"Cancer? Me? But I exercised and ate broccoli. I'm a vegetarian!" Almost every newly diagnosed cancer patient is astonished and outraged.
I hear this all the time because I'm a chaplain in a cancer center and I've been diagnosed with cancer myself. I've seen patients spend six months getting over the shock of diagnosis and by then, their chemotherapy is over. However, receiving the news that your cancer is back is another matter altogether.
That outraged shock isn't there because once you've had cancer, you know there is always the possibility of a recurrence. There are a lot of different responses to a recurrence, but there are two primary ones that I have seen in dealing with cancer patients.
There is the, I'm-in-a-battle-for-my-life-and-I'm-going-to-beat-it stance of White House Press secretary Tony Snow. And the, it's-chronic-and-I'm-not-going-let-treatment-take-over-my-life response of Elizabeth Edwards — wife of Democratic presidential hopeful John Edwards. Both are saying in different ways, "I'm not going to let cancer control my life."
It's tempting to think it's a gender thing, but it's not. I've seen both sexes have both reactions.
Sometimes treatment can cure a recurrence, but sometimes it can't. So if total eradication is impossible, then the idea is to keep the cancer from taking over your body... and killing you sooner. If you've been through the whole treatment circus once, how can you possibly go through the same thing again, especially if there is no promise of a cure?
The answer is that you don't go through it the same way. When it's clear that chemo will be a way of life, people usually make the switch from having chemo in the foreground of their lives, to putting chemo in the background.
One longtime patient said to me, "On Tuesdays I shop for groceries, get my chemo and take the kids to soccer practice. It's no longer the main event in my life. It's just part of the Tuesday schedule."
My friend Manuel was the best example. He had metastatic colon cancer and wore a pump that continuously infused chemo into him. After 40 years of golfing, he was out on the course, wearing his fanny-pack pump when he hit his first hole-in-one. There were so many people crowded around the hole screaming that he never saw the ball go in himself. Everyone on the course that day knew he didn't have much longer to live. He died a few months later.
Another patient on lifelong chemo said, "My friends are afraid that I'm about to die any moment. But I'm not. This is so different than the first big-slam-kill-it-all chemo. I'm spiritually and emotionally in a different place. I've had time to think about my life and consider my death. And what I've learned is that living my life is way more important to me than focusing on my treatment."
This patient regards her cancer as something that will always have to be treated, because without treatment she will die sooner. Note I said, "die sooner," not "die."
When Katie Couric reminded Elizabeth Edwards, "Here you're staring at possible death," Elizabeth Edwards politely pointed out, "Aren't we all, though?"
Debra Jarvis is the author of "It's Not About the Hair: And Other Certainties of Life and Cancer."