Part I. Introduction
Cancer is the toughest fight most of us will ever have.
If you have cancer, you must fight. You fight to stay alive, but also for much more. If you win the fight, you have added another new life to your old one. Whether you are prolonging your life or sure to die, you are still fighting for other things, just as important: you are fighting for self-respect and dignity; you are fighting for peace and understanding; you are fighting for the ultimate reconciliation and love with your family and your spirituality. These are difficult challenges in the midst of your illness, but achieving these goals will give greater meaning to your life and the experience of dying, whenever it happens.
––John Roberts
I have fought a good fight, I have finished my course, I have kept the faith.
––The Bible: II Timothy 4
For our discussion is about no ordinary matter, but on the best way to conduct our lives.
––Plato, The Republic, 370? B.C.
Keep your face to the sunshine and you cannot see the shadows.
––Helen Keller
Perseverance and spirit have done wonders in all ages.
––General George Washington
Great is the art of beginning, but greater the art of ending.
––Henry Wadsworth Longfellow
Every man, every civilization, has gone forward because of its engagement with what it has set itself to do. The personal commitment of a man to his skill, the intellectual commitment and the emotional commitment working together as one, has made the Ascent of Man.
––J. Bronowski, The Ascent of Man, 1973
What does not destroy me, makes me stronger.
––Freidrich Neitzsche
This book is addressed primarily to the patient diagnosed with cancer. It makes no difference how strong or weak you are, or where you are in the course of the disease, even if you are probably cured or have many years to live. Whatever finally causes your death, this book will help you live your life with cancer; it will help you prepare, fight, and eventually accept death in peace and dignity. Here you will find compassion and respect, but you will also find motivation and the expectation that you will fight with everything you have.
I also address everyone in the unique and motivated cancer community so that even the healthy support team can better help the endangered patient to fight for life and happiness. Little patient progress is possible without all those caregivers, fellow patients, researchers, writers, bureaucrats, doctors, nurses, managers, medical staff, close friends, and loved ones. Connecting them all is a vast, haphazard network of effort and communication aimed at improving our treatment and cure of this terrible disease. Science, caring, and resolve join us together to preserve life. Yet, at the center of each one of these millions of diverse support groups and battles is a lone, untrained, stricken individual, somewhere on a wide spectrum of disease, outlook, and capacity, whose attitude, leadership, and personal effort may change the future more than any other involved person.
The intent here is to explain and encourage the fighting spirit, strength, and attitude that will contribute to greater quality and quantity of life. Everyone must work together as a team to make this happen. The major problem is that the central figure, the cancer patient/survivor, has some degree of serious illness and is likely to be suffering from complications of mental and physical weakness. This calls for both tender compassion and support from the surrounding group and the building of a motivating spirit that is largely under the control of the patient.
For most of us, the subject of death, uncertain in time or cause, should be faced squarely rather than denied. Once this is done, the patient and those giving care and love may then deal with the issues and advice in this book that will make the entire process of living with cancer and the possibility of dying from it much easier. In most cases, ignoring the reality of impending death makes the remaining life, however long, more difficult.
Fighting cancer does not necessarily require that we carry on a belligerent and bitter fight to the exclusion of a happy life along the way and a peaceful acceptance at the end. At some point, however long or brief the final acquiescence, there is a valuable reward in using one’s acceptance and spirituality to ease the final days. We might say that, as fighters, we do not simply give up and let go in despair, but rather design the end of the fight with our mental comfort in mind, whatever that may be.
Everyone in the cancer world is trying to do a better job of helping patients live, and helping them die, as they wish. And, as I pass through this unique world, I have seen that almost all caregivers could do a better job of this, not only for the patient, but for themselves. For most of us, there is no school for this. Even some trained and experienced doctors still have difficulty in dealing with it, for they must try to balance their compassion with the need to maintain their own unemotional state of mind over years of contact with the intense emotions of a multitude of dependant patients whom they do not know very well.
If you are a member of the world of cancer––professional, caregiver or loved one––but not a patient, I ask you to consider your overall ability and motivation to help the patient try to prolong the quantity and increase the quality of life. Perhaps something in this book will help you to improve that, and to use your knowledge to motivate the patient to actively participate in, and, in many cases, to lead the fight. You must also care for yourself. While the chapters are largely addressed to the patient, others may read them with empathy and do better.
Those who are not cured will always be on the lookout for the symptoms of debility in those organs subject to the cancer and the body as a whole. As that progresses, there will be ups and downs, good times and bad, and the will to fight will come under increasing assault. Each person will reach a point where it seems certain that all hope is gone, and each person will have to decide when to accept this and whether or not to “rage” against it until all life is gone. Many, who fight bravely and steadily, will decide that it is also wise to prepare in advance a peaceful state of mind for the distant conclusion. Fighters can do this with self-respect, for it also has an important purpose in closing the book without anger and regret.
