What Can Cancer Do To Me   by Dr. Rick Boulay


This is a question best answered by what we have all seen and experienced in our lifetimes. Cancer affects at least one in three Americans; and therefore, nearly every family will be directly affected in some way by cancer. Since our experiences are unique, it is often hard to see the full scope of what cancer can to do our lives.   


First and foremost, cancer will change everything. All that we have held near and dear to our lives, our sense of selves, our sense of family, relationships with friends, spirituality, safety, sexuality, financial security, and how we age will change. Almost everyone's initial thought is, "What will life be like for my friends and family after I am gone?". This seems to be the first step in most patients evaluation of their cancer. Like it or not, we all face our own mortality when dealing with cancer. Surprisingly though, less than half of those patients who are diagnosed with cancer will actually die from their disease. Nonetheless, evaluating the value of own lives is an important exercise to help put things in better perspective.


Life has always been short and fragile. Nothing brings that closer to home than the diagnosis of cancer. As we look at our lives critically, we begin to reevaluate and re-prioritize the importance of everything. We begin to look at whether are lives are full and meaningful. We begin to evaluate whether we are good or wicked.    We begin to see time pass quickly and realize that there are number of things that we still need to do with our lives. This sense of mortality and finality many times taints how we view the rest of our lives. This can be a positive or a negative thing.   


In the negative sense, I have seen patients view cancer as a scourge that has robbed them of life. They begin to view every day as a countdown to their death. They loose themselves in fear, anger, and hopelessness. They choose to lash out against those around them; and with the diagnosis of cancer, they lose the things that were once very important and essential to their lives. Whether they live only 1 more year or another 100 years, they have given into their disease and chosen to live hopeless and futile lives.


On the other hand, I have seen many people choose to view their cancers as a blessing in their lives which has allowed them to re-prioritize what is important. Their sense of mortality has allowed them to quickly identify what is really important and to spend the rest of their loves working to accomplish their clarified goals. I have seen the love expressed by these individuals returned countless times over, and I have seen inspired accomplishments in the writing of books, creating art, starting companies, reuniting with lost or estranged love ones—all fulfilled goals to make their lives better. Whether you choose to view cancer as a scourge or a blessing or both, it is certainly a choice and the choice that you will carry with you throughout the remainder of your lifetime.


When diagnosed with cancer, people begin to look at the physical manifestation of their disease. Most people will notice some changes in their bodies as a result of their cancer or treatment. Cancers can cause pain and nausea. Fortunately, there are a number of medications and ways to give those medications that can minimize these symptoms and improve the quality of life. Cancer can cause loss of the function of limbs, senses, and internal organs. However, there are a number of medical devices that can help people adapt to these changes. Cancer treatments can cause pain as a result of surgery, nausea as a result of chemotherapy, hair loss, and skin changes as a result of radiation or chemotherapy. These changes are most often temporary and can be controlled with medications, holistic approaches, and relaxation techniques. I find these physical changes are most worrisome to patients but often are most easy to control from a medical standpoint.


As you go through cancer diagnosis and treatment, it is very important for you to develop a relationship with your cancer care providers so that you feel comfortable in relaying which symptoms are most problematic for you. In my many years of treating cancer patients, I have found that it is not uncommon for them to try to protect me by downplaying their symptoms and not telling me exactly what how they are really feeling physically and emotionally. Since I can only attempt to treat what I know about, it is important for my patients to be open and honest about the difficulties they are having with their cancer and treatments so that I can help to mange those symptoms.


The most difficult symptoms of cancer to manage seem to be the non-medical ones. Patients often describe feeling less safe and secure in their lives. They often note that their spirituality is changed. Relationships with close friends and family have changed. These important changes are as important to address as the physical manifestations of their disease.


Fear. I do not think that anything causes as much fear as learning you have cancer. There are so many fears that are manifested as a result of a cancer diagnosis, but they are difficult to mention in a short paragraph. Fear of death, fear of treatment, fear of loss of control, and fear of what is to be are common in everyone who develops cancer. These fears are often times overwhelming when someone is first diagnosed with cancer. The manifestations of fear include inability to make decisions, depression, anxiety, anger—all of which can impact negatively on those around us—and are the actual treatment of the disease. There are a number of ways to help control this fear. Education is extremely important. Finding out as much as you can about your disease, its treatments, and what you can expect many times allay a lot of fear. Our minds are terribly powerful and often times can imagine things way worse than what actually happens. A great way to educate yourself and your disease is to link up with someone with a similar cancer. Your healthcare provider may be able to do this for you. Local support groups in our community through your physician's office may be helpful. Counseling is often times helpful. Many patients fail to utilize this as they see it as a sign of weakness. There is nothing weak about treating your mind as you treat your body. There are many experts who are well versed in helping patients through the emotional hurdles of developing cancer and the emotional hurdles of its treatment. There are few other times in our lives when we have such a tremendous amount of change and fear as with a new diagnosis of cancer. Healthcare professionals have spent many years training to help people through these times. Focused meditation, relaxation techniques, calming times are also helpful in controlling fears. Some patients fear and anxiety is debilitating enough to require treatment with anti-depressants or anti-anxiety medications. These are usually temporary and most needed in patients who had prior history of depression or anxiety disorders. If you need them, use them. They are there as an adjunct to help in your cancer treatment. They can help you get better.


Cancers will cause changes in relationships. Even long-term relationships which seem to be solid and resolute often times change with a cancer diagnosis. At this time of great stress, interactions between those with cancer and their loved ones can be misinterpreted and result in stress within the relationship. For instance, for someone who is diagnosed with cancer, maintaining independence may be a very important part of their recovery. Those around them may wish to help with simple tasks so that the person with cancer can focus on their recovery. Actions as simple as washing the dishes, helping with housework, helping with chores may be seen by someone with cancer as intrusion into their space. This interaction, which was meant to be helpful, may result in arguments between individuals and a sense of loss for the patient with cancer. It is important during this time to communicate these feelings. I have always said that an individual is not diagnosed with cancer alone. It is the individual's family and entire support network which changes. I have seen in the past close friends and family flee when a loved one is diagnosed with cancer. This is simply because they do not know what to say or do and feel that they can only make the situation worse. It is incumbent on everyone to know that they can only help to improve the situation. If they say something unintentional which is perceived as hurtful, that can be worked out. If they do not say anything at all, a sense of abandonment can often at times be much greater. It seems to me that over time these relationships begin to normalize as the initial shock, fear, and anger of a cancer diagnosis abet, and a sense of wholeness returns.


Spirituality also changes after cancer diagnosis. I have seen in my own family those who have been extremely religious begin to question whether God was on their side or against them during this difficult time. I have seen others accept willingly that this was God's fate for them, and he will get them through. There is great variation in people's religious beliefs and an additionally greater variation on how these beliefs change or adapt at the time of cancer diagnosis. Those people who already attend religious services often times find comfort in discussing their spirituality with their church leaders. Those who have not been participating in religious worship may wish to explore this spirituality within their lives. This can be done through family and friends attending worship services and discussing their spirituality with independent chaplains or religious leaders in their community.


Isolation is a common response to a cancer diagnosis. There are few other times that we feel so very alone than after the diagnosis of a cancer. It is our disease, affecting our body, intruding on our lives, and no one can fully understand that besides ourselves. This loneliness and isolation can rob us from important positive interactions of those around us, close family, and friends. This isolation usually resolves by itself; however, can be a sign of a deep depression or an anxiety disorder and may require treatment.


Finally, cancer can present a positive change in our lives. Cancer can re-prioritize and re-energize our experiences for the better. A diagnosis of cancer can really define what is important to us and what our life's long-term goals are and energize us toward completing those goals. Whether those goals are teaching children to read, singing in the church choir, reuniting within an estranged loved one, or starting a brand new business, I have seen cancer diagnosis result in all of these goals. Use this time in your life to reflect at who you are and what you would like to do. Let your diagnosis energize and reinvigorate your life to accomplish these goals. Let the little corks in irritation go by, and enjoy every special moment as small as it may be.

Draw on your strengths prior to your cancer diagnosis
How Did I Get Cancer?
Discussion of gene abnormalities, environmental agents, dietary deficiencies, genetic changes, and adaptation to the environment
How Did My Cancer Begin?
Discussion of genetic diseases, gene abnormalities, sporadic cancer, carcinogens, and genetic instability
What Is Cancer?
Explanation of cancer, cancer’s terminology and definitions, and the goal of oncology
Cancer Diagnosis
Introduction to needs, questions, and pillars of wisdom for cancer diagnosis
What Cancer Cannot Do To Me
Discussion that cancer cannot change who you are, cannot define who you are, cannot take away hope, cannot take away love