Remember: You’re in the Driver’s Seat

Since we’re halfway through October – Breast Cancer Awareness Month – this is a good opportunity to remind everyone who’s had a cancer diagnosis that you’re still in control.

That might be very different from what you’re feeling. The whole thing with cancer is the sense that your life is out of control. Even your most faithful ally, your body, seems to be out to get you, growing a tumor behind your back.

Does it feel like someone else is controlling everything in your life?

That’s to say nothing of how your weekly schedule gets highjacked with oncological appointments, radiation treatments and days recovering from chemo. Then there’s the onslaught of new medical terms, the many pills that you’re supposed to take, even the practically unpronounceable chemotherapy drug names (what kind of a suffix is “-ib”???).

If anything, this might feel like the most out-of-control time of your life. When you’re slapped with a difficult treatment plan, you want it all to stop, but your oncologist tells you, “we won’t let you skip an infusion or stop taking your medication.”

That sense of being forced to do something (especially when it’s unpleasant) can open the floodgates to a deluge of anxiety on top of the fear and frustration that you might already feel about your cancer treatment. No one wants to feel like they have no say in a matter that affects them so deeply and personally.

This life is yours…and so are decisions about your cancer treatment.

But remember this: you always have a choice. Even though your medical team might not be phrasing it that way, you are still in control.

Perhaps this tiny acknowledgement may relax some of that perceived pressure and actually make it easier to continue. Your cancer treatment choices remain yours to make, so allow that realization to help you to step back, get perspective and weigh your options. When you demand space for yourself, you have room to think and it’s easier to act in your own best interest.

So, breathe. You’re still calling all the shots.

And, hey, medical team: maybe stop being so pushy and remind those cancer patients that they get to make the decisions about their treatment and their lives. It would go a long way towards helping your patients feel better about their treatment plans, like they’re part of the team instead of a prisoner of their situation.

Exercise Trumps Genes for Longevity

By now I’m probably sounding like a broken record about how important exercise is to all aspects of your life, but here I go again…

Although this is not specifically about cancer, an article recently published in the Journal of Aging and Physical Activity (Posis et al., 2022) scored another point for the benefits of maintaining an active lifestyle.

This study was conducted at the Herbert Wertheim School of Public Health and Human Longevity Science (University of California, San Diego), where the researchers examined the effect of physical activity/sedentary time on longevity in women. The 5400+ study participants spanned the entire range of genetic predispositions for longer or shorter lives. You can read a synopsis of the research here.

When in doubt, keep moving.

The results of this prospective study (2012-2020), while not surprising in the grand scheme of things, can be considered a wake-up call.

Regardless of their genetic predisposition, women who engaged in higher levels of activity had a lower mortality risk and those who were more sedentary had a higher risk. This is important, because it’s tempting to think that if your family members are long-lived, you will be too. However, your own activity levels do matter.

In addition, being physically active was effective in extending the lifespans even of those women whose genetics suggested a shorter life.

This can be considered promising news: you do have some control over your lifespan. Even when you’ve been dealt what may seem like a losing hand in terms of longevity or disease, providing your body with the supportive behaviors that it needs and deserves still makes things better.

It’s easy to forget this when we focus on the negatives in life. And while we do need to acknowledge our hardships and allow ourselves time to grieve for our losses, making choices that benefit our bodies and minds is a sign of respect for ourselves.

So go ahead, soak those tootsies…then get back outside for a walk. And don’t stop.

Unlike a glass of wine or a rich dessert, commonly considered an “indulgence”, self-care in the form of moving ourselves, step by step, day by day, closer to a healthier lifestyle is the kindest, most loving indulgent act you can ever do for yourself.

What one little thing can you do today that you didn’t offer to yourself yesterday that will move the needle further towards a more active life?

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References:

“Physical Activity May Have a Stronger Role than Genes in Longevity” by Yadira Galindo, UC San Diego News Center, August 24, 2022, https://ucsdnews.ucsd.edu/pressrelease/physical-activity-may-have-a-stronger-role-than-genes-in-longevity.

Posis et al., (2022) Associations of Accelerometer-Measured Physical Activity and Sedentary Time With All-Cause Mortality by Genetic Predisposition for Longevity, J Aging Phys Act, https://doi.org/10.1123/japa.2022-0067.

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.

Lovingkindness When It’s Hard

Lovingkindness (n.): a tenderness and consideration towards others (Oxford Languages)

Sonder (n.): the realization that each random passerby is living a life as vivid and complex as your own (Dictionary of Obscure Sorrows)

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One of my goals for 2022 is softening my views of difficult people.

This takes some mental calisthenics. There have been individuals in my life that have impacted me in negative ways, and trying to see around that is usually met with a great deal of internal resistance on my part.

But when we hold onto hurt, we sully ourselves, not to mention completely (and possibly unfairly) writing off the person whom we view as the cause of our pain.

There have been people in my life who seem to go out of their way to be cruel.

I need to stress that giving difficult individuals a second look to examine their internal motivations does not mean absolving them of all responsibility for their actions. What they did or said remains that and their role in your pain is not diminished. But in letting go and softening our own reactions, we heal ourselves and decrease the impact that the individual’s actions have on us.

What has been working for me is one simple thing: to pause and imagine what pushes people to be uncharitable. In my experience one of the main motivators seems to be fear. We all have our own ways of dealing with this emotional state, some of us may retreat and tremble (this would be me), others may lash out and attempt to control the situation that way.

I’ll go out on a limb and say that many of those in our lives that we perceive as “evil” may be running away from something. And their inability to deal with their fears and shortcomings makes them very pitiful indeed. The more thoughtless and controlling and misery-inducing an individual seems to be, the more fear they may well have bubbling under the surface.

If we can step back a bit, we can mitigate their power to upset us, because that’s when we see their behavior in a different context.

Let me offer an example: One of the most toxic bosses I ever had would go into “tyrant” mode, judging immediately and harshly, seemingly unable to manage her employees without bullying them. There was intense tension when she was around and I felt like I was never good enough, something that affected me deeply.

Difficult people may be fighting their own inner demons.

But I soon learned that she made everyone feel that way…and also that she was locked in an unhappy marriage and had little control over her personal life. So she established (and overestablished) control where she could. She hired young employees who would work for lower wages and greatly increased her profits, although it also resulted in a significant turnover because the conditions were psychologically distressing.

I dreaded work so much that it was only a matter of months before I resigned my position. I got myself out of there, a decision I never regretted. And I stress this because if a situation is bad, even if you can find some sympathy for the perpetrator, it never means you should stay there and take the abuse.

But understanding what a difficult person is going through can offer some balm for your soul as you shake off the effects of the negativity. Naturally, this is far easier to do from a distance, but it can also help create some emotional space for you if you cannot put physical space between the two of you just yet.

And in the context of a lovingkindness meditation, this makes it much easier to bring that individual into focus and offer them kindness and compassion for what they are experiencing.

It may help to consider this: true power comes not from expressing your dominion over others; it comes from understanding the reality of the situation and making the choice to respond with compassion.

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In the case of my former boss, upon searching for her recently, I was shocked to learn that she had founded a charitable organization to help children in need. All those profits that she had amassed had gone to a very good cause, as she now worked exclusively on a volunteer basis.

I’m so happy to have seen this giving, caring side of her. Wish she’d been able to show it to us.

And I sat there, staring at her photograph on my computer screen. That was her, certainly decades older, but different from the way that I had remembered her. So much more complex a human being. And instead of scoffing at the “old person trying to get into heaven”, I was filled with joy. Inside that being that I had only known as a tyrannical boss was a genuine caring person who was finally able to express her true loving nature.

Nothing could have made me happier.

Losing My Voice and Finding Calm

About a week ago, I lost my voice. This doesn’t happen often (some in my family might say it doesn’t happen often enough) as I tend not to get demonstrably sick beyond a runny nose.

Oh yeah, and cancer, but that’s beside the point.

Quiet is contagious.

I was coordinating a lectureship that was to take place on a Monday and Tuesday (luckly, I was not the speaker, just the one making arrangements), and on the previous Friday evening my voice disappeared. I could only manage a whisper as the event approached.

And I noticed something funny. As my voice became quieter, so did the voices of my family members. When one of us is not speaking loudly, others don’t have to either. Everyone is heard. Like magic!

As we all lowered the volume, I found myself less anxious about work. As I became quieter, it felt as though the world slowed down a bit too. Things felt a bit calmer.

This made me wonder how much I was adding to needless noise clutter at home…and how much I was responsible for driving the hectic state.

Sometimes we need to be reminded that we have more control over our mental state than we may realize.

It also reminded me that even when things felt “out of control”, that was just an illusion. They were most definitely within my control. I could turn down the rush of anxiety. I just had to remain aware of what was happening and that I had a choice in the matter.

Now, none of this is a miraculous revelation. I’ve known this since before I started meditating. But knowing something is not the same as putting it into practice. And sometimes to put it into practice, you have to realize that even though you “knew” it, you didn’t truly believe that you could do it.

I need that reminder now and then. That’s the gift mindfulness has given me. And even then, I still might need a nudge.

And the lectureship? It came and went, a little hiccup here and there, but under the circumstances everything worked out well. No voice required. And more importantly, no anxiety required.

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I’m not going to pretend that it’s easy to switch off anxiety. If I knew how to do that I would be living a carefree and very wealthy life. But just being aware that we have a crumb more control than we thought we did…brings us one step closer to a little more peace in our lives.