June 2022 – Frantic Shanti

Cancer, “Why Me?” and Mustard Seeds: The Path to Acceptance

At some point in a cancer patient’s life, there are certain questions that tend to come up. The most likely one of these is why we were singled out to have such a serious calamity befall us.

I went through a long period of this. I mean, loooong. The early posts of this blog are filled with agonized questions about why cancer hit me even when, by all accounts, it shouldn’t have. I posted about not having risk factors and blah blah blah. I kept going around and around and around on this, stuck on a hamster wheel that wouldn’t stop.

I clung to the same ride, unhappy but not wanting to get off.

Allow me to stress: cancer is a serious illness. That is not to be taken lightly. Most of us, regardless of lifestyle, experience profound shock with our cancer diagnosis. It may seem that life is cruel and unfair (well, it is) and that we didn’t deserve to get cancer (well, we didn’t).

I struggled with anger and frustration for years. It’s both embarrassing and freeing to admit that.

Acceptance is a process. I thought I’d accepted my situation a couple of years ago, but in retrospect, I hadn’t. Some days I felt holy and zen-like, floating on my own little cloud, but it was a sham. I’d have glimpses of acceptance and then a wave of anger and resentment would wash over me and I’d be pissed off for another week.

I thought God hated me. A purportedly loving and merciful being allowed this to happen. It was hard to not think of cancer as a blow against my value as a person because of how I interpreted my situation.

It wasn’t until I stepped outside the confines of that type of thinking that I gained a different perspective. I posted about re-writing my life (basically, viewing the same experiences through a different, more positive lens) which provided a glimpse of another way to assess what had happened. And when I heard the retelling of an ancient Buddhist tale I finally understood what it meant.

Never seen mustard seeds? Here they are. Kisa, however, came up empty-handed.

What was that tale? It was “Kisa Gotami and the Mustard Seed”. In brief, Kisa Gotami’s young son dies and she is so distraught–not understanding why she would deserve such a painful experience–that she goes to the Buddha in hopes that he can bring the son back from the dead.

The Buddha agrees to revive her son if she can bring him mustard seeds from households where no one has died. Of course, she cannot because death touches all living creatures. She is comforted by the realization that her sorrow is shared and understood by everyone in the community and she finds acceptance of her loss .

Another way of looking at this is that we all suffer. For me, it’s a reminder that while a cancer diagnosis is life-threatening, there are few (if any) humans on this Earth who have not experienced some form of loss or grief at some point in their lives. Yes, some of us bear a far greater burden than others–grave inequities exist. But they also bring profound opportunities for growth.

And while I (and I expect most cancer patients/survivors) would have preferred to experience this personal growth through means other than cancer, being able to be here in this moment, having turned the corner, is one of the most beautiful gifts I could ever receive.

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Two points need to be made here:

Point #1: Burdens are distributed unequally. Socioeconomic, racial and other disparities further tip the scales, making outcomes from a disease like cancer even worse. As a society, we haven’t come close to rebalancing this. Acceptance is easier for some than for others; no one has a right to preach to anyone else.

Point #2: It’s been over five years since my initial cancer diagnosis, and even longer that I’ve been worrying about it. As I mentioned above, it took a LONG time to get to this point of acceptance. Knowing this, I would never rush a new cancer patient to get here. Acceptance must come organically, and yes, sometimes never does. Cancer breaks hearts and no one experiences it in the same way. Be patient.

“Where Am I?”

I have a problem. And if you’ve been reading this blog, that statement won’t surprise you.

My thoughts take me for a ride and it’s a wild one. I’ve gone from being perfectly calm one minute…and the next minute gesturing wildly, face screwed up, whisper-arguing with a person who is not there. I can feel agitation in my belly and an increase in breathing and heartrate.

The story takes off.

I have a solo argument with an invisible adversary. Sometimes it’s someone I know, rehashing past hurts; other times it’s an imaginary situation that my brain concocted, a fear of the future. Regardless, there is always some form of negative state change involved.

When my mind starts creating stories, it’s hard not to jump on board the train and get taken for a ride.

In the past, I would have barreled along like a runaway freight train, exhausting and unnerving myself. It became a habit, like an itch I needed to scratch. It was so hard to stop those thoughts once the train started rolling along.

Mindfulness changed that, but it took time to develop awareness. I learned to ask one very simple question of myself as soon I realize that I’m being swept away by that torrent of brain activity.

Three simple words: where am I?

This works like magic for me. It’s instant grounding.

That’s because the train screeches to a halt and I shake off the mental noise and look around myself. I’m usually somewhere alone. There’s often some far away street hum or something else not very intrusive. I feel where my body makes contact with whatever surface I’m on.

As soon as I poke my head out from the noise, I realize that I’m on the train. And I get off.

I am HERE. And in this moment, I am safe. Regardless of all the thoughts that suggest otherwise, I am safe.

It doesn’t mean that there aren’t problems that will need solving or work that needs to be done. But all that noise that was panicking me just a bit ago? I am reminded that it doesn’t exist right now. And right now is the only moment that matters.

Three simple words. Man, if I’d known this years ago, I could have saved myself so much heartache. But at least I know now. And now, so do you.

It Took Cancer to Teach Me Self-Compassion

One thing I’ve had trouble with is expressing self-compassion. When you’re a driven perfectionist it’s easy to believe that “giving yourself a break” is tantamount to “going soft” and “losing your edge”.

I couldn’t forgive myself when I felt that I’d failed. And guess what, getting cancer made me feel like a failure. I had tried to live the healthiest adult live I could, given the sometimes-limited resources I had, often denying myself what others called “pleasures” or “indulgences”.

I’ve lived most of my life feeling like I had to constantly push myself…and that I was never good enough.

The fact that I was convinced that I shouldn’t have gotten cancer was a recurring theme early on in this blog–I was convinced that I must have done something wrong, even when I tried so hard to do my best.

I was also ashamed. Cancer, I felt, opened my life up to judgment by others.

Getting myself out of that funk took serious work. It meant rewiring my brain and allowing in the same kindness and compassion for myself that I allowed for others. At the same time, I reminded myself of a quote by author and humor columnist Dave Barry: “A person who is nice to you, but rude to the waiter, is not a nice person.” I prefer to interpret Barry’s words in this way: I cannot be genuinely kind and non-judgmental to others until I’ve learned to be so to myself.

Cancer gave me perspective to see how much I needed compassion from myself.

But how do you do that when you’ve spent your life pushing yourself, not accepting excuses? It wasn’t until I hit the lowest low that I ever experienced that I learned to dip into unadulterated compassion for myself. I imagined who I was as a chemo patient–skinny, bald, dehydrated, vulnerable, frightened. And suddenly felt it: that overwhelming desire to wrap my arms around that version of me and protect it.

And while that was “cancer me”, I realized that same version of me was the scared person inside that I had always bullied with perfectionism and accusations of not being good enough. This was who I really was, in need of and deserving of gentle holding.

It took a life threatening illness to make me realize that I deserved kindness and compassion. I believe that you are deserving of the same. Do something today to prove it to yourself.

The Benefits of Physical Activity During Cancer Treatment and How to Begin

While this isn’t exclusively an exercise blog, if you’ve perused my posts you’ve probably noticed that I’m a huge proponent of exercise for both cancer patients and survivors (well, actually for everyone; but see my important message at the bottom of this post).

The best way to achieve this is to start exercising right now, if you are not yet, no matter what stage of the cancer experience you’re in.

There is a growing body of research that shows the benefits of exercise for cancer folk (I’ve written about it here). But the fact is that only about 17-37% of cancer survivors meet the minimum physical activity guidelines set out by the American Cancer Society (Hirschey et al., 2017, Cancer Nurs) even though doing so reduces the risk of cancer recurrence by 55%, not to mention the improvement in quality of life (Cannioto et al., 2021, J Natl Cancer Inst).

Exercise, the Cancer Fighter. In the not too distant future, your oncologist might hand you an exercise prescription as part of your cancer treatment.

Now, there is a call to include exercise as an adjuvant therapy for cancer for those who are currently undergoing chemotherapy. During the Oncology session of the 7th International Congress of the Spanish Society of Precision Health (SESAP) that took place in Spring 2022, Adrián Castillo García, a researcher at the Barcelona Biomedical Research Institute (IIBB) of the Spanish National Research Council (CSIC), reviewed recent studies regarding the benefits of exercise during cancer treatment, including the potential role that it had in “modulating the tumor microenvironment and immune function.”

You can read a synopsis of his statements here in the section entitled “Exercise as Oncological Therapy” (starting towards the bottom of page 2). Castillo states that physical exercise “has been shown to have the ability to modulate the tumor environment… . This modulating effect translates into an improvement in the efficacy of chemotherapy and other oncological treatments.”

Castillo goes on to say that “prescribing doses of physical activity at an established intensity and volume can be very decisive in combating the tumor microenvironment, but this preliminary evidence must be confirmed in trials on humans to ratify the role of exercise as a treatment capable of improving the efficacy of the main therapies.” (All quotes from the aforementioned synopsis.)

With such promising results, it’s quite possible that future cancer treatments may be a combination of medicine and physical activity.

Ok, so say that you are not an avid exerciser, but motivated by these studies you’re willing to give regular exercise a go. What do you do when you’re already feeling fatigued from treatments?

I wrote about this here, but in a nutshell, the idea is that you need to decide what the right starting point is for you, and this will depend on your previous experiences, both physical and emotional, with a physical activity program. It will also depend on what you can manage at any given time in your treatment.

Starting an exercise program? Make it something that you can do and enjoy, and it will become a life-long habit.

Ask yourself, “what is reasonable for me?” But don’t respond to that with a t-shirt slogan-type answer (“Exercise? I thought you said extra fries?!?”) that immediately shuts down the idea. Admittedly, there may be times during treatment that getting yourself to the toilet without help is a momumental achievement. But that will pass. And exercise will make you feel more in control of your health and better overall.

IMPORTANT: Find what you can do and then do it as consistently as you can.

This may mean starting very simply [always get your doctor’s okay first!]. Choose an activity, duration and frequency, say, brisk walking for 20 minutes a day, three days a week. Follow that pattern for two weeks, then add to it–perhaps another 10 minutes–not to overwhelm yourself, but simply to push the edge a bit (you can always ease off if you need to, give it a week and increase again). If possible, increase some aspect of your program every couple of weeks, as it suits your condition. In the example of walking, incorporate a flight of stairs and gradual upper body movements: first pumping the arms, then hand weights, eventually strength training for both upper and lower body.

The timing is up to you.

If a walking program feels too easy for you, train at a higher level, but remember that the same concepts still apply: (1) consistency, (2) progression, (3) balance in your activities. If you’re interested, read my post about my three “pillars” of fitness.

Most importantly, start, progress gradually and keep it up for the rest of your life.

If your starting point is a standstill, this will take patience. But I PROMISE you, no matter what you can muster, it will still be better than doing nothing.

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I know I already said this, but it bears repeating, especially for cancer patients and survivors: do not start any exercise program without consulting with your medical team first. While I feel that improving your physical fitness is one of the best things you can do for yourself, every body is different and every cancer situation is different. Talk to your doctor and let them know what you’re planning to do.