Between the Past and Future: A Cancer Survivor’s Perspective

I attended a workshop on cancer and stress given by the social workers at my cancer center. Since I like to take advantage of every opportunity to explore what’s going on inside my noggin I was looking forward to the presentation, but I didn’t realize that I would be offered a curious vantage point at the same time.

Sitting in the front row as I always do, I was joined by a woman who was awaiting the results of her second breast tumor biopsy; her first had confirmed cancer but another tumor was discovered shortly thereafter.

She told me about her racing thoughts, lack of appetite, inability to sleep — all those symptoms of intense stress that I also experienced as I awaited diagnosis. How odd it was to revisit this through her, now that I had a comfortable seat on the other side of that experience.

I commiserated with her, briefly offering up my own experience, and assured her that some of the anxiety would mellow once she had a definitive diagnosis and accompanying treatment plan. That’s the only thing I assured her of, knowing the nature of cancer, but I hope it gave her comfort seeing how far I’d already made it on the cancer journey.

And then, ironically, I realized that the woman sitting directly behind me was someone I had sat next to during one of my chemo infusions in 2017. I re-introduced myself, and while she didn’t remember me, she said she’d been through so many chemo sessions that it was hard to differentiate one from the other.

When I met her in 2017, she had hair and a good dose of energy. We talked about our kids (hers were grown) among other things. She was being treated for lung cancer but we didn’t dwell on the particulars. That’s not generally what you talk about during chemo. You gravitate towards non-cancer topics.

Things don’t always turn out the way we predict they will.

But now, she wore a ball cap to cover her bare head and walked with a cane. She seemed frail and was accompanied by a caregiver — several years of cancer treatment, not to mention the cancer itself, will do that to you. I’m not sure what her prognosis was, but given what I knew about her and the fact that she was still doing chemo, it probably wasn’t favorable.

There I sat, trying to stay present, next to my past and in front of my potential future. I had the good fortune of surviving the one and a decent chance of escaping the other.

There is no crystal ball with which we can gauge the future, deciding whether or not we like it, and if not, opting out. So here’s to making the best of the time that we have.

Unpacking the Monkey in the Courthouse; and, Mindful Justice

I wrote my last post about my not-so-mindful behavior in the jury lounge of the local Superior Court, waiting to see if I’d be called to serve as a juror on a case.

I wasn’t, but the situation ended up being stressful nonetheless, and it had nothing to do with my forgetting that I had a metal fork in my backpack and being called out by security for it. (Oops!)

No, what did it was the runaway narrative being played out in my head about potential frustration if I were selected, and whether I could manage all the facts of the case (chemo brain) and the sitting (neuropathy and back pain). While not completely inconsequential, neither chemo brain nor physical limitations were an issue for me as I was sitting in the jury lounge, waiting.

That evening, released from jury duty for another year, I came across an article by beading teacher and author Kristal Wick, who settled on beading as meditation to help her deal with her monkey mind, and in it she wrote about her realization that we are making stress up.

In stressful times, it’s not always easy to differentiate between what’s real and what’s not.

I would clarify that by noting that we don’t make up stressful events themselves, but the toll that anticipating what may happen takes on us depends in great part on our reaction to it. And whether or not we want to admit it, ultimately that’s under our control — although if we’ve established a behavior pattern of anxious reactivity (*cough, cough*), it will take practice to rein in those responses.

But the reminder that those “thousand deaths” that I was dying in advance of something that was not real or guaranteed…ahhhh, I needed that.

Next time a calmer, more realistic response, perhaps?

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Mindful media blogger Smilecalm wrote a beautifully thoughful account of his experience as a juror, and I found it so compelling that it became fodder for an evening of discussion with my husband and children.

Do we equally offer everyone the benefit of the doubt?

In his post, Smilecalm describes how mindfulness creates a situation where justice truly prevails. Whereas it would have been easy to make a snap judgment and convict someone who seemed, on the surface, to be guilty, pausing and carefully sorting through the facts provided a different picture.

When I think of the concept of “beginner’s mind”, I think of this kind of patience and open examination of what is before you, instead of moving down well-worn paths to conclusions based on circumstances.

I am sure that the defendant in Smilecalm’s case was grateful for the care with which the jurors considered his testimony. I, for one, am grateful to Smilecalm for bringing to light not only the importance of serving on a jury, but doing so with care and compassion.

Mindfulness Programs I Love: “Mindfulness-Based Stress Reduction”

Although I may never be able to prove it, I’m willing to bet that stress played a role in the proliferation of my cancer.

As a result, getting my stress response under control was a high priority, so I started a meditation practice and once the toughest parts of my treatment (chemo, radiation) were done, went searching for a formal class to address anxiety.

My clinical counselor had told me about a book called “Full Catastrophe Living” by Dr. Jon Kabat-Zinn. As it turned out, Kabat-Zinn had been a long-time meditator and, drawing on both Buddhist Dharma and scientific research, developed a stress-reduction program for patients at the UMass Medical School in the 1970s called Mindfulness-Based Stress Reduction (MBSR).

So when I found a Center for Mindfulness at a local university, I jumped at the opportunity to take that same flagship MBSR course.

This is an 8-week class with an additional full-day retreat. The curriculum has been developed to introduce students to mindfulness and help them, over a two month period, develop a practice, both formal and informal to manage stress in their lives.

It is also not cheap! The non-discounted version may cost about $600, depending on where and when you sign up. If I hadn’t had cancer and therefore a powerful reason for needing in-person guidance in mindfulness meditation, I would have considered myself priced out of this course, instead opting for a self-paced, free online version, such as Palouse Mindfulness.

But I used the significant price tag to motivate myself to do each and every homework assignment. The classes themselves were 2.5 hours a week, with daily home practice lasting about 45 minutes to an hour. That’s no small commitment! I had to move around my schedule to be able to fit the practice time in, and even the Center for Mindfulness itself recommended that if you could not accommodate the home practice to wait for a time that you could before signing up for the class.

The teachers were warm and supportive. They genuinely cared about student progress and themselves had a regular practice in addition to having spent time and resources on their own teacher training. As such, the instruction was excellent.

There were a number of resources for the students, including audio and video programs, which are also available to the general public. Currently, as an MBSR alumna, I have access to all the day-long mindfulness retreats for students free of charge. This gives me an opportunity to immerse myself into silent meditation for substantial periods of time in a similarly conducive environment.

The development of a mindfulness practice has more to do with the effort of the student, rather than the expense of a class.

I was struck by how quickly the class registration filled up, and how during the first session, when asked why we were taking the course, so many of us cited the amount of stress and anxiety in our lives. It is a sign of the times that so many people are willing to pay a significant amount of money to take a class to help them get some semblance of control over their inner state.

Actually achieving this was harder than simply paying the cost of admission. This class began with about thirty of us, but fewer than half made it to the very end. A number of people admitted being unable to complete the homework. Some gave up completely. There were others that came for several sessions but then never returned. Everyone was looking for help with stress but not everyone was successful.

As a secular version of Buddhist mindfulness, the course does justice to the tradition. While the expensive registration fee may be off-putting for some (many?), there is tuition assistance available, which I feel is important. As I’ve written before, I don’t feel that it’s appropriate to make mindfulness available only to those rich enough to afford fancy classes.

But in the end, regardless of what type of mindfulness instruction you utilize, what matters is how much effort each student puts into the practice of being mindful.

And that is available to all.

Addendum to Anxiety

I am just coming off a bout of particularly intense anxiety, so this is a good time to write an addendum to my last post. This episode of anxiety was striking in its intensity, hit me much harder than I expected and took a lot more out of me. The trigger was something that happened to someone I love, so I had no control over it but felt all the emotional pain.

It’s now been almost a week. Intellectually I’m over it but its physical effects linger and threaten to pull me back in. This is a change from the past because I used to be able to shake these feelings more easily. Now anxiety casts a long shadow that remains after the worst has passed. I get flashes of the stressful event and I re-experience that despair.

As it did with my cancer diagnosis, my weight plummeted over the past week. The reason: my reaction to anxiety is in the gut and intestines. A cold, tight, miserable feeling — emotional pain made physical. As days go by and things seem to fall back into place, meditation grounds me and staying mindful keeps me focused on the “now” and not ruminating on what has happened. But while I can calm myself, the physical effects of the nausea hold on. 

That nausea, then, serves as a reminder of the event and re-triggers the anxiety. In times of distress I fear eating because the nausea is even worse with food in my stomach. But not eating weakens me and increases the sense of agony. This transitions into a depression of sorts. Quite simply, at this point I can’t win.

What causes even more anxiety is the link between stress and inflammation, and thereby inflammation and cancer. While I’ve been assured that it’s not the case, there’s a part of me that still implicates stress in the proliferation of my cancer. 

As my weight drops I am reminded of that same fear I felt after my diagnosis, that the drop in weight would worsen my outcome because I still had to go through chemo and its effects. So all that fear is concentrated and deep in meaning. One event triggers multiple memories.

This seems like an impossible situation. Anxiety brings worries of cancer, which cause more anxiety. I’m afraid of being afraid. Doesn’t that sound ridiculous?

The cycle runs its course as time passes. The intensity fades. Slowly I regain my emotional footing, but I’m still attached to the expectations I had before the event that triggered this anxiety. Those expectations will eventually transition into a new reality, but until I am truly able to practice non-attachment, I am destined to repeat this.

Chemotherapy Dreamin’

This is going to sound very strange. In fact, it seems bizarre to me as I’m writing it. But there are parts of chemotherapy that I miss.

So this deserves some clarification: chemo was absolutely miserable and by far the worst part of cancer treatment. When I entered the infusion room, I knew that I’d be out of commission for the next week. I’d feel nauseated with a burning throughout my GI tract and be laid out as if I’d been hit by a locomotive. I could.not.wait for chemo to end.

What changed my opinion? You may think this sounds crazy, but hear me out. The sad fact was, chemo was the only guaranteed way that I could get some rest.

I knew I wasn’t going to handle work issues, clean the apartment, pick up the kids or do anything else that I’m usually expected to do. It was a forced convalescence. One that I desperately needed.

When I was going through cancer treatment, I didn’t worry about the little things. And truly, when you have cancer, everything else seems inconsequential. When you’re wondering whether you’ll live to see your kids graduate from high school, nothing matters as much as survival.

It wasn’t until I finished all my treatments and my hair had grown back that the “little things” started to creep back and set up residence again. Memories of the misery of chemo lose their clarity, the fear of death passes. The overwhelm from a diagnosis is replaced by the more familiar overwhelm of daily stressors, now made worse by the additional complication of chemo brain. No, they’re not life-threatening, but they are all-absorbing.

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I’m gonna lie down and close my eyes for just a sec…

So is it surprising that I wish I could close my eyes and be left alone for a week? Even more so, isn’t it sad that it took cancer for me to be allowed to rest and let others take care of things for a while?

That, I believe, was a warning that my life needed to change and is now the major driving force in my meditation practice.

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Consider: Because my cancer treatment lasted over a year, it became the “familiar”. The “unknown” is what follows, and that includes the threat of recurrence. That’s when things really get scary. Learning to deal with that will literally take the rest of my life.