ROJoson’s Advices on How to Deal with Cancer
Lecturette in 33rd Cancer Crusaders Club Annual Christmas Get-together - December 6, 2020
I have divided the phases of cancer journey into:
ROJoson Classification of Cancer Journey
1. PHASE OF CANCER DIAGNOSIS
2. PHASE OF CANCER TREATMENT
3. PHASE AFTER CANCER TREATMENT (IN REMISSION BELOW 10 YEARS FROM TREATMENT)
4. PHASE DURING SURVIVORSHIP (IN REMISSION 10 YEARS OR MORE FROM TREATMENT)
5. PHASE OF CANCER RECURRENCE
6. PHASE DURING CURTAIN CALL (NEAR THE END OF LIFE)
Psychological distress is a general term used to describe unpleasant feelings or emotions that impact a person’s level of functioning. In other words, it is psychological discomfort that interferes with the person’s activities of daily living.
In all phases of the cancer journey, there will be psychological distresses.
Each cancer patient has his/her own unique set of psychological distresses.
No two people experience one event the exact same way. Psychological distress is a subjective experience. That is, the severity of psychological distress is dependent upon the situation and how a person perceives it. One can think of psychological distress as a continuum with 'mental health' and 'mental illness' at opposing ends. As one continues to experience different things at different times, one can travel back and forth on the continuum at different times throughout one’s life.
There are so many variety of psychological distresses. They usually occur in combination.
I have simplified the types of psychological distresses into four categories:
ROJoson Categorization of Psychological Distress during Cancer Journey
1. Fear
2. Sadness
3. Personal apprehensions
4. Psychosocial apprehensions
FEAR - fear in general; fear of death
SADNESS - sadness in general; anxiety; depression
APPREHENSIONS: PERSONAL APPREHENSIONS; PSYCHOSOCIAL APPREHENSIONS
"APPREHENSIONS" is operationally defined as anticipation of something bad, something unpleasant, some difficulty or trouble. It will include "APPREHENSIONS" on existentialism (such as questioning religious beliefs or searching on the meaning of life and death) which are commonly encountered in cancer patients.
APPREHENSIONS will be categorized into PERSONAL APPREHENSIONS (meaning exclusively confined to the cancer patient himself or herself) and PSYCHOSOCIAL APPREHENSIONS (meaning influenced or affected by social factors like family, place of work, and community).
How to cope with the psychological distresses in a cancer journey
I consider 2 phases:
· Phase of preparedness for cancer development (before cancer appears)
· Phase of cancer journey (when cancer has appeared)
Phase of Preparedness for Cancer Development
All persons should be prepared for possible development of cancer in their whole life time just like they should be prepared for possible development of any disease in their whole lifetime as well as the day of their death. Remember cancer can affect anybody. Nobody is totally immuned. Cancer can strike anytime. Nobody knows when it will come. There is no absolute way of prevention.
To be successful in coping with the psychological distresses when cancer strikes, all persons should at least possess the following:
1. Basic essential information about the cancer as a disease
2. Awareness of tell-tale symptoms of cancer to promote early recognition
3. Awareness of importance of early consult, early diagnosis and early and correct treatment for the best chance of COMPLETE REMISSION
4. Identification of which trusted physicians to go to right away (place in a directory)
5. Identification of which trustworthy and affordable hospitals or clinics to go to
6. Financial plan for medical expenses
7. Knowledge of possible psychological distresses that might develop when cancer strikes
8. Formulation of coping tactical plans to be used for the psychological distresses that may occur
9. Feeling of contentment in the thought that one has dutifully done what should be done in terms of preparedness, mitigation and contingency plans in case cancer strikes (otherwise, there may be regrets during the cancer journey that one has not prepared for this)
Phases of Cancer Journey (when cancer has appeared)
Here are my recommended coping strategies:
· ACCEPTANCE OF THE CANCER
· TRUST IN A COMPETENT AND COMPASSIONATE PHYSICIAN
· SPIRITUAL TRUST
· SUPPORT FROM LOVED ONES and SIGNIFICANT OTHERS
· CANCER JOURNEY STORY SHARING
· INTENTIONAL LIVING PLAN IN THE LIGHT OF CANCER
ACCEPTANCE OF THE CANCER
After the establishment of the definitive diagnosis of cancer by a trusted physician, acknowledge it as soon as possible. It is better and psychologically (emotionally and mentally) to face head-on the cancer than to try to deny it. After acceptance, concentrate on planning and deciding with a trusted and compassionate physician the realistic goals of treatment (whether to aim for complete remission or just palliation); the most cost-effective (inclusive of affordability) medical management based on the goals; and the coping tactics that will be harnessed for any psychological distresses that have been identified.
TRUST IN A COMPETENT AND COMPASSIONATE PHYSICIAN
Even before cancer strikes, identify already a trusted physician to seek right away for consult and medical management. Identify a competent and compassionate cancer specialist. Competent not only in expertise in the medical management of the cancer but one who also provides psychological and psychosocial therapy and support simultaneously with the medical management. Compassionate not only in expressing sympathy and empathy but one who also exert tangible efforts in providing psychological therapy and support inclusive of easing the financial burdens of the cancer patients and relatives.
SPIRITUAL TRUST
The concept of the word “spiritual” as will be used here is that it is not exclusively equated to “religious” or identified to a particular religion or referring to the presence of a God, a creator or a higher power. “Spiritual” will be operationally defined here as one relating to deep feelings, thoughts, and beliefs affecting the human spirit rather than to the human bodies, material things and physical surroundings. It is something beyond the physical world. In the Philippines, oftentimes, “spiritual” is used to refer to something religious, to a religion or to the presence of a God or creator. Whatever spirituality a cancer patient has, he / she can seek or rely on it to use as a coping tactic for the psychological distresses he/she is having. A caveat is to still factor in usefulness and limitations of medical science in the use of spirituality as a coping tactic.
SUPPORT FROM LOVED ONES and SIGNIFICANT OTHERS
The advice is NO TO DO IT ALONE. Seek the support from loved ones and significant others to cope with the fear, sadness, personal apprehensions and particularly the psychosocial apprehensions. They can provide great assistance in coping with the psychological distresses if the physician is not providing or cannot provide PSYCHOSOCIAL SUPPORT. A caveat is for the loved ones and significant others to fully support whatever sensible decision is made by the cancer patients on the management of their cancers.
CANCER JOURNEY STORY SHARING
Cancer journey story sharing is encouraged as it shows acceptance. Acceptance is the most effective coping tactic for the psychological distresses of cancer patients.
Cancer journey sharing or sharing cancer stories is a meaningful and effective way to raise awareness (about cancer, its treatment, prognosis, psychological distresses, etc.) as well as to provide psychological and psychosocial support therapy not only to others but also to the sharer herself or himself.
INTENTIONAL LIVING PLAN IN THE LIGHT OF CANCER
Living a life with cancer is a journey into the world of cancer.
The cancer world is full of uncertainties, such as unknown specific causes; always with the possibility of recurrences after treatment; and not knowing the mode and time of exit, to name a few.
The journey or voyage is rough, with unquantifiable physical pains and psychological distresses.
Everybody with a cancer must formulate an intentional living plan in the light of a cancer diagnosis.
Although cancer is not always a death sentence, especially those who consulted early, diagnosed early and treated early and correctly, recurrence is always a possibility.
For those with advanced cancer diseases and recurrence, they will have limited lifespan left.
Whatever be the case, whatever groups of patients, with early or advanced cancers, they must continue to live on. They must continue to be productive; to have a peace of mind; to be contented; to enjoy life; to be happy; to reach the realistic longevity targets; and to be ready to face curtain calls (death). They can achieve this if they formulate an intentional living plan targeting these goals.
For those who are near the end-of-life because of cancer, the Intentional Living Plan should include the following:
1. Try one’s best to stay alive and productive up to the last moment.
2. Make peace with God or Creator or Higher Force.
3. Make peace with everybody.
4. Endorse material possessions.
5. Make clutter management of earthly possessions.
6. Make an advance directive, both healthcare and funeral arrangement.
6. Bonding with family.
8. Enjoying oneself to the fullest up to the last moment.
I have a free course on how to make Intentional Living Plan (ILP) not only for people with cancer but for all people even without cancer. https://sites.google.com/site/rojocilonintentionalliving/home
Concluding Remarks:
Again, for coping tactics, I have suggested at least following general strategies based on my experience and introspection:
· ACCEPTANCE OF THE CANCER
· TRUST IN A COMPETENT AND COMPASSIONATE PHYSICIAN
· SPIRITUAL TRUST
· SUPPORT FROM LOVED ONES and SIGNIFICANT OTHERS
· CANCER JOURNEY STORY SHARING
· INTENTIONAL LIVING PLAN IN THE LIGHT OF CANCER
There are a lot of coping tactics that cancer patients can use. Each patient will have his / her unique way of coping. There are no wrong ways as long the coping tactics utilized succeeded in resolving or controlling the psychological distresses.
ROJ@20dec17