Cancer Debates

Yesterday, I read an atricle on daily telegraph about Albert Espinosa ( check also http://www.albertespinosa.com/books/el-mundo-amarillo) and although the article itself was quite encouraging, some of the comments below were really bold and some of them messed my mind.

Debate 1:
Does attitude affect the prognosis?

A lot of research and fuzz on this question as some scientists say it does, some say it doesn't. However, there is no light at the end of the tunnel because cancer remains a multifactoral disease and I am beginning to notice that doctors are frequently deceived by the test results and give prognosis that turn to be far from the outcome.  

Generally, by talking to countless doctors for the past two years and repeating the same questions I can plainly put it this way:

Oncologists' attitude is most reserved but they tend to overstress the negative outcome, perhaps in an effort to lower the patients' expectations. If things go well, the patients kiss their hand. In case things go bad, they had already informed the patients, so they keep their hands clean.

Surgeons are more optimistic. The leaps of advance in the medical/surgical field give them a slightly more positive mind and a belief that they can control the cancer but cutting of the naughty bits of tumors from here and there.

Everyone else,including patients and relatives have as many opinions as their number.

Then, in my hospital at least, the volunteers and nurses of the oncology ward share the belief that miracles do happen and those that "give up" are usually the ones to go while for those that have decided to fight , cancer means at the worst case a bad quality of life.

Some researches suggest that there are three categories of patients that generally outlive the prognosis:

a.those in denial

b.the agressive and angry ones

c. the positive and optimistic ones

(if I have the time, I should track them down and post the links...)

Debate 2:
Use of the words "fighting", "beating"  etc. as in "fighting cancer", "beating cancer"....

Some comments of relatives (of patients that passed away) on the article about Espinosa were pretty bold and stated that this phraseology is damaging and ignorant. They said that the use of this words imply that everyone that decides to stay home and not "fight" to live is thus considered a quitter and possibly coward, while in fact, accepting death is an act of courage.

My thesis in this, as a cancer patient, is a bit unrelated but I believe it to be a keen observation. I realised that relatives and loved ones are having a more difficult time to accept the situation and they tend to mature in a "slower" pace than the patients themselves. 

I have not encountered yet a fellow patient that was concerned about this phraseology. They simply don't bother and usually put such debates in the potato-potahto section. 

In the end, if we have to resort to philosophy, life means fighting. From the moment we are born and we fight to expand our lungs and breath through crying to the moment we close our eyes, surrendering to death in any form, we do fight. 

In the case of cancer, whether it is a 28 year old like me that fights to live a life yet unlived or it is a 86 year old lady that is filled with memories of gains and losses and fights to maintain her decency in her final days, it is still fighting. Both have to converse with death and learn to live with the prospect of it. But on the other hand, who doesn't? Our mortality is as certain as the rising sun. 

Finally, concerning "beating" cancer:

 who cares if the attitude served the outcome or if the chances where just good. You get a second opportunity to live and that's what matters. I say ,only God knows and decides how and when our life shall end so we should fold our sleeves and get down to do some serious living before our time comes. Right?

Notes on a cemetery..

I always found the sight of cemeteries appealing.
One might rush into a conclusion that I am morbid, but truth is far from that.
Cemeteries can be fascinating. They represent the culture and the beliefs of a religion and of individuals and blah blah blah..
I could say so much about their significance culturally but in the end what draws me into these places is always the calmness. There is a sensation of peace and loneliness that leads to deeper thoughts. Thoughts of our transient nature, of impermanence, of life and death, of wishes, of time.
Monks and philosophers used to keep rooms with view of cemeteries or they kept in their room objects reminding of death.
"Memento mori" they called it. Quoting Wikipedia: "[it is] a Latin phrase translated as "Remember your mortality", "Remember you must die" or "Remember you will die".It refers to a genre of artworks that vary widely but which all share the same purpose: to remind people of their mortality.."
And remembering our mortality is -opposed to what most people believe- the start of the most fulfilled and rich life. For knowing how to die is knowing how to live.
Being aware of how short and unpredictable life is, lets us appreciate the moments. Prompts us not to keep malice between each other, because what today angers us in aspect of death it means nothing, while love and kindness means everything.
Would you keep being angry at your partner if you knew you would never see him the next day? No.
Would you cry and be depressed over what a client shouted at you at work if you knew you had only a month left to live? No
My favorite psychiatrist-author ,Irvin Yalom, says :"Although the physicality of death destroys man, the idea of death saves him".
In the end, conscience is what separates us from animals, and knowledge is our burden and our privilege as a species, as God's image creatures and as individuals.