning in his spiritual being, his inner self. Whether or not he is actually present, whether or not he is still alive at all, ceases somehow to be of importance.”
This deep realization also helped Frankl process the death of his beloved wife in the camps.
Gia knew she wasn’t in a “death camp,” but she sure did not feel like she was much better off. “People die of cancer,” she would think. So, she took great comfort that someone who survived a death camp and had real insights could provide her with some legitimate wisdom for her journey.
She read another essay in which Frankl quoted Nietzsche: “He who has a why to live for can bear with almost any how.” This somehow struck her heart. Yes, she had circumstances she might not be able to change, but she had control over her mind. She recalled the famous idea Frankl shared of his horrific experience in the camps: “Forces beyond your control can take away everything you possess except one thing, your freedom to choose how you will respond to the situation.”
“Well,” Gia thought. “It sure feels uncomfortable, but it makes sense. I do have control over how I will respond.” This day was a turning point for Gia. It wasn’t easy, but it was the start of a new chapter in her journey.
Bob’s Next Steps: The diagnosis of “probable pancreatic cancer of high stage” dropped on Bob like a bag of cement. … Bob had predetermined that he wasn’t going to “process” a cancer diagnosis in any mental or emotional way long before he received this diagnosis. … From an emotional and mental position, there was nothing to work through from his perspective. Bob had seen firsthand pancreatic cancer take lives, and he hated that cancer. “Why couldn’t it have just been a massive heart attack?” he thought hopelessly.
In contrast to Gia, Bob was not feeling like progressing or being empowered at all. Bob was stunned and grieving the loss of his life before cancer. Bob became more and more angry. He had spent his life telling himself, and those who would listen, that if he ever got cancer, he would likely end it all. “I’ve seen it close up, and it’s horrible. No way would I ever go through that.” Bob would recount stories of patients and all the negativity they would experience like the horrific therapies and side effects. He would go on to say, “If it isn’t something curable, it’s just not worth living.”
It became “put up or shut up” time for Bob. He’d spent a career saying all of this. How was that going to play out in his life now?
His partner asked if he would see a counselor and work through the shock, anger, and disbelief. He flatly said, “No. Furthermore, none of that mind-body BS works anyway.” This deepened his anger and at times his rage. Nobody argued with him that this was an easy diagnosis, or massively life- changing, or about any detail. His partner simply wished he didn’t have to add the mental suffering he was creating on top of everything else.
The stages of grief/processing: Are they real and do they matter? As you can see, the differences between Bob and Gia are unfolding as two opposite methods of coping and processing. Gia is not “happy” with her cancer diagnosis but is open to learning a better way. Bob is ruled by his anger and grief and is not open to learning.
Gia received the news of her cancer as most people do, with surprise and shock. Her initial thoughts were not “constructive,” but they were normal. What she did at first was to make sense of what she was thinking and feeling and then work toward a solution focus rather than a fear or anger focus. Was this easy? No. No, it was not. I watched it happen. The important thing is that it did happen.
Upon diagnosis, Bob had the same amount of surprise and shock as Gia. He was, like any human, completely entitled to those thoughts and feelings. He chose to take the step to more anger and agitation.
As I will mention elsewhere in the book, Bob, like anyone else, is entitled to react and do as he pleases. It is a human right, and I would never attempt to deny him. So, I am not judging him or his reaction but rather using it in a clinical sense as a counterpoint to what I have seen as more helpful strategies in moving toward empowerment.
Most people have heard of the stages of grief originally written by Elizabeth Kubler-Ross, which include denial, anger, bargaining, depression, and acceptance. These stages were developed to describe the process patients go through as they come to terms with their terminal illness.
While there is some debate about the accuracy of these stages in all people, I can certainly tell you from years of working with patients during some of the hardest moments of their lives, the stages of grief are excellent observations.
These are common stages that both patients and loved ones go through. What I have seen, and many people relate to, is that a person often gets “stuck” in a stage and, once stuck, has a great deal of difficulty progressing.
Nobody (or very few people) would argue that a person diagnosed with cancer should not feel these things. That is the human condition. And it stands to reason that as we are all individuals, we may experience a stage or two more or less intensely than another. The important aspect is that we continue to move through these completely valid feelings and stages to arrive at a point that affords us maximum health and benefit as we (or our loved ones) live with our cancer journey.
Your Next Steps: Here are some factors I have seen that make the realization and processing of the grieving stages work toward better outcomes and eventually lead to empowerment.
1. Recognizing the stages are real. Honor them. They are normal and not a sign of human frailty. You are wired to process large shocks this way.
We may choose different words to describe the phases of this process, but most people go through them in the same order. However, you may process them in a different order or move rapidly through one and not the other. As I will discuss later in the book, there can be “cycles” or “grief within grief,” all of which is completely normal.
Based on our individual past experiences, personality, and other factors, we all process the diagnosis and every other part of cancer at varying speeds. Some people experience more denial while others experience more anger. There is no right or wrong way to process. The important thing is to let the process happen. While there are predictable steps in the process, you may know where you will take longer to process (or it may surprise you). This book provides insight as to where you may need help, support, and personal growth.
2. Know that however you move through them, it is YOUR way.Moving, processing, and growing are the important parts. You will not do this like others, and that is perfectly normal.
3. Know that close supporters and loved ones are going through their version of this as well. Those around us may not realize this will happen. Often, they know they have shock and sadness but do not realize they have to process the entire diagnosis, change in life, and relationships as well. This often helps you, the patient, to understand others’ reactions as well as to help or suggest help for them.
4. Realize that acceptance is not resignation. The act of acceptance is embracing the reality of the journey and all it encompasses while also knowing that you have control over your responses to and interpretation of the process. Acceptance allows you to reset and move on to an empowered, proactive, and progressive state, which, in my experience, is healthier and associated with better outcomes throughout the journey.
5. Find outside help if you cannot process through a stage, need help understanding a loved ones’ processes, or feel lost in your own process.
For flow and simplicity, I will use the term “counselor” throughout the book to represent whatever form of outside help you choose. You may find a psychiatrist, psychologist, counselor, spiritual advisor, or one of the many other helpers to facilitate your journey. The important thing is that you resonate with them and that they resonate with you. As a note, you may already have a relationship with a counselor. If not, know that the process of finding the right person takes time. Ask friends or professionals for referrals (your healthcare team will likely have many), and work with someone you feel you resonate with.
Cancer – The Journey from Diagnosis to Empowerment is available in print, audio and electronic editions. Links available at https://drabooks.com/cancer-diagnosis-to-empowerment/.
