Cancer: a 'fighting' chance?
Do people with cancer have to 'fight' it?
We brought together two of our listeners, Stephanie Butland and Rachel Pearce, who question whether you need to have a 'positive mental attitude' when faced with cancer.
This is the unedited version of their discussion with Eddie, part of which we'll play on Saturdays programme. Stephanie begins
We invited you to respond and Contemplative Arthur suggested we contact an oncology centre for some professional input.
Thanks Arthur and welcome to the blog. We contacted Prof of Cancer Medicine and oncologist Karol Sikora.
This is the unedited version of his interview with Eddie, a shorter version will be broadcast on Saturday.
UPDATE: You can read the list of comments on our original posting on cancer here. There are a large number of comments covering all aspects of the subject. Sorry if you were unable to find it.
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Jennifer:
You can usually fight CANCER and most of the time win it...
By all ways, I am not advocating sometimes people will have relapses in the course of treatment...
~Dennis Junior~
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Coping Strategies and Survivorship Agenda - Eric Watts Briefing Note, Dec 3rd 2008
Summary
There is well-established evidence that many patients suffer long-term psychological distress following treatment for cancer. Some studies have shown dissatisfaction with the attitudes of healthcare professionals. Many patients find their own way through the stress and turmoil of life with cancer and have learned coping skills which can benefit others.
Too many professionals are disease centered and do not appreciate how much the patient's distress can be influenced by their behaviour towards their patients.
Randomized trial evidence shows that patients can be taught problem solving and coping skills which can improve their outcomes.
Whilst further trials are required to define which approaches would be most beneficial for particular patients the case is strong enough to recommend teaching all professionals and carers of value of developing coping skills and problem solving approaches as part of its best practice in cancer care.
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My Personal Paper
Following my e-mail in August and discussions at the conference in September I am floating some ideas based on my experience and limited reading on coping. These issues overlap with work of the other groups and therefore I have copied this to a wide distribution.
My purpose is to raise awareness of issues that could be explored further, again overlapping with the work of other groups. where I have stated facts these can be supported from authoritative sources, I have omitted references in the interest of speed and when I have expressed an opinion it is one that I know to be shared at least some other people.
The Problem
There is now increasing awareness of the non- medical effects of cancer with recognition that some patients’ emotional needs are not met and that although there are higher incidences of anxiety and depression in cancer survivors than the general population many believe that they have gained something from the experience. More patients would feel better about their experience if carers had a better understanding of coping mechanisms and how their approach to patients will influence them.
The Lance Armstrong Foundation's survey showed that cancer physicians were identified as being unable to accommodate non-medical needs. Of those expressing that view 70% said oncologists did not offer any support in dealing with nonmedical issues and the other 30% said oncologists willing to talk that did not have enough information nor experience to assist in this area. They commented that the emotional toll was substantial with 72% stating that they had to deal with depression however 78% did not seek the help of a professional.
Major factors in the patient's adjustment to illness include how they view the illness and their ability to withstand the stresses and strains. Although cancer is no longer a taboo subject people at large are generally poorly informed as most media coverage concentrates on terminally ill patients denied miracle drugs. Naturally it is a frightening diagnosis.
We certainly need to educate the public at large of improving survival and the chronic illness philosophy but for some time to come we will be dealing with patients with poor expectations of outcome. Key factors in patient's adjustment to their illness are their pre-existing knowledge of illness and their ability to cope. These can be influenced by health professionals both by the formal advice they give and in their general attitude and in their non verbal signals and signs.
Many health professionals are disease rather than patient centred. Doctors often spend more time in discussion with other doctors than with patients and when speaking to patients forget their lack of background knowledge using medical terminology and quoting facts out of context. This can be particularly troublesome for patients when a doctor speaks on treatment and prognosis using average figures and not quoting the ranges nor how well the figures refer to that particular patient.
This can make patients feel that their destiny is predetermined, in reality treatment is modified in the light of progress and giving specific information on the future as if it were a certain fact can engender feelings of helplessness. Nurses spend more time talking to patients and generally (but not always!) follow the medical lead. Most of the time they are true to their Angel image in that they readily provide immediate comforts and support to those in distress but not all of them have an appreciation of patients’ different needs and how they may change with time.
A common strategy which I see in nurses is comforting through expression of sympathy and sharing of emotional pain which certainly helps in the acute situation but can be wearing for the nurse and is not necessarily the best option for all occasions. One chapter in the ‘Coping’ book ( Ed C. R. Snyder) describes coping as using the limited resources people have available to them leading to ‘ego depletion’ – implying that the process involves loss – this can help to explain avoidance strategies by patients & professionals.
What are the factors in determining how well we meet patients’ information & support needs?
There has been a paternalistic view that patients should only be given limited information, that the ‘whole truth ‘ would upset them Professionals , being human can become stressed by dealing with distressed patients, need to keep their own emotions in balance and can protect themselves from burnout through distancing themselves when patients ask questions they find hard to handle. If the professional senses they are being asked an emotionally loaded question then they can find ways around it which sends a negative signal to the patient. Many professionals are still uncomfortable with dealing with uncertainty whilst many of the questions patients ask are to help them overcome that sense of helplessness in the face of uncertainty. Patients in this situation may not want to have an emotionally loaded discussion but the professional may fear that is the case.
My work on patients’ information/support needs (workshops at self help groups conference) demonstrated that the only thing 100% of patients agreed on was that they all wanted answers to their questions.
QUESTION ANSWER
Does the patient want: Average Score
Range
The diagnosis
An explanation
Answers to their questions
Outright, dispassionate ‘ruthless’ honesty
‘Protection’ ie withholding worst aspects of bad news
Sensitivity
Comforting
Emotional support 8.6
9.8
10
2
2
9.7
7.8
9.6
5-10
8-10
0-10
0-10
6-10
2-10
7-10
I see this as a significant disconnect between patient’s reasonable expectations and the response they often receive - patients’ lives have become chaos and they expect professionals to have the answer, professionals are largely disease focussed and when asked the questions that naturally occur to them they can move the professionals out of their comfort zone – epitomised brilliantly by Rob Buckman’s book (which applies to carers as well) “I don’t know what to say”
Patients trying to make sense of their situation may turn elsewhere or become frustrated. Caring for patients has often been taught as if it were a simple process of giving treatment and awaiting results. I now see the trials and tribulations of guiding a patient through the cancer journey as being more like the parenting experience with emotional growth on both sides as the relationship changes and developing maturity leads to independence.
We know that some patients have come through the cancer experience to say that life is better; the natural question is want makes the difference ? Why should some feel they are long term victims whilst others have found benefit?
Whilst pre- morbid personality has some predictive power I expect more answers can be found from the newly emerging field of positive psychology which can help explain some of the benefits patients have experienced through social networks and self-help or support groups.
The practical importance to carers is to be aware that patients can find benefit in adversity and to encourage rather than try to suppress patient’s attempts to move forward.
One antidote – Self Help Groups
Self-help and support groups come in a variety of forms, some very small and informal others are bigger with more structure, I have attended the National Conference of Cancer Self-Help Groups since 1993 and was involved in drawing up the good practice guide for groups. Common to all groups is the philosophy of total nonjudgmental acceptance i.e. they are a haven for anyone in distress as well as providing other opportunities.
They generally allow people the opportunity to discuss freely what has happened to them and how it has affected them and expression of strong emotion is seen as natural .Ventilating emotion, sharing a story, and translating emotional experience into words have been shown to be positive coping strategies. Group discussion is beneficial not only for the person relating their narrative but for the others whose own unexpressed feelings can be validated by having someone express what they also feel.
Personal Anecdote
Self help groups helping with the self image.
For myself – years after I knew I was cured I had the dilemma of how to speak about my experience – if I said it made me feel angry on one hand or more sensitive on the other I risk the accusation of being wimpish. If I celebrate the success of the medical science that cured me I run the risk of being a freak & insensitive to those not so fortunate .
One example of the value to me of the self help group was hearing the story of a man with testicular cancer - his reactions and feelings were same as my own. Over the years the commonest response to expressing my views was “you’re different - too thoughtful, or too thick; too sensitive, or too simple to sort yourself out”. Hearing him – obviously fit & well, physically & mentally, saying exactly what I had thought - was the most effective support I have ever had.
A common feeling among patients is that are on their own or feel abandoned leading to a vicious circle of repressed emotion. Sometimes patients meeting in wards and outpatient departments will naturally form into supportive groups but this is hampered by shorter inpatient stay. Groups enable patients with difficulty to meet patients who have come through their experience and are living well. this not only gives encouragement that gives the opportunity to learn coping skills without necessarily appreciating that this is what they are doing.
The feeling as a patient of being in a lost world is common, contact with other people, prepare to help is the answer. Simple folk wisdom “there’s always someone worse off”, delivered in an empathic way can help to break out of an absorption with one’s own problems.
Analyses of interactions that occur involve acquiring emotional intelligence developing mastery and rebuilding assumptions.
I hope the psychologists can help me in describing emotional intelligence, I have read about mastery oriented thinking - this is described as taking an active problem-solving approach, it is the opposite of feeling helpless and involves enjoying the challenge and trying new approaches if the first is unsuccessful. Whilst this may describe a minority behaviour, workers in the educational field have shown that students can be encouraged to take a more masterful approach if they are told that this will bring them benefits.
The book on coping by C.R. Snyder also contains chapters on optimism how it can be learned , hoping, finding benefits in adversity and rebuilding shattered assumptions after traumatic life events. The last item being particularly relevant to younger patients where a sense of injustice can be added to the mix. A not uncommon feeling is "I 've done everything right and this is what's happened- so what do I do now?" You can no longer trust the old certainties
One has to rebuild everything that was taken for granted. This can help develop inner strength and can be a benefit. I believes that those who adopt a masterful approach have most to gain. However the questioning and re-questioning of all the old assumptions in relearning how to trust one’s own judgement and how to handle the mostly ill informed gratuitous advice is a time of difficulty for patient, carers and relatives which can lead them to discourage thoughtful approach.
Optimism – the belief that good things can happen and the benefit of “positive thinking” has been studied extensively and a growing literature supports the notion that expectations for the future have an important impact on how people handle adversity. I must emphasise that I am not preaching a facile optimism – from the out set one must be realistic – people will discover themselves if their optimism is misplaced by the turn of events- when the situation is uncertain – as is the case most of the time in assessing the prognosis in cancer why not give the message that it is better to travel hopefully?
Implications for self management
It is common for patients to feel lost or disturbed by events and to fear their abilities to cope. However many patients have reached the point of realising that they can influence many aspects of their lives and start to regain control- we are beginning to be more positive in this respect – but still much les so than in the USA – the Lance Armstrong Foundation and Livestrong give a much more upbeat message and although we may not want to copy them I believe we could be more positive in the messages we send & that we should investigate coping methodology further.
How should self management be ‘prescribed’?
Most patients have their views on how much stress they can handle & how much help they need & from whom, most will expect doctors & nurses to respond to their concerns and few will want to see a psychologist. The Macmillan Nurse is the most popular source of support and therefore is the most suitable person to introduce the subject. Eventually I would hope that all doctors and nurses will be happy to discuss it and signpost those that wish to know more
The Handbook of Cancer Survivorship chapter on psychological distress contains references to show psychosocial interventions , in particular education, cognitive behavioural interventions and support group therapy are effective in improving quality of life. The authors, Arthur and Christine Nezu describe their studies showing that patients with better innate problem-solving ability have fewer problems in dealing with their cancer experience and problem solving therapy can be taught to patients with successful results.
In their Project Genesis they carried out a randomized controlled trial of distressed cancer patients divided into three groups in the first cancer patients have 10 one and a half hour therapy sessions in the second patients were seen with with a significant other and the third group had standard therapy only. The treated groups were trained in rational problem solving and the therapists fostered the patient own coping skills. Both the treated groups showed significant improvement and improvements in patients who were treated and significant others showed more continued improvement over time.
My opinion is that there is a good enough case to advise all carers that a problem-solving approach is beneficial and should be incorporated as part of standard care. Those patients who are distressed should be offered the services of an experienced therapist
I recommend that we should establish best practice in supportive care to be part of all cancer care to include an individualised assessment of the patient’s coping skills and that all carers be made aware of the benefits of self management through including it in relevant curricula and CPD courses.
Eric Watts 3/12/08
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Love the shirt Eddie!
*Vote milk float.
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I didn't think I would want to go along to a support group, although I'm generally a joiner, as I thought I was a tough cookie. However, on the evening of my first chemo, I felt so unexpectedly fine I rebelled against my caring friends (who thought I was tucked up resting) and drove 18 miles to my local centre where the support group was meeting. I met SO many people who have become friends, and have learned not to feel "guilty" or perverse at enjoying my cancer experience.
I have foot massage during my chemo, reflexology for relaxation, dietary advice, and hypnotherapy for my needle phobia via the local hospice. Previously, although educated (!), I tended to view hospice services as for those in the later stages, and support groups for the less strong. I grab all that is on offer now and am very grateful for it. It makes such a difference to have so much attention, and reinforces my instinctive positive outlook towards my cancer. There are days I wail, especially when sickness and constipation cripple, but I view it more like a pregnancy, where I am generally positive but feel ok to say so when I feel yukky, and that I am "otherwise normal".
I view my cancer journey as a business, where I have selected my staff, decided my mission statement and have crafted a dynamic business plan, have carefully researched the market, and co-operate with fellow businesses. The emphasis is that I am in charge. It is in this way that I am "fighting" my cancer, like someone would fight for their business or family to thrive.
Thanks to a lucky break recently, I can afford to look forward to flying lessons block booked to get my pilots licence this summer once treatment is over. This is also helping to keep me focused on life after cancer, a life that has always been ambitiously adventurous, positive and full of friends.
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I used to write a column about having cancer in my local newspaper, and I found 2 of the columns that touched on cancer as a battle. The dates are the original pblication dates:
18. On being a patient
When asked about my illness (which is less often than you might think) I describe myself as a “cancer patient”. The cancer is obvious enough, but patienthood might not be quite so obvious. After all, reflex tabloid is “cancer victim”, or, for variety, “cancer sufferer”. Each noun has an immediate force that the word “patient” lacks.
“Victim” is a word whose use has developed recently, particularly in connection with crime. The word hasn’t changed its meaning, but these days there is an unquestionable dignity about the status of victim of crime. Victims are said to be at the heart of the criminal justice system. This is a change of emphasis, since the heart of the ritual used to be the proof of guilt and punishment of the criminal, who was formerly the central figure in the drama. Now, vindication of the victim is accomplished by the invocation of our sympathy.
“Sufferer” on the other hand would imply that the cancer causes me suffering, which (apart from the inconvenience of an over-active bowel) it does not. I do suffer from the chemo, but it would hardly do to describe myself as a “treatment sufferer.”
The word “patient” is more modest. It is also irredeemably passive. Suffering is an active process, and victim-hood these days is an assertive status. Patients on the other hand, don’t have fights or do battle with the forces of disease. The drugs that they take or the operations they undergo are brought about by others. The patient only suffers such things in the sense of permitting them. Indeed, to acknowledge yourself a patient is to confess to being powerless over the condition that confers the status upon you.
Powerlessness is not fashionable. One of the keywords of our day is “choice”. Choice is an aspect of freedom. We can choose careers, lifestyles, lovers; and parents are told that they can choose their children’s schools. But, while we patients have the one human choice that you cannot be denied, the choice of refusal, once we have admitted that we are patients, we renounce the power to choose. We are brought face to face with one of the inescapable facts of human existence: our ultimate destiny is beyond our control.
Does our choicelessness mean that we aren’t free? Or does it mean that freedom is not to be equated with choice? Of a truth, each choice we make shuts out many other choices. Think, for a moment, of the thousand or more existences any of us might have had, except that we chose this one. I chose to be a lawyer and, when the chance came (an important qualification) I chose to live in the Yorkshire Dales. Those choices give me the freedom to practice my profession and to roam the countryside around my home. But I am no longer free to choose to be an industrial engineer (a choice my father might have wanted) nor to decide on the spur of the moment to roam the National Gallery (as I could when I lived in London). We are prisoners of our own choices.
But choices are contingent, and the freedom implied by the word choice can itself be illusory. I chose to study law because my father wanted me to study a vocational subject: if I wasn’t going to be a scientist, at least I should do something that would lead to a career. The picture of ourselves that we nurture as free determiners of our own destiny has to be qualified by circumstance. Even so, the patient is a stark contrast: indeed a direct denial.
The other contrast for patienthood is with other receivers of services: passengers (as I have noted before) have become “customers”; those who receive services can be termed “clients”; but I am Dr Fraser’s patient. My relation with him is not an economic one. At its best, the doctor/patient relationship is not merely one of power, indeed it is not a power relationship at all. It is one of trust. In my extremity, Dr Fraser knows what can be done for me. He (with the multi-disciplinary meeting) proposes treatment which will cause me suffering and put me at risk. I have accepted what he proposed and have undergone treatment because of that trust. Given the seriousness of my cancer, the need to trust was forced on me, but in my dealings with Dr Fraser, with Mr Mackay, with Aiden and Julie and Marion at HODU, I have felt cared for. When you are a patient, those who treat you bestow time and effort upon you in a way that you rarely receive it during daily life, and in a way that you certainly never experience as an autonomous being made free by your own choices.
“This seeing the sick endears them to us,” wrote Gerard Manley Hopkins. “Us too it endears.” We patients have to accept this endearment of ourselves, that we are dear to others, this mutual endearment, that others are dear to us. It is the essence of being a patient.
4th February 2005
66 Battling on
On the day I went into hospital for my second liver operation, a friend, who had suffered from a different form of cancer, sent an e-mail: “It was on this day 5 years ago that I went in for transplant and full body radiation. Keep strong and let your will bring you through.” My friend is warm and supportive. He gave me a surge of confidence, but when I reflected later, the language bothered me. Language in this context is a problem.
Early in his book, “C”, John Diamond says: “[This] isn’t a book about the battle against cancer because I despise the set of warlike metaphors that so many apply to cancer. My antipathy to the language of battles and fights has nothing to do with pacifism and everything to do with a hatred for the sort of morality which says that only those who fight hard against their cancer survive it or deserve to survive it – the corollary being that those who lose the fight deserved to do so.”
There’s a more fundamental objection to the metaphor of battle when applied to cancer patients: there is a battle going on, but it’s not me who’s battling. My doctors are fighting a battle, and the battlefield is my body. They’re deploying their learning and experience and the strategies that medical science has developed – surgery, chemotherapy and, if appropriate, radiotherapy – in an attempt to slow down or even quell an entirely natural uprising: the overwhelming of my body by rampant hordes of cancer cells which will kill me and liberate the cells that constitute me for other functions in the universe.
I don’t take part in the struggle even in the limited manner in which a criminal defendant takes part in his or her trial: the advocate fights the case – cross examines prosecution witnesses, calls defence evidence, marshals arguments in a closing submission – but the defendant can at least give evidence, get a feeling of joining the fray. Although I reported the first symptoms – diarrhoea and bleeding – I’ve had no active input since: the extent of the cancer and its subsequent recrudescence were found by scans, not symptoms, and I don’t know if it’s advanced until my doctors tell me.
When I meet people who ask how I am, I usually give a stock reply, either “I always ask my doctors,” or “I’m still here.” (I used to say “Still in the land of the living,” but I’m less florid these days.) These days when friends say (truthfully) how well I look, I mutter “Appearances can be deceptive.” Occasionally, when there is news (and news so far has never been good) I blitz my interlocutor with the full facts.
Some people just say, “I’m sorry”, my friend Amy says “Stay strong”, and some, of course, say “Keep trying,” or even “Keep fighting.” After all passivity in the face of an onslaught is almost offensive, a submission, a surrender. Rage, rage against the dying of the light. And do not go gentle into that good night.
Within oneself one has a conflict, which is all the more taxing when, as with me at present, the proposed cures are worse than the disease. I don’t feel ill, I walk the hills vigorously, I’ve just a had a lovely holiday with Jane and the children, Jo and I have been to the first two parts of Northern Broadsides’ “Wars of the Roses” (catch it if you can) and I long to be well enough (in the sense of neither an in-patient nor convalescent) for us to share “Richard III” in June. Yet every waking moment, I have a sense of my own mortality. (That’s what makes a trip to the theatre with Jo the more intense.) I know that one day Dr Fraser may tell me that, instead of making a cure less likely, a development means that he will alter his clinical objective from cure to palliation.
What’s the proper task for the patient in this fix? It’s important to hope for a cure. Not being an island, it’s important for those around me – Jane, my children, the rest of my family and my doctors and nurses – that I authentically hope for a cure. It’s part of my relation with them that I don’t want to leave them. Second, you have to keep nurturing that mystery that puts conscious beings beyond mere dull description or scientific explanation, life. You have to do it because the spirit in you arouses the spirit in others, and the spirit in them arouses the spirit in you and indeed creates them, you, me. You have keep living – not in the hedonistic sense of going and having a good time, but in the quieter, deeper sense of being a person with other people.
There’s no evidence that will power can repel cancer. The only choice that I could make is not to be treated, which would seal my fate (although it’s not as clear in life as in print, since symptoms that then amassed would require palliation). Yet a wholly passive attitude negates the purpose: if you’re wholly passive, you’re one of the living dead. We’re bound to hope, even when hope is faint, or we’re past hope. “I will not cease from mental fight” – I know I’ve wrenched the phrase out of context, but not so far that it’s inapt. The will that is required is the will to be human.
I disagree with Diamond. There is a proper application of the military metaphor to human existence, although it’s inadequate as a complete description – life can be seen as a battle, one that each of us is doomed to lose. Indeed, the phrase, “He lost his battle with cancer” is a euphemism for the brutal statement, “He died.”
26th May 2006
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I’m convinced that a positive attitude is one of the most important factors in determining whether cancer sufferers get well again. I would therefore like to make a plea to those who do not have the disease… when you are told that someone has cancer, please do not try to empathise (if that’s what you’re doing) by recounting tales of all the people you know of who’ve had cancer, particularly if the outcome has not been good. By all means recount positive tales of recovery. That’s helpful. But please save the stories of people brimming with health one minute and in their coffins the next for someone else.
Apart from mental attitude, there are several things you can do yourself which will improve your chances of getting well again. I'm referring in particular to lifestyle choices and diet. I believe that the causes of cancer are manifold but your attitude to life, the way you live and what/how you eat are important contributory factors. Your environment also needs to be examined and possibly changed. Avid reading of the literature, which one does on diagnosis, quickly reveals that positive attitude, and change of diet (largely cutting out foods on which cancer feeds - like sugar, dairy products and alcohol) will have a tremendous effect, not only in terms of physical well-being, but in taking control of your own healing. There are many well-documented cases of cancer being healed by the patient’s own efforts, eg visualisation (cf Simonton et al in Getting Well Again) and by healthy and controlled diet (eg with the Gerson Therapy).
PS I was surprised at first to find there were so few comments on this blog from ordinary people who have cancer. But I can understand that people may feel reluctant to start talking about something which is hard to put over to people without the experience of living with it. It has taken me all week till late on Friday night to get round to it myself!
PPS (not for broadcast) Why do you invite people to 'complain' about each comment? Why not offer them the opportunity to 'comment' on the comment?
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hugh-lestrange
Hi there, haltymandi here. Two points you raise:
1. I am one of the ordinary people you mention here. Can I suggest you look at the separate section on Battling Cancer, which has 75 people comments, most of which are by "ordinary" people with cancer.
2. The "complain about this comment" is literally for doing that: it's for registering a complaint to the moderators. If you want to comment on a posting, it's seem to be etiquette here to do as I am doing here. Say who you are relying to and simply post another comment.
Hope this helps. And I do agree about visualisation, and diet and exercise, being effective in addition to clinical treatment, and positive outlook. I surround myself with positive people and make it clear what conversations I am prepared to be part of. Can I suggest you look up the Penny Brohn Cancer Care centre of Bristol. Your comments lead me to think you may find it helpful. Best wishes.
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haltymandi, this is Hugh L'Estrange.
Hi. Thank you for replying to my comments.
To be honest I thought I was writing to the Battling Cancer blog. At the top of this page it says "Thanks Arthur and welcome to the blog". That's why I expressed surprise at there being so few contributors. I still haven't found those 75 people comments you (and the programme this morning) refer to.
I agree, the positive people are very important. I am also blessed in having such people around me. I have looked up the PBCC and am very sympathetic to their philosophy. I had the honour of knowing Penny Brohn before she had cancer and have always admired the spirit wiith which she faced every new twist and turn. I myself have chosen to go with the Gerson Therapy.
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hugh-lestrange
Hi, haltymandi here.
If you go to the bottom of this page, you'll find a previous arrow. Do this on the next page again, and about 4 or 5 times more, to find the page you were after. I agree the navigation is not all that obvious.
I will google the Gerson Therapy but if you have any links or references, I'd be pleased to learn of them. Thanks and best wishes.
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Hmm.. not an easy question. I'm sure there is anecdotal evidence that having a positive attitude can help the immune system. And that at times of severe stress, say bereavement, that one's physical health can be affected.
But I think it is a stretch to impose upon cancer patients a 'Think and Grow Rich' style pop-psychology. For one thing, it is very easy to say 'think positive' - it may be very difficult for the person at the time.
And the implied threat that not thinking positively will have detrimental impacts on their health will further pressure them with a sword of damocles hanging over them.
Certainly support to feel positive surely cannot do any harm, and an alternative of feeling helpless or hopeless must, if nothing else, make it more difficult to pluck up the emotional energy to get through the treatment.
I believe that the most recent study showed that 'attitude' was not that significant a factor in cancer prognosis - although it would have to help an awful lot to enable a scientific link to be proven.
I guess a lot of it is about making life bearable as tough chemotherapy and radiotherapy treatments are undergone.
If you are naturally a 'glass-half-empty' person who is introverted, one is not going to change overnight because one is unwell. But maybe some help to make a change at the outset of treatment may help to avoid wanting to throw the towel in later on in the treatment.
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New developments every day:
"Cancer protection secret revealed
Zebrafish share the p53 gene with humans
Scientists say they have discovered a missing link in the way cells protect themselves against cancer.
They have uncovered how cells switch a gene called p53, which can block the development of tumours, on and off.
The researchers say the finding has important implications for cancer treatment and diagnosis..."
http://news.bbc.co.uk/1/hi/health/7861474.stm
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...And, sometimes more than one-a-day and this one's significant, very much so:
"Biology exists in a physical world. That’s a fact cancer researchers are beginning to recognize as they look to include concepts of physics and mathematics in their efforts to understand how cancer develops -- and how to stop it..."
http://www.sciencedaily.com/releases/2009/01/090130104256.htm
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Hey what happened to my comment in reply to No 10 from haltymandi?
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hugh-lestrange - not sure. I can see comment 10, which looks like your reply?
Apologies you had trouble finding the earlier posting with the bulk of comments on them. The link again
http://www.bbc.co.uk/blogs/ipm/2009/01/cancer_share_what_you_know.shtml
Hope you found useful.
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To Jennifer Tracey
Think Hugh-lestrange may have replied to my comment 10, in which I ask him for links re Gerson Therapy. In comment 14, he is asking you if you know where his reply has disappeared to. Can you help Jennifer? If not, please advise Hugh-lestrange that unfortunately he may have to repost it. Thanks to both of you.
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Thank you, Jennifer for your reply. haltymandi is right in that my reply to her didn't get through. This is roughly what I said:
The Wikipedia article on Dr Max Gerson (http://en.wikipedia.org/wiki/Max_Gerson) is pretty accurate and covers the Therapy in broad outline. It has had some outstanding successes, but "conventional" medicine as usual has its doubts. The basic approach is two-fold: rebuild the immune system (by means of a regulated intake of juices and organic food, plus supplements) to enable it to overcome the cancer cells, and eliminate toxins (mainly through coffee enemas - not as bad as it sounds).
I came across it through a small book called A Time to Heal by Beata Bishop - thoroughly recommended. She describes her own encounters with traditional attempts to cut out her melanoma, and her subsequent completely successful treatment with the Gerson Therapy. All some 25 years ago or more, and she's still going strong.
The whole therapy is described in detail in Healing the Gerson Way: Defeating Cancer and other Chronic Diseases by Charlotte Gerson (Max Gerson's daughter) with Beata Bishop.
If there was a way of contacting you privately off this blog I'd be happy to share more, but don't want to bore other readers of this blog.
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