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Nov 11

How to Cope Better When You Have Cancer

How to Cope Better When You Have Cancer

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Table of Contents
Foreword by Bernie Siegel, M.D

Preface

Introduction

An Opening Letter of Hope

Part I: Getting the Lay of the Land

1. Welcome to Cancerville

2. Turning Down the Spotlight on Catastrophe

3. Converting Rapidly from Powerless to Powerful

4. Striving to Adapt to a Place from which You Really Want to Run

Part II: Understanding the Land

5. Making Eye Contact with Cancerville

6. Meetings with the Dedicated Doctors

7. Hair Grows Back: Coping with the Physical Effects of Cancer

8. Minds Come Back: Coping with the Emotional Effects of Cancer

9. Lives Come Back: Coping with the Impact of Cancer on Your Everyday Life

Part III: Making the Land Your Own

10. How Minds Work

11. Embracing a Really Simple Philosophy: Realistic Optimism

12. The Power of Positive Self-Talk

13. Dealing with Depression, Debilitation, and Distress

14. Calming Your Fears and Anxieties

15. Reining in Your Rage

Part IV: Tools That Help You Tend the Land

16. Relaxing Tools for Natural Healing

17. Cognitive Tools for Taking Charge of Your Mind

18. Traditional and Alternative Treatments and Complementary Support Options

19. Having a Counselor and/or Support Group in Your Corner

20. Big Boys and Girls Do Cry

21. Laughter in Cancerville

22. Communication in Cancerville

Part V: Putting Distance Between Yourself and the Land

23. No One Really Knows Where the Road Goes

24. Helpful Life Lessons You Can Learn from Your Cancerville Experience

25. A Modern Day Fairy Tale

26. On Becoming Even More Empowered

A Closing Letter of Caring

References

Foreword
I found this book to be an easy read because Bill Penzer and I agree with one another. We may have a few differences of opinion, which I will also discuss, but basically we have learned the Cancerville lessons, which help people to not just cope with cancer, but to survive it as well.

My reorientation as a doctor came from one of my patients with breast cancer telling me she needed to know how to live between office visits because she couldn’t take me home with her. As I helped more cancer patients learn how to live, I realized that the side effects of learning how to live, cope and survive provided them with a longer healthier life.

Woody Allen shares the key point in a dialogue between two friends, one of whom is very depressed about the bleak, absurd cosmos. When his buddy asks him, “What are you doing Saturday night?” he answers, “Committing suicide.” His friend responds, “How about Friday night?”

It reminds me of the letters I have that describe how people changed their lives when their mortality became very evident, by being at risk, and so they started to live a new life they could love, and loved their body as well. Their letters end with, “I didn’t die and now I’m so busy I’m killing myself. Help, where do I go from here?” I prescribe what they need, a nap, because they are burning up and not out. We all need to accept our mortality and not wait for a disaster to get us to truly live our authentic life and not the one imposed upon us. Rather than becoming strong at the broken places, we need to learn from those who preceded us and from the lessons shared in the following pages.

It is basically about our potential and feeling enough self-esteem to not be afraid to participate in our lives and health. When we fear failure and are dealing with the guilt, blame, and shame imposed upon us, we are fearful of trying to achieve what we are potentially capable of by participating and taking responsibility.

Many years ago one of our children, at age seven, was diagnosed with a bone tumor. I was sure from the X-ray he had a sarcoma and about a year to live after his leg was amputated. I went home and shared this with my wife and his four siblings and basically informed them about the depressing future. The next morning he came to me and asked if he could talk to me for a minute. I said “sure” and he said, “Dad, you’re handling this poorly.” From then on he became my therapist by teaching me about living in the moment and enjoying the day rather than worrying about or being depressed about an unknown future. The good news is that he had a very rare benign tumor and he taught me a great deal in the week before his surgery.

He also taught me about the difference between the native and the tourist. If you have not experienced cancer you are the tourist and should be listening to the native and not giving them directions because you haven’t been to Cancerville. He taught me that lesson after the surgery I performed upon him. After showing him everyone and verything in the hospital he would see and meet, he woke up and said, “You didn’t tell me it was going to hurt.” Yes, I was a tourist in his land as the patient. So when you lose your health, find the people with experience to help you find it just as you do when you lose your car keys and need a ride home. Bill is definitely a native guide, so you can trust his lead. Follow his umbrella as he takes you through this complex but manageable maze.

In our family we have experienced MS, cancer, Lyme disease, and many more problems. I have seen how much better I am at living the experience than I was decades ago. This is where Bill and I share some common ground as we both learned how to cope better. The doctor in me and the psychologist in him are the problem. I was trained to cure and prescribe for the disease rather than care for the person and help them to cope and heal their lives. When I learned to love my fate and the lessons going through Hell were teaching me, things changed for my family and me.

I learned by observing my “exceptional” patients, especially those that were not supposed to survive, but did. When Bill learned to follow his instincts, his knowledge, and what he would have encouraged his clients to do things changed for him. We both needed to get out of our professional roles and into our loving, caring, and healthy hearts and out of our heads that only served to confuse us.

What follows in this book can help you to learn in a much healthier way. Bill consistently offers you a horse named Hope upon which to saddle up. You may fall off from time to time, but he will help you get back up and enjoy her stride.

I have seen what hope, love, peace, and faith can do. Things I was not taught about in medical school but now have an open mind to and have experienced and, therefore, can believe in. When I talk about learning from one’s feelings and problems let me share what helped me. A friend asked me, during a difficult time, what I did if I was hungry. I told her I get something to eat. She then said, “Then ask yourself what nourishment you and your life need to help you to respond to these feelings and heal your life and body.” That advice has helped me many times. The mind and body are a unit and must be treated as such. When people believed they were being treated with chemo or radiation but weren’t, due to medical errors, they still had side effects and their tumors shrank none-the-less. One doctor noticed that the chemotherapy program entitled EPOH, based upon the first letter of the four chemotherapy drugs, could be reversed and he could give his patients the HOPE protocol. With that title more of his patients responded to the chemotherapy than those being treated with the EPOH protocol, though they were identical except for the name.

So remember to make your therapeutic decisions based upon your intuitive wisdom as well as your intellectual decision so there is no internal conflict creating more side effects. You decide how you are treated, not your family or your doctor prescribing for the good patient, or submissive sufferer. I want you to be a respant, my word for a “responsible participant.” I recall a doctor at a major cancer center apologizing to me in his book. He told me that his wife had cancer and he was apologizing for what he had thought of me and my work and that now that he was living with the problem I was an enormous help.

One more little bit of advice. If you want a good doctor, find one who, when you ask, “Are you criticized by patients, nurses, and family?” says, “Yes.” Why? Because they are learning from their mistakes and lack of experience. As a doctor my patients taught me how to be a better doctor. They were my coaches and guides just as I was theirs. So keep your power related to therapeutic decisions, finding the right doctor, and training him or her. When you love your life and body, your internal chemistry lets your body know you are choosing life and it does all it can to keep you alive.

Basically it is to choose life and not try to avoid dying since that is impossible and there are many vegetarian, meditating joggers who are very bitter people in Heaven. So choose life-enhancing choices, which benefit everyone and allow miracles to happen. If they do happen your doctor will probably not be interested in what you did, while the nurse and social worker are. So become a character your doctors are aware of so that you are not just a diagnosis, and then they will learn from you about the benefits of integrative medicine, meditation, laughter, and the potential, which resides within all of us.

The healing mechanisms are built into us by our creator, but they have to be turned on for our genes to get the message. I call it survival behavior because I have learned the qualities from people who exceeded expectations, and this is related to all kinds of afflictions we have to deal with. Survival behavior is what all the great sages of the past have taught us.

As a woman wrote, her life was now BC and AC, or Before Cancer and After Cancer. You have to abandon the wounds of the past related to parenting distortions. Genes don’t make decisions, but our internal environment and chemistry gives them the message. So find healthy growth in your life and don’t let your growth go wrong. Our childhood is stored within our bodies and needs to be dealt with by our not evading the truth and having the body present its bill. Bill’s model of the mind sums it all up simply— vent cess and be “DAM STRONG!”

If you did not grow up with mottos, which help you to let your heart make up your mind, and see difficulties as God’s redirections, you have to reprogram yourself. When you do, your energy changes and amazing things can then occur. In his book Cancer Ward, Solzhenitsyn describes self-induced healing as a rainbow-colored butterfly. He understands it is not a spontaneous remission or miracle but self-induced. The rainbow represents a life in order created by transformation, the butterfly symbol. I recited this passage from the book to Bill when we met in my backyard, and he captures these images clearly in Chapter 26. I am pleased to have been a spiritual guide to him as he reached to expand his views on love, medicine, and particularly miracles.

This is not about winning or losing, but participating. This is an area Bill and I may not agree about. I find that when people see cancer as a battle or war, they focus too much on killing the enemy and not enough on healing their lives and bodies. I like to eliminate the disease and heal lives. A Quaker friend, a conscientious objector, walked out of his oncologist’s office because the doctor said, “This treatment will kill your cancer.” His words became swords and Dave said, “I don’t kill anything” and walked out of the office to live twelve more years doing his thing and in his imagery he carried his cancer cells away. Mother Teresa said it very well when said she would not attend an anti-war rally, but if they ever had a peace rally to call her. We may not always follow the exact path, but Bill does build many bridges across which he and I are able to walk together.

In many ways the side effects of cancer are not all bad or problems. For some, cancer becomes a gift, wakeup call, or new beginning. So ask yourself what words you would use to describe your experience and see what those words tell you. If they are negative words, then eliminate from your life all the things that cause words like pressure, confusion, draining, failure, and more. Then find words that help nurture and heal your life—body, mind, and spirit.

In closing let me say hope and your future are not controlled by statistics. It is about your potential and desire to participate. Be sure to pay attention to your dreams and drawings so your intuitive wisdom and intellect can communicate and you can learn from your imagery and visualize what you desire, so your body expects good results from treatment and more. Do not be afraid to discuss death. Let it teach you about life and be comfortable with the word so you can speak freely to friends, family, and physicians. Death is not a failure and the only thing of permanence is love. So if you want to be immortal love someone.

To sum up, what you have to do is to create the person you want to become by rehearsing and practicing just as an actor would do. See the changes you need to make and your treatments as your labor pains. When you see them in that way you will have fewer pains and find they are worthwhile because the result will be your giving birth to a new and healthy self. Get your friends and family to help coach and direct you so when you are not performing well they will be there to correct and guide you. Actors in a comedy enhance their immune function and lower stress hormone levels, while those acting in a tragedy have the opposite happen.

So become the person you want to be and if you have a problem finding a role model ask yourself WWLD? or What Would Lassie Do? Animals and children live in the moment and are great teachers. I know of and have seen miracles and energy healing of cancer in our pets when they were loved and touched and not euthanized as the vet suggested. So love and treat yourself as well as you do your beloved pet, and if you don’t have one get one because they improve relationships and increase survival rates.

You are always a work in progress, and as long as you are alive the canvas is never finished, as there is always more color on the palette.

Bernie Siegel, M.D.
Author of Love, Medicine & Miracles, A Book of Miracles and Faith,
Hope, & Healing
July 5, 2012

Preface
As I began to write How to Cope Better When Someone You Love Has Cancer, I created a personal image of excellence. I wanted it to push me to write an exceptional book about a less than exceptional topic. I decided to use the same image for this book as well because it needed to be just as good, if not better. The image I chose was symbolic of my goal. I was determined to write a clear and powerful book that would truly help people. I wanted to “knock it out of the park.”

As a kid who grew up in the Bronx, New York, in the 1940s and 1950s, I was an avid baseball fan who spent a fair amount of time at Yankee Stadium. I therefore picked the following image to motivate me to write the very best book that I could.

It is the seventh game of the World Series, and the Yankees are playing their hearts out in their old stadium on Jerome Avenue. It is the bottom of the ninth inning, and we are down by three runs. There are two outs, and the count is three balls and two strikes. The bases are loaded, and I am at bat. I need to hit a home run—nothing less. That walk-off hit will give us the game and the series. I want to hear the Yankee announcer of old, Mel Allen, screaming at the top of his lungs, saying, “There is a high fly ball to deep, deep center field. That ball is going, going, and it’s gone. The Yankees win the championship. What a hit, what a game, what a series, what a win!”

That was the image I kept in mind while writing this book. I swung as hard as I could and aimed it right at you. I sincerely hope you will catch the ball and that my words will help you to stand tall during a difficult time. That is much more important than the outcome of a baseball game. I want you to win. That is really all I care about.

Introduction
One of the greatest victories we can achieve is defeating a life-threatening illness such as cancer. Please try your hardest to assume that is exactly what you are going to do. Right from the beginning, see yourself as becoming a member of that elite “green beret” group of survivors. Embrace that thought and image every single day—allow it to both enable and empower you.

I have no doubt that cancer will test your strength by pushing you to the limit every step of the way. But you will be both surprised and pleased with the strength and resilience that you will mount to fight back; and I will help you do just that. I will walk by your side every step of the way. You and I will walk this beat together like two tough street cops in a crime-ridden neighborhood.

I am sincerely sorry that you need to read this book. I wish you could be reading Danielle Steele, John Grisham, or any other book of your choice. I so wish that your life were lighter, brighter, and free of suffering and worry. I hope you get back to that space soon. In the meantime, you have made a good choice. My words will help you through. They have helped many before you and they will help you too. I will walk you through this most difficult situation, while helping you hang tough and remain strong.

Most authors, I would imagine, want everyone to read their books. Oddly enough, I want no one to need to read this one. My sincere hope is that this book will become obsolete very soon. I want cancer to be a thing of the past and cancer centers to become empty ghost towns. That may not happen in my lifetime, but I am hoping it will happen. We are closer than ever before—we will get there! For now, I hope you will choose to read this book as a way to gain added support at a very difficult time in your life. Nothing—and I mean nothing—prepares a person to deal with a cancer diagnosis. The person diagnosed as well as family and friends are all caught off guard. On July 8, 2005, I knew that someday, if I lived long enough, I would write a book to help family and friends of cancer patients. That book, How to Cope Better When Someone You Love Has Cancer, spawned this one.

On that torturous July day, forever etched onto my brain like a permanent tattoo, I sat in the waiting room of Memorial Sloan-Kettering Cancer Center in New York City. I realized many things that day as we sat with our thirty-one-year-old daughter, Jodi, awaiting her surgery for breast cancer. I already knew from my work as a psychologist and psychotherapist that life wasn’t always fair, but my experience helping others did not immediately prepare me for helping my family and myself. I was as lost as a tourist in a strange and foreign land, unable to get my bearings or even speak the language. At that very moment, I realized that cancer was not only a horrible and hated medical diagnosis, but it was a place as well. I knew then that my daughter, my wife, and I had entered what I came to call Cancerville.

As we sat there quietly waiting for our daughter’s procedure to begin, my mind was numb, as if frozen by an icy cold frost on a winter’s morning in Montana. When the nurse called Jodi’s name, signaling her turn, she, dressed in a gray hospital gown, stood up quickly and bravely. A single angry thought shot through my head in outraged indignation: “This cannot be my daughter’s turn!”

As Jodi took the first steps toward the operating room, elephant-sized tears began to fall down her checks as if she were a prisoner on her way to execution. Yet in reality she was an innocent victim of cancer. My frozen mind thawed and instantly overheated, as if I had been thrust headfirst into an oven. I was helpless, as was she, to prevent the ensuing barbarism. Though the surgeon was just trying to save our daughter’s life, it felt much more like a dirty trick than a treatment. It was a macabre Halloween scene, without costumes or candy. There are so many different, difficult, and dark images that can immediately come to mind when you enter Cancerville. Slowly but surely, you and I will work together to eliminate or minimize them, one by one.

Consider this book a guide to a place you really never wanted to visit. Like Jodi, you were never given a choice—just a by-invitation-only command in the form of an X-ray, MRI, blood test, biopsy, or any combination of the above. To get through this very difficult territory, you need a strong voice to lead the way. I am honored you are allowing me to be that voice for you. I take that responsibility very seriously. I will teach you how to provide that added strength for yourself. As you probably know, the majority of cancer-related books are written by medical doctors or by cancer survivors. I am neither, as I am a psychologist by profession and, most fortunately, I never had cancer. People have understandably asked me, “How can you help people cope better with cancer when you are neither a medical doctor nor a cancer survivor?” That is a fair question, and here is my response:

• I understand the emotions of Cancerville from my entrance, by proxy, in 2005 when my daughter was diagnosed. Despite my training and experience, I did not cope well. In Chapter 10, “How Minds Work,” I will explain how my past life experiences led me to enter Cancerville kicking and screaming on my emotional knees. It took me a while to get to a better and stronger place. I want to help you get there much more quickly than I did.

• A mental health professional does not need to have personally experienced something to be able to help others deal better with that something. As an example, I have never been divorced. However, I have helped hundreds, if not thousands, of people through that troubling and painful maze.

• Similarly, I have helped many people facing cancer throughout my forty-year career as their counselor and life coach. I understand the emotional dynamics of Cancerville almost as well as if I had gone through it myself.

• In addition to the people I have helped all these years, as research for these books, I have spoken to many, many people who have been to Cancerville. This has helped fill in many gaps in my understanding of the experience. I came to learn about the range of reactions and coping strategies, as well as those experiences common to all people in Cancerville. On the pages that follow, you will learn how the people I have spoken to all dealt with their Cancerville experiences, as well as how they are doing now.

• Having cancer or being a physician doesn’t automatically qualify someone as an expert on emotional coping, nor does it enable someone to translate experiences, thoughts, and feelings into understandable words. Therefore, some Cancerville books fall short of their good intentions while others are excellent. I will reference many of the latter as we go along.

Thus, I believe you will find the words that follow helpful and appropriate. My expertise pertains to matters of the mind in many different and difficult life zones, and Cancerville qualifies as majorly difficult in just about every way. I am also able to explain complex emotional issues in simple terms. I am very confident that the words that follow will resonate with you and will be helpful to you.

I assure you that you will find ways to take Cancerville on. You will rise to every challenge and fight back with all your might and moxie, and I will help you to do that. Together we will, slowly but surely, climb to the top of the slippery Cancerville mountains with an agility and balance you never knew you had. Once you get to the top of the highest peak, you will silently shout, “I have beaten cancer. I am a survivor—I now own the land that tried to own me!” Picture yourself in your mind’s eye standing on top of the mountain and planting a flag with your name on it into the salty soil, moistened by your tears of joy.

Holding on to powerful, positive images is one way to keep your mind strong. I will teach you many more tools to do that as we go along. Once you have made it through the obstacle course I have come to call Cancerville, it will be a triumph of grand proportion—a very powerful “Yes!” moment. Toward the end of our journey together, I will tell you about the fairy tale “Yes!” experience my family and I enjoyed a few years after our difficult trek through Cancerville. In many ways, it was the highest mountain peak we ever climbed.

Know in advance that on our way up to the top of the mountain, we may fall off its slippery slope from time to time. That won’t mean you are failing “Penzer’s Positivism 101 course”; it is simply par for the Cancerville course. We will just pick ourselves up, dust ourselves off, and return to continue our climb. Cancerville teaches patience and perseverance like no other place I have ever been.

What we quickly learn there is that we are much more able to cope, adapt, and rise to the challenges of life than we think. Just as necessity is the mother of invention, survival is the mother of any and all action. We do whatever we have to do and whatever it takes. You may not always be happy doing that, but you will be driven to do just that. You will keep taking it on the chin until your cancer takes it on the lamb.

Know that not all professionals agree about promoting positivism in Cancerville. They are concerned about people being unrealistic. They may also be concerned that people will feel that they are “failing” when they can’t sustain a hopeful, positive attitude. As you will learn, my beliefs are based on a philosophy I call realistic optimism. As I’ve said, be aware from the onset that few people can be consistently positive and optimistic in Cancerville or in other complicated situations. That is why we fall off the mountain from time to time. It does not matter how many times we fall off. What matters is that each and every time, we get back on and resume our journey in a proactive and positive way. This complex issue will be revisited in Chapter 12, “The Power of Positive Self- Talk.”

Know that the choice of the yin and yang symbol on the cover of this book was not an accident or merely a design choice. The yin and yang symbol stands for polar opposites that are connected in some way—like life and death. As I sit here on the beach in Jupiter, Florida, writing these words, I observe the brown, textured grains of sand and the white, fluffy, frothy waves; they are about as opposite as two elements of nature can be. Yet they kiss and embrace at the shoreline like lovers, becoming integrated partners in their magnificent and timeless marriage. They soothe us while they get to smooch regularly and rhythmically. For me, watching this over and over is as mesmerizing as a metronome—even more so.

So it is with the two very different parts known as our bodies and our minds. Though that yin and yang is not always as gracefully aligned as the tide and the beach, the bodymind marriage is undeniable. To the extent that I can help you maintain a strong and healthy mind while your body is dealing with all of the effects of cancer and the side effects of treatment, you will be much better positioned to take on the physical challenges, heal, and get well. My goal is to help lighten your journey while increasing the likelihood that you will join the millions of people who are cancer survivors.

Yet another yin and yang of Cancerville is health and illness.Most people tend to assume their health and deny their disease potentials. Most do not focus on the possibility of getting sick until they receive feedback that they are. All of a sudden, the yang of a serious illness crashes into the yin of wanting to be okay. This is similar to giant waves pumped up by a major storm crashing into and crushing the shoreline; the once gentle embrace quickly becomes a disruptive and destructive chokehold. The same is true of cancer and other serious diseases.

Understandably, we do not process and experience a serious and life-threatening diagnosis the way we do a cold, stomach flu, broken bone, or the like. We easily absorb these minor illnesses with our health-based self-image and see ourselves as getting back to health soon. We see the yang as temporary and anticipate the rapid return of our health-based yin.

I want you to strive to do the same in Cancerville. Though the process is longer, more demanding, and much more risky, see yourself returning to health in a reasonable time frame. Try to see yourself as having an illness that is far more complicated than a head cold or broken ankle, but treatable and curable. Eventually the storm moves on and the waves return to quietly kissing the shore once again. Hopefully, the same will occur for your Cancerville storm; try to just assume that will be the case.

There is another yin and yang pairing with which I would like you to be familiar. It is the strength of people and the strength of cancer. Both are formidable in their force; it is a struggling tug-of-war all the way. At some point these opposing forces meet head-on. Know that you will do your very best to prevent cancer’s yang from winning and to help your yin of powerfulness ultimately prevail. Your doctors will be pulling on your side of the rope as well, with everything they have and then some, which will add much power to your side. You and your team of support are a force with which cancer must reckon. Your goal is to stay pumped and powerful.

Understandably, people’s moods in Cancerville have a yin and yang aspect as well. Emotions there are often in flux and tend to go up and down as events unfold. Sometimes in a flash, the yin of good feelings can switch and sink to the yang of mental misery. My goal is to teach you many tools that will help you return to positive or at least neutral feelings whenever you can.

Clearly, it is my goal to help you draw upon your many yins to counter Cancerville’s many yangs. I do not expect you to be a robot, but I hope I can contribute to your being as robust as you can be. My goal right now is to reach out to you so I can help you find that positive place more quickly and more often. A hopeful and positive mindset is key to making this very unpleasant experience a little easier to bear. As many research studies have demonstrated, an optimistic belief can also influence the results in a positive way.

Now, please reach out and grasp my hand. Though it seems silly, I mean it seriously; indulge me for a brief moment. Instead of feeling foolish, try to feel empowered. Every little bit of support helps in Cancerville. Close your eyes and imagine my tight grip leading the way so we can get going. We have a long and demanding journey ahead.

I am firmly convinced that in or out of Cancerville, hope is essential; without hope we are lost and doomed to despair, depression, and defeat. As Barbra Streisand so beautifully sang, “Walk on, walk on, with hope in your heart, and you’ll never walk alone.” As Maya Angelou so beautifully wrote, “Hope slips through the tangle of our fears and evicts despair.”

With hope, you have a fighting chance—in today’s world, a very good chance at that!

William Penzer, Ph.D.
July 8, 2011

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