Month: August 2025

Another Oncology Visit and “Not Being Good Enough”

(Title image: Photo by Nik on Unsplash)

“I see pharmacological interventions in your future” is a paraphrasing of what my oncologist told me at my last doctor’s visit.

So let me back up a bit. I had my “eight-years-since-finishing-chemo” appointment with my oncologist last week. Things went the way they’ve been going for a while. He was very pleased with how things have been going and that made me feel very positive.

Certainly, I have my share of stressors churning at the moment, but most of them are not health-related. Most.

When my oncologist reviewed my bone density reports, however, he made the same prediction that he has during my previous two visits with him (see his quote above). The issue is that my bone scan in 2019 showed osteopenia, which I have to say is pretty weird given my lifestyle, which includes a lot of strength training. We both thought that perhaps it was an issue with the way the numbers were calculated.

Unfortunately, my 2024 bone scan showed a significant loss of bone compared to 2019. Enough to really concern my oncologist and befuddle us both.

So despite my living the lifestyle that medical guidelines say I’m “supposed to” live in order to stay healthy and strong, it’s still not good enough.

Tried as hard as you could? Well, too bad, try harder.
(Photo by Mads Schmidt Rasmussen on Unsplash)

This harkens back to what I experienced after being diagnosed with breast cancer. It seemed like I had done everything I could to lessen my chances of getting cancer, including things that should have been protective, but there I was, a breast cancer patient, and a young one at that (which, I later learned, what one of the reasons the risk factors didn’t necessarily apply to me, but I didn’t know that at the time).

It drove my perfectionistic mind haywire.

It brought on feelings of helplessness and even despair.

The only thing that gave me a bit of a lift was learning to meditate. Meditation imparted a sense that I had a teensy bit of control, if not on the situation, at least in the way that I reacted to it.

I got through that period of my life, brushed myself off and went on. And for a while, I was feeling blessed.

But cancer treatments have long-term effects. And the repercussions of being pushed through menopause and being on endocrine therapy eventually caught up to me. Physical movements that used to be easy started to hurt. I lost muscle mass…and apparently, I lost bone too. I felt like I was treading water with a weight tied around me.

Never good enough.

So I am bearing down and reworking my diet and exercise program even more. And to be honest, this is also an opportunity to shed some of my perfectionistic tendencies. While I want to feel like I am doing everything I can to help stop my bone loss and avoid taking medication for it, I need to learn to give myself grace. Sometimes even doing everything “right” will not be 100% successful, and I have to be okay with that.

Favorite Calm Things: Kaiyukan Aquarium in Osaka

(Title image: Photo by Cristian Palmer on Unsplash)

It’s been quite a week. And that means another post with some of my favorite ways to bring calm into my life…

This time around I’m posting about a video instead of a livestream. It’s a 12-hour long YouTube video of the central tank at the Osaka Aquarium Kaiyukan in Osaka, Japan, and it is glorious.

The central tank is a massively huge aquarium, showcasing marine animals from the Pacific Rim. According to the Kaiyukan Aquarium Wikipedia page, the tank is 34 meters (112 feet) long, 9 meters (30 feet) deep and has a staggering capacity of 5,400 cubic meters (190,699 cubic feet) of water. Its enormous size enables it to house an impressive range of animals, including whale sharks!

The central tank at Kaiyukan Aquarium in Osaka, Japan.

As long as you don’t have a fear of ocean scenes, the blueness of the water is very soothing. It feels nurturing and safe.

The soundtrack itself of the video is a little surprising: it’s disarmingly upbeat and I would not have expected it to have a calming effect…but give it a listen. I turn the volume down a bit while still allowing the tune to fill the space around me—excellent for focus as I’m working. Not distracting or sleep-inducing, just an effective noise blocker that helps with concentration.

Give this a view – I hope you enjoy it!

Remembering to Do Nothing

(Title image: Photo by Ken Cheung on Unsplash)

I remembered something last night about mindfulness meditation that I’d realized I had somehow forgotten.

I don’t have to do anything when I meditate.

Not strain, nor grip, nor furrow my brow.

The only thing I need to do when I meditate is to exist, and to be aware that I am existing.

I was thankful that I remembered this because I’d been struggling with the concept of sitting and being present for the past few months. I had slipped into the belief that I needed to work at it.

But last night I asked myself, “What would it feel like if I didn’t try so hard? Or at all?”

Simply exist.
(Photo by Jeppe H. Jensen on Unsplash)

If you’ve practiced mindfulness meditation, you know that the guidance is simple and straightforward.

It goes something like this:

“Sit comfortably with a tall spine, alert but relaxed. Take a few deep breaths, stretching upward on the inhale and settling down on the exhale. Soften the muscles of your body starting from your face, moving down the neck, shoulders, torso, arms to the fingers, hips and seat, down the legs to your toes. Then allow your awareness to settle onto a focal point like the breath, tingling in the hands, the hum of an appliance or sounds of traffic in the distance.”

Does that sound familiar? There are of course numerous variations of this. You select an anchor to come back to whenever you realize that you’ve drifted away from the present moment and into the thoughts in your head.

And that’s it. It’s quite basic and yet we find ways to complicate it and make it a strenuous exercise.

You don’t necessarily have to sit, you can lie down or even stand if that works for you (or you’re practicing while queuing up for something).

There are no rules for mindfulness meditation. Yes, there are principles and/or steps to take, but no real way to do it “wrong”. The only thing that would be considered “incorrect meditation” would be going to meditate, but then spending all that time doing something else.

Last night, when I remembered that my meditation didn’t have to be a certain way and all I needed to do was simply to be and to be aware of myself being, it felt like a release. The last year has been difficult and there have been tough things that I have been required to do.

This felt like a gift, that I could rest and think, “Oh, yeah…I don’t have to do anything.” And I was so grateful for that moment.

Why do I make these things so much harder than they should be?

Bang a Gong: The Problem with the End-Of-Cancer Treatment Bell

(Title image: Photo by rhoda alex on Unsplash)

When I finished my final radiation treatment for breast cancer in 2017, I got to bang a gong as part of my cancer center’s tradition.

The gong-ringing marked getting to a milestone, one that I only dreamed about when I was handed my treatment plan. It felt like closure…except that I wasn’t really “done”—I still had months of Herceptin to go and years of endocrine therapy ahead of me. But the toughest chemo and radiation were over.

And those around me who weren’t done yet also celebrated along, just as I had for the patients that had gone before me, eagerly awaiting their turn at the gong. This tradition also occurs at many other cancer centers, although instead of a gong, it might be a bell or a chime or something similar.

However, as with many things that have to do with cancer, there is a more somber side to the end-of-chemo bell. As noted in this article from Psychology Today (“The Psychology of the Cancer Bell”), hearing the ringing of the bell can be devastating for someone with metastatic cancer, who will never be done with treatment, or is at late stages of the disease.

There are many other creative ways to commemorate the end of treatment for cancer than simply bell-ringing.
(Photo by Nick Fewings on Unsplash)

The article also points out that in cases where someone experienced a cancer recurrence, hearing the bell rung by someone else elicited painful emotions. What should be a jubilant event for all can feel depressing and isolating, like being left behind.

But it goes beyond that. As a study by Williams et al. (2019, Int J Radiat Oncol) found, even those who are finishing their treatment might not have a positive response to ringing the bell. From the “Conclusion” section in the study’s abstract:

“Counter to our hypothesis, ringing the bell on the final day of RT [radiation therapy] worsens patients’ evaluation of overall distress from cancer treatment, and this distress persists and even worsens in the months after treatment. Emotional arousal created by ringing the bell may magnify the distress from cancer treatment and subsequently worsen the perception of distress from treatment.“

Not what I would have expected! And it certainly came as a surprise to the study’s authors.

These findings have been reflected in a reimagining of the completion bell. As the Psychology Today article mentions, some cancer centers are moving it’s location and renaming it the “Bell of Hope”, or providing different means of allowing patients to mark the stages of their treatment rather than focusing on “completion”.

Personally, I was looking forward to banging my gong and was more focused on what treats I could bring for the radiology staff and saying goodbye to all of them. But I can see why such a commemoration could be problematic, especially when so many parts of the cancer experience are stressful. You don’t need one more.

How about you? How do you feel about ringing a bell (or similar)? Is there something else that you did or would prefer?

REFERENCES

Leeby C, July 30, 2025, The Psychology of the Cancer Bell. Psychology Today Blog, https://www.psychologytoday.com/us/blog/consciously-creating-your-soul-life/202507/the-psychology-of-the-cancer-bell

Williams PA et al. (2019) The Cancer Bell: Too Much of a Good Thing? Int J Radiat Oncol, 105, 247-253. https://www.redjournal.org/article/S0360-3016(19)30838-7/abstract

For information on what Penn Medicine has done to reimagine the bell-ringing tradition:
Greer M, December 23, 2022, Redefining the Bell Makes the Ritual Inclusive for All Patients With Cancer. ONS Voice, https://www.ons.org/publications-research/voice/news-views/12-2022/redefining-bell-makes-ritual-inclusive-all-patients