The Human Side of Cancer

HarperCollins Publishers

Chapter One

What Is the Human Side of Cancer?

I assume that you've picked up this book for the same reasons people come to see me. You may have just found out you have cancer, or you may already be undergoing treatment and feel you've hit a snag. Perhaps you are a survivor wondering whether you're cured or not. Or you are coping with cancer as a chronic disease and feel the need for more support. Maybe you are a fellow traveler on the path, supporting and assisting a loved one with cancer, but feeling the need for help yourself.

Whatever your situation, I wish I could sit with you and talk about what's been going on for you and how you've been coping, and help you find the kind of support that's right for you. That's the way I would like to do it. But since that's impossible, I've tried through the chapters of this book to talk with you as I would if you were in my office and we were talking face-to-face about your illness or that of your loved one and about the problems you've had to deal with along the way.

When I see someone for the first time at our counseling center at Memorial Sloan-Kettering Cancer Center in New York, I usually ask a question like this: How have things been going for you since you got sick?

Often the response is: I don't even know where to start.And I usually say: Well, let's start with your illness. Tell me about what's happened to you.

Then I hear about a cancer journey, starting with finding a lump or having a pain that took the person to the doctor, who diagnosed cancer. Or, for others, it's how they were completely surprised by the results of a routine mammogram or colonoscopy or chest X ray that showed cancer. Somewhere along the line, each has heard a version of the words It's cancer.

Some people come to see me at that moment, right after hearing the news, when they are scared, mixed up, and overwhelmed to the point that they can't take the next step. Others come later, after starting their treatment. They hit a bump in the road as they cope with radiation or chemotherapy. A psychological bump might be feeling wired or scared, not being able to sleep or to concentrate on anything, feeling tired and down in the dumps, or being uncertain about the future.

These feelings lead to questions like these: Can I get through this? Is there a light at the end of the tunnel? Will I have done it all for nothing?

Ironically, some people don't come to see me until their treatment is over. They handled treatment fine because they were in a crisis mode and were doing something to fight the cancer. Now that the treatment is completed, they begin to reflect on what they've been through. The reality sets in, and the nagging question arises that I hear so often: Did I have cancer, or do I have cancer?

Sometimes it's not the person with cancer who comes to see me at all, but a family member or other loved one who finds it painful to watch as the person encounters the curves, valleys, and hills of the cancer journey.

With each of these people, whatever their situation, we talk about how difficult it's been for them to get to where they are now. They often have looked only at their personal shortcomings in meeting the day-to-day crises, seeing only the trees and not the forest. I help them focus on the bigger picture, which so many times reveals how remarkably strong and courageous they have been in the face of one of life's gravest challenges: the threat to life itself.

Together, we look for their inner sources of strength and try to identify their well-honed ways of dealing with adversity that have worked in the past and will likely work again. We review what they know about their cancer and what treatments are out there, and I help them get more information when they need it. We go over their reactions to the diagnosis, their problems with treatment, and their stress as they see family, friends, and coworkers adjusting to the illness of someone close.

Every person brings unique characteristics to dealing with illness: a particular personality, a way of coping, a set of beliefs and values, a way of looking at the world. The goal is to take these qualities into consideration and make sure that they work in favor of the person at each point along the cancer journey. I hope that my suggestions, impartial information, and sharing of what I have learned over many years of clinical work can make your own journey a little easier and keep you from losing hope.

When I first arrived at Memorial Sloan-Kettering in 1977, very little was known about the human side of cancer. Psychosocial research related to cancer was so new it was hardly viewed as a scientific endeavor. But we began to learn about it from the real experts: the patients and their families who were going through the experience. Those of us who shared in this exciting beginning at Memorial Sloan-Kettering felt the joy of discovery -- of being pioneers -- as we identified common threads in what we heard, while recognizing that the experience for each individual was unique.

Our work has spanned two decades during which cancer came out of the closet, allowing the word cancer finally to be spoken aloud and the diagnosis honestly given in the United States, as compared with many other countries where the diagnosis is still not revealed. Survival from certain cancers has become much more common, and concern for the psychological dimension of patient care has taken on greater importance...

Excerpted from The Human Side of Cancerby Jimmie C. Holland Copyright © 2000 by Jimmie C. Holland. Excerpted by permission.
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