Cancer remains the scariest and most anxiety-provoking 6-letter word I know.
But we now have more tools than ever to proactively and pragmatically approach a diagnosis while better controlling emotions—namely fear and anxiety, which can lead to depression.
Leveraging the Anticancer Toolbox
Your anticancer toolbox must focus equally on the physical, psychological and emotional aspects of living with a malignancy. It includes, but is not limited to, seeking additional expert academic opinions, utilizing precision medicine approaches to testing, going beyond standard of care when necessary, and incorporating integrative oncology and lifestyle medicine.
The toolbox must also include access to social workers, onco-psychology experts and, as necessary, psychiatrists. While your oncologist should invest the time to recognize your psychological and emotional needs, you know yourself best: speak out and communicate where you are at and how you are feeling.
Most importantly, self-care approaches to help mitigate anxiety and depression should be carefully identified and consistently incorporated into everyday life.
COVID-19 + Cancer = Isolation for Too Many
The COVID-19 pandemic has added an extra layer of challenge for those hosting a malignancy. The isolation and anxiety for many people, especially the elderly and those living alone, has contributed to a mental health epidemic. Globally we’ve seen a 25% increase in cases of anxiety and depression since the pandemic started.
And for those living with cancer—especially for folks with comorbidities, and blood cancers where they’ve had a zero to low antibody response from vaccines—it is only natural for many to experience an elevated level of fear, anxiety and, yes, oftentimes depression.
Turning off Fear and Anxiety
If you struggled with anxiety or depression in earlier points of life—prior to a cancer diagnosis—you are more vulnerable to have this re-triggered or even amplified as you’ve navigated the cancer journey.
When diagnosed (at 28 years young and newly married) with incurable leukemia back in 1991, I quickly learned that the current therapies were essentially ineffective. That stopped my range of emotions right in its track.
I went from shock to fearful to anxious, and experienced severe situational depression. Hearing the words ‘watchful waiting’ for my particular situation also did not help. It gave me a feeling of helplessness, and of loss of control—a perpetual holding pattern without clear answers on how things might play out. Being so young and a newlywed compounded the stress and anxiety.
From my personal experience as a 30+ year cancer survivor thriver—and based on observations from well over 1,000 individuals I have coached over 19 years—I can unequivocally say that for most cases, not all, it is the process of losing control and the resulting emotional overwhelm that leads to anxiety and depression for those living with cancer.
Once some semblance of control is asserted by the patient—through appropriate professional psychosocial support and a range of resiliency skills—things tend to change… and for the better.
Different Situations, Varying Level of Resources
In life, in health, we are each an n of 1. Any disease we host is specific to us as an individual. There are no two identical tumor types, just like there is no person truly identical to you, even if you have an identical twin, as your DNA is not a 100% match.
Our cancer prognoses differ: where we live… how cancer treatment is coordinated and delivered… the availability of various drugs… out-of-pocket financial availability… our partners and support systems… our psychological strength and resiliency, all have a bearing. No one person can walk in another’s shoes.
Yet, we do have some choices, some level of decision-making, that we can bring to bear in the face of a cancer challenge that can so easily tilt to fear, anxiety, depression, and sometimes suicidal thoughts.
The Austrian neurologist, psychiatrist, philosopher, Holocaust survivor, author of Man’s Search For Meaning, Viktor Emil Frankl, was a prolific advocate of positivity. His famous quote is a must for every anticancer toolbox:
Between stimulus and response there is a space.
In that space is our power to choose our response.
In our response lies our growth and our freedom. ~Viktor Emil Frankl
Below are thoughts, snippets, and links for a few pieces I’ve written over the years that may apply to your unique situation. They encapsulate my own experiences and what I’ve learned over decades as a cancer thriver.
On Taking Control
Once I could clearly differentiate what I actually had control over I started to become much more at ease with my diagnosis. I developed a consistent emotionally-balanced constitution … and owned that.
There was a window in my room. Through it I could see a blue sky and a few fluffy clouds. Outside waited a perfect July day. And here I was cooped up in a cold, clinical setting, with broad-spectrum antibiotics dripping into my vein. Ill though I was, I desperately needed a change of scenery. A bit of “nature therapy.”
I slid my legs over the edge of the bed, stood up, and grabbing the IV pole, I slowly walked to the door of my room. My legs felt a little weak. But since I didn’t fall over, I kept going, out into the hospital hallway.
Once I got to the end of the hallway I felt pretty good. I wasn’t lightheaded or anything, so I headed back in the other direction to extend the walk. I paced around, walking the halls. After walking for maybe 10 minutes, I had seen everything there was to see in my ward, so I returned to my room and got back in bed.
But I couldn’t stay there. I stood up again, but this time I went to the window. I looked down. I could see the manicured grounds surrounding the hospital, traffic flowing along MacArthur Boulevard, and a line of trees across the street. Beyond those trees, but invisible to me, lay the Potomac River.
In fact, out there lay the entire world, and a dose of the world was exactly the medicine I needed. I called the nurse. She arrived promptly, and I told her I needed some fresh air. She crossed her arms, and dutifully explained that the doctors still didn’t know what was going on with me, and I was still running a low-grade fever, so an excursion was out of the question.
I felt a pang of remorse, because I had put her in an awkward situation. But my life was at stake, and what I needed at that moment was a dose of outdoors. I asked the nurse to close the door to my room. “Look,” I said, “I am not asking for your permission, nor am I discharging myself. Here’s the deal: I am leaving the hospital building for 45 minutes, but will stay on the grounds. You did not give me permission, but you know where I am. See you in a bit.” And with that, I waited for the nurse to leave, grabbed my sunglasses and IV pole, and headed towards the elevator.
Dialing Back the Fear of Cancer
In addition to shifting focus to healthy lifestyle activities, a powerful response to counter the fear of cancer recurrence is to be grateful, mindful, hopeful, and present—and to apply the emotional intelligence to ‘respond’, but not ‘react’, to the negative words or actions of others.
The key is to recognize but filter out negative thoughts—your own, and those thoughts and comments of others—to simply continue to be an inhospitable host in every way. Send certain thoughts on their way. Show negative comments the door. Instinctively know that every change to your body (pain, cold, temperature, lethargy) does not mean your cancer has returned or progressed.
This is not easy to put into daily practice. It takes time. It requires patience and perseverance to build a calm mind and reinforce resiliency. Engaging the mind to positively influence your cancer journey is powerful stuff; as powerful as lifestyle changes.
The Best Stress Reduction Techniques for Cancer Survivors (Thrivers)
The best stress reduction techniques for cancer survivors are the ones you will actually incorporate into your daily life. The secret of your success is found in your daily routine, creating habits that you thoroughly enjoy and become one with. Be that chanting, meditation, forest bathing, drumming, hot-tubbing, laying in a hammock, or an entirely different set of activities or practices that you deeply connect with.
I spend as much time outdoors as possible. For me, nature is powerful medicine. The sounds of animals and insects, scents of plants, breezes, rain, and sunshine—all nature’s splendor—works for me.
Alternatively, I find music is therapeutic. It takes me places. It dissolves stressful thoughts.
Yoga and Pilates also get me to a good place, not to mention keeping my lower back in check.
I can take 10 deep breaths, at any point in the day, to instantly reduce my blood pressure, anxiety level, and reset my focus. That focus may, in fact, be my way of being quiet and still.
Unleashing Your Brain’s Powerful Natural Pharmacy
We each have a natural pharmacopeia that sits on top of our shoulders, ready at all times to unleash a set of chemicals, including dopamine and oxytocin, that should be leveraged at all times to support our wellbeing.
Some time ago, I shared a piece on forest bathing. With this embrace of the trees, folks can experience improvement in the list for the outcomes of gratitude. Certainly, in Japan, there is a massive following of this way of life/this way of wellness—scientists have referenced the oil that trees release which positively affect those who spend time in the woods.
Forest bathing is an expression under the wider umbrella term of nature therapy or earthing. Ultimately, it promotes that nature holds the secret to healing, and anxiety and stress reduction.
Engaging the Mind to Positively Influence Cancer Outcomes
While chronic stress, B-vitamin deficiencies, and an unbalanced diet can lower dopamine levels, eating protein-rich foods – such as nuts, beans, and fish, and getting a proper amount of antioxidants and amino acids—can ensure healthy chemical levels. Switching to caffeine-free beverages and reducing alcohol intake also helps increase natural dopamine levels.
One of the best ways to increase endorphin and serotonin levels is through regular exercise—effectively creating the equivalent of little anti-depressant and anti-anxiety pills. Quality carbohydrates in the form of whole grains, fruits and vegetables are excellent sources of serotonin. Another terrific source for boosting serotonin and endorphin levels is through hearty laughter.
By keeping the mind well-nourished with a proper balance of nutrients and healthful intellectual stimulation, you better position the body to unleash its innate ability to heal. A healthy, balanced diet, regular exercise, and plentiful laughter are all terrific ways to decrease the negative neurotransmitters and increase the good ones. These ‘nourishers’ may not be enough to sustain the ideal balance of brain chemicals at all times, but there are other avenues in which you can rest the mind to assist the healing process.
Coming Full Circle
Frankl’s quote speaks volumes. “Between stimulus and response there is space. In that space is our power to choose our response. In our response lies our growth and freedom.”
Translated for this piece: between a cancer diagnosis, active treatment, and survivorship (aka thrivorship), a health creation plan covering our physical and emotional health must be activated at all times.
With most diagnoses, there is usually time to allow for careful decision-making. That time provides the space. And in that space is the power to decide on a plan of proactivity (our response) to best inform our wellbeing and survivorship along the journey.
Join my private Facebook Group Anticancer Thrivers—a community forum for achieving your best life while living with cancer.
Photo credit: bigstock.com/New_Africa