They know that I am a medical oncologist and that I care for mainly individuals with breast cancer. There are always many questions about advances in the field, what New England Cancer Specialists has accomplished in the past month, and my personal reflections about my work.
We all know that they are many kinds of cancer, and that the types of cancer are now classified by unique features of the cells or even the tumor’s genetic imprint. One of my friends challenged me however, that in their mind, there really are only two types of cancer. There is cancer to which we surrender (can surrender) or cancer from which one survives (can survive).
They could not have been more correct. It really is that simple.
And the line in the sand that divides surrender from survival is frequently blurred by one’s own psychology and how physicians, family, and friends choose their words and actions when relating to one with a cancer diagnosis.
When an individual first discovers that they have cancer, one of the first things that they wish to know is “can there be a cure?” Because of earlier detection, better surgery and new treatments, many individuals can be cured of their cancer. We say that the treatment intent is CURATIVE, meaning that the expectation with a high degree of certainty is that the abnormal malignant cells in their body, their cancer, can be eradicated forever and will never return.
But does a cure ensure a long life devoid of illness and full of happiness once these cancerous cells are gone? Perhaps, if the person works to restore health by working to eliminate potential cancer triggers in their life. The “I dodged that bullet” philosophy might be a dangerous position to adopt. A cancer cure is a wonderful time to thoughtfully evaluate lifestyle and make some changes that can further restore health for all the organs. Why would one ever dare another cancer event or another medical illness to develop with time and ruin the victory and their cancer cure?
Many individuals with a new cancer diagnosis cannot be cured. Their disease is spread to distant organs from the primary tumor and current treatments available may only be able to regress the cancer with hopeful alleviation of symptoms. These individuals are treated with PALLIATIVE INTENT. The curious thing however, is that these individuals can also be survivors. Newer treatments that are now available today can convert some cancers into chronic diseases. Some individuals with advanced disease can have extraordinary survivals beyond their physician’s initial expectations. They are not “survivors” that are free of cancerous cells, but “survivors” that are living with cancerous cells active in their body on a daily basis.
Just because an individual cannot be cured forever and ever of their cancer does not mean that there should be a surrender. Physically and psychologically surrendering means that the most precious gift, life, now has a timeline attached to it. Most of the time, what our mind believes, will translate into reality.
Whether treatment is able to provide cure or palliation, the human spirit will ultimately decide surrender or survival. Supporting that spirit with good nutrition, movement and exercise, life, laughter, community, and an ongoing sense of self-worth is every bit as important as the sometimes miraculous therapies that science has evolved to treat cancer.