Cancer Case Study

By Nancy Wardle, MD

One of my patients likes to say that he is four years, a few months, weeks, and days past his expiry date. Told some time ago, after being diagnosed with metastatic colon cancer, that he needed to get his affairs in order, he decided that this meant starting to live what time was left to him differently. He began to understand and practice one of my favourite definitions of health, namely that health is "not just the absence of pain or illness, but rather, living the best life possible, whatever the circumstances." He, rather indelicately, pointed out that he'd gone through life controlling things and, "By being and asshole. But they've taken it out, so now I have to find a different approach."

His medical team, alopathic and complementary, were in charge of helping him eradicate much, if not all, cancer from his body. He was in charge of doing whatever he could, not necessarily to "beat" his cancer, but to move beyond his fear of it and its impact on his life. That meant moving out of a normal and understandable state of fear based reaction, into a more 'how can I best handle this' responsive state. This was especially important when it came to dealing with one of the more persistent and difficult consequences of multiple surgeries, chemotherapy and radiation ….. fatigue. More than pain and more than nausea, his profound loss/lack of energy interfered with his efforts to live well.

"Fatigue makes cowards of us all." Vince Lombardi

Cancer patients consistently report that of all the problems they face, fatigue is the greatest and can be even more debilitating than pain and/or nausea.
Several things helped him. First, as Martin has written about in his essay, medication to increase hemoglobin and white blood cells gave him the necessary building blocks to physically exert himself. Secondly, the information that physical activity was a valuable healing tool, validated by research, gave him confidence to make appropriate demands on his recovering body. Thirdly, his willingness to see clearly the ongoing changes that had been imposed on him, allowed him to be more self-caring.

For him, and for others like him, living well with cancer started with the awareness that, until he accepted the diagnosis, he couldn't defy the prognosis. At the moment of acceptance, his experience with cancer became what psychologist, Lawrence LeShan, calls a 'turning point'. This signified that he was ready to take up the challenge and respond to the unique call to action on his own behalf: mentally, physically and spiritually.

Accepting his fatigue did not mean he liked it, and dealing with it on a daily basis and moving through it required a shift in perspective. His life became a progression of little victories, getting out of bed and to the bathroom one day, (an early mantra was, 'mind over mattress'), next extending his range to the kitchen and then to the garden. He had to 'show up' and live in the moment each day, learning to pace himself and gradually push his recovery boundaries. This was a new life, not to be compared to his physical performance in his previous pre-cancer life. New ways of inhabiting his body/mind and living well presented themselves, yoga replaced his old timers hockey games and he found wisdom in an old admonishment 'walk, don't run'. He learned to use the breath to release, renew and fuel his body. Rest became reasonable and honourable because it allowed for improved recovery. Through setbacks and achievements, recurrences and remissions, he decided to follow Auden's advice and "stagger on, rejoicing" or as he liked to say, "I looked at it this way, if I was vertical that meant I was six feet up, not under."