Abstract

Keywords: Support groups, colorectal cancer, colon cancer, Colontown, cancer survivor.
Citation: Brown EH. Can we just choose to live? J Participat Med. 2012 Jul 25; 4:e16.
Published: July 25, 2012.
Competing Interests: The author has declared that no competing interests exist.
 

“…it all comes down to what you want most in life.[1]”

Some time ago I had lunch with a fellow colorectal cancer survivor. Joy is still in treatment for a recurrent rectal tumor and her general outlook is very good. I finished my own treatment for late stage colon cancer almost 10 years ago and, luckily, have not had a recurrence. While we both have different stories, they demonstrate the same two basic insights:

1. “Choosing to live” provides a pathway to survival.
2. Serving others serves both me and others.

The “choice to live” might simply be the result of a direct conversation with oneself. We don’t presume to know why or how this happens; we are just clear that a person might have a better chance of recovering from calamity if an internal “discussion” takes place in the mind of the suffering person.

To illustrate, Joy was suffering deep depression last year after her husband’s sudden, fatal cardiac arrest. She had been his loyal care giver for two years during his prior, successful treatment for head and neck cancer. He had been pronounced NED (no evidence of disease) from his cancer just a few short weeks before he collapsed. Joy fell into a deep depression and was non-functional for weeks following his tragic demise.

Imagine Joy’s shock to learn a few months later, during her colonoscopy screening, that she had evidence of a rectal tumor. Yet from a deep, personal reservoir of strength, she was able to spring into action, reconnecting immediately with the doctors with whom she’d developed strong relationships while caring for her late spouse.

Around the time of her own cancer diagnosis, Joy held a “meeting” with herself. In that “meeting,” she and her alter ego had a question and answer session that concluded: “If you really want to live, you’ve a lot of work to do to rid yourself of this cancer.” Joy became instantly amenable to the idea of medication for her depression and pulled herself up and out of a crippling sense of overwhelming despair.

She says that she felt a shift in her life, and today her attitude about her future is totally optimistic. Joy wears a smile everywhere, and her general appearance is one of health and good humor. She is currently undergoing a very rough regimen of chemotherapy and radiation for cancer recurrence. But her approach to her situation is one that embodies her knowledge that she has treatment options. Joy demonstrates her life choice daily, and is becoming an empowered, engaged, enlightened patient.

We survivors often have discussions as we ponder aloud why we live when others die. It’s not necessarily that I had the most advanced treatment regimen (I had the “gold standard” regimen at that time). There was no guarantee that “mop-up” chemotherapy would rid my system of the micro-metastases that had found their way to eight lymph nodes. Could my survival also be attributed to relatively good overall health at the time? Could that relative good health have also contributed to my determination that I would live through this episode? Might not I have been guided by, and given strength by, my decision to simply “choose life?”

But there’s another piece to this survival theory. We feel that “serving others” serves both others and us. Today, Joy makes herself available to other patients, sensing that doing so is another proactive tactic in her own self-interest. We believe deeply that survival-directed patient outreach in support of others is a second, strong survival strategy that ultimately improves one’s own survival experience.

Furthermore, maybe I’m alive today to show others how to live through their own terrifying experience? Mightn’t the cost of my own survival be a responsibility to aid the wellbeing of others? Maybe I’m still alive so that I can be of service to them.

I’ve been involved in the “cancer universe” long enough to speculate that we might survive longer because we’ve internalized and implemented our choice for life, and because we have taken the right actions in the direction of service to others.

To add to this discussion of service, I’m also able to point to a couple of additional cancer survivors who live today, I believe, because of their own personal commitments to reach out in support of others. Both Karen and Susan are survivors who have stories to tell. One common denominator is that they are constantly thinking of others and reaching out in support of them. No matter how tough their battles, whether with recurrence or a new, primary disease, they feel there is always someone else who has it tougher than them. Maybe they are also alive today because of their service missions?

Karen, a Lynch Syndrome carrier, has been diagnosed with her sixth primary malignancy. Because of her inherited mutation and genetic predisposition, she has had six separate diagnoses of cancer. Five times she has defeated the ugly beast in different organs of her body. Just recently she disclosed that another tumor (in her kidney) has been causing her discomfort and will require surgery and chemotherapy. While we find it disheartening to learn of Karen’s most recent development, I have no doubt that she will again beat back the beast. Because of her activities in cancer research, Karen personally knows many of the best physicians and, even better, much of the research that has been done. Her service to others will serve her well in her prognosis and survival process. Susan is an almost 14-year survivor of stage IV colon cancer. Her cancer journey has included almost every known chemotherapy, brachytherapy, and surgical treatment. She describes her life as a game of “whack-a-mole,” viewing each new report of cancer progression as “…just another bump in the road.” While Susan, like Karen, personally knows many of the best medical practitioners and research specialists, she also believes her key role is to serve others. Susan travels throughout the world, telling her cancer story to receptive audiences, and is always ready to offer a listening ear and a word of comfort to those who are in need.

Both Karen and Susan’s first priority is to make their own experiences available to others. Both are available to anyone who reaches out to them. Their sympathy and empathy are palpable, and their work for others is widely recognized. Both of them continue to live through maladies that have felled other giants!

My own story involves cancer but my journey of choosing survival began when I had a similar “meeting” with myself, more than three decades ago. Today I have no recall of what precipitated my decision to hold that self-meeting.
I was about 36 years old when I remember asking myself if I really meant it when I said that I wanted to live. At that time, I had no health issues and didn’t expect any! “We” had a back and forth conversation: “Do you really mean it when you say you want to live?” “I’ll have to think about it.” Finally, “I” decided “I really do want to live.” And I responded: “Well, if that is the case, there is no way that you can continue to smoke cigarettes.” The idea of smoking tobacco became repulsive, and I have not smoked a cigarette since that time (1981).

This conversation came to mind a short time later, when I was confronted by another life problem: alcohol abuse and its destruction of my life. I was becoming aware that, because of alcohol addiction, my life was in a downward spiral. I needed to do something, and I needed to call upon all my own internal resources. Going into treatment, like stopping smoking, was going to have consequences. But I also knew that I could (and should) live more fully, and that I could find freedom from confusion and the dangers of my present lifestyle.

It’s good that I had made the commitment in 1988. Fifteen years later, during my first colonoscopy, a lemon-sized tumor had been found in my ascending colon (where I had felt a sharp pain that had plagued me), and I was soon on my way to surgery and other treatment.

I rejected the idea that anything was going to kill me. It was not going to be easy, but I knew I could get through this. A whirlwind of CT scans, surgical consultations, decisions, disappointment, surgery and its aftermath, and a 6-month course of deadly chemo awaited me. I was willing to go to any lengths to find recovery and survival. Staged at IIIC, I was diagnosed perilously close to stage IV. Not only did I have a tough diagnosis, but I also knew that I was going to have to survive abandonment of family, divorce, and bankruptcy before I could get back on my feet. I knew, in my soul, that I was prepared to confront this. The choice I had made to actively pursue a healthy life was also going to help. Choosing life effectively tilled the ground for my “garden” of recovery and growth from this experience.

I frequently renew that commitment to myself. Today — almost 10 years later — I’m cancer- and alcohol/drug-free, able, and ready for life. I continue to actively serve others who suffer from cancer, especially colorectal cancer. I do this by leading colorectal cancer patients toward survival and a cancer-free life, using a growing social network that I founded: a nonprofit social network and community called Colontown.

Today, I know that all of my experiences have made me a credible person who can say to another patient/survivor, “I know how you feel. I know that you can do it. If I did it, you can, too.”

During a recent lunch with Joy we reviewed how we had each personally experienced a moment when we decided to “choose to live.” We also were both convinced that serving others would make us feel better. We departed from there recommitted, with feelings of goodwill and a sense of a bright future. Somehow we’d shared what we think are some secrets to survival.

And we committed to share those secrets with others.

Reference

1. Johnson J. Making life decisions amidst the prevalence of colon cancer. Ezine Articles. 2012 Apr 6. Available at: http://EzineArticles.com/6977636. Accessed May 2, 2012. ↩

Copyright: © 2012 Erika Hanson Brown. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the author, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.