By Greg Anderson, Founder, Cancer Recovery Group
Breast cancer is indeed a different kind of illness that demands a different kind of response. Recovery demands patient participation. For breast cancer patients determined to conquer this illness, that is very good news indeed.
You may have been told, “Get your affairs in order,” or “You have just a short time left,” or a favorite in the medical community, “Your breast cancer is terminal.” Don’t believe it. Refuse to give in to that despair. Only God knows how long a person has to live.
In 1984, I was given thirty-days-to-live. It was lung cancer. I’d previously had one lung removed. Now, four months later, the cancer was back. This time it was in my ribs and lymph system. The surgeon put his hand on my shoulder and said, “Greg, the tiger is out of the cage.
Your cancer has come roaring back. I would give you about thirty days to live.”
Part of the reason that surgeon was mistaken is that no healthcare provider can predict a person’s response to illness. After several days of believing I would die, I made a profound decision. I decided to live.
Please clearly understand what I am saying. By deciding to live I made a decision to do all I could to triumph over the cancer. I determined to live each day I was given to the very best of my ability. I chose not to focus on the blatant despair communicated in the surgeon’s words. I would instead adopt a stance of hopefulness. These decisions dramatically changed my experience of illness. They resulted not only in better days but many more days as well. I believe such a decision by you may result in a similar outcome in your breast cancer journey.
I deeply empathize with you and your health crisis. I have been there. I have been torn by some of the same emotions that now rip at you. I can identify with your fear and uncertainty. It is the most frightening time of your life.
Two paths are before you. One is marked by the road signs of passiveness and despair; the other by the guideposts of engagement and hope. You have a choice.
If you have been told that your time is limited, I encourage you to believe that life can still be a fulfilling adventure. Choose to live life to the very fullest. Focus on the possibilities of life not the problems of breast cancer. Affirm that each day is a good and perfect gift in spite of the circumstances of illness. Keep your thoughts on health not illness. In that intentional choice are the seeds of your health and healing. Water those seeds, not the weeds of dis-ease.
Without question you can improve your potential for survival. What you do makes a significant difference. Believe it: there is no such thing as a hopeless situation.
The Roadmap to Recovery
Between 1986 and 2008, Cancer Recovery Group interviewed and received surveys from over 16,000 survivors of cancer. This group included all types of cancers, not just breast cancer.
These inspiring individuals, who possess no more courage or ability than you or I, teach some very powerful lessons from which breast cancer patients would be well-served to learn. These ideas and practices have worked successfully for tens-of-thousands of other cancer patients revealing the lessons and strategies that can be pivotal in your life and your health.
After the first 500 interviews, it became clear there were similar patterns to most of the individual experiences. For example, the vast majority of survivors do not believe they recovered their health by chance or by being passive. The triumphant patients worked for their wellness, earning it on a daily basis. Neither do most cancer survivors credit their doctors alone, or even primarily, for their recovery. Instead, these exceptional patients focus on personally mobilizing body, mind and spirit in their quest for high-level wellness.
Consistent patterns emerged from the survivor interviews. In 1988 the lessons were first summarized and combined into an eight-strategy program. In 2006, after thousands of additional interviews, they were further refined into six easily-understood concepts that anyone could implement. Today, through the various affiliates of Cancer Recovery Group, over five million people have used these principles as a road map, a strategic plan to enhance their health and enrich their lives. I want the same for you.
The Six Key Strategies
Let’s take an overview of the six basic approaches that cancer survivors have in common. Here is what emerged from the survivor interviews.
Over 96-percent of cancer survivors start and complete at least one treatment program that is grounded in conventional medical care. Surgery, radiation therapy, chemotherapy, hormonal therapy and immunotherapy—often in combination—are the orthodox treatments of choice.
The Cancer Recovery team was both surprised and encouraged by this. Orthodox treatments have a central role in cancer survival. The overwhelming majority of cancer survivors do embrace conventional Western medical treatment. This is an important message that must be heeded.
But there is a significant problem, an exceptionally troubling issue that has now become clear since we first started our work. It’s the inconsistency in the medical treatment prescribed for similar diagnoses. For example, although several well-designed studies have clearly demonstrated that Breast Conserving Treatment (BCT) or lumpectomy for Stage I and II disease has the same success rate as mastectomy, the removal of the breast remains the predominant treatment.
There are also marked differences based on factors like the size of the city where patients live.
The evidence in the Dartmouth Atlas work is clear: women in larger cities more likely to receive
BCT than those in rural areas, again despite the fact that the outcomes are statistically the same.
“I did my homework,” shared Marti. “And I challenged the surgeon’s recommendation (for mastectomy). We even had an argument about the need for a sentinel node biopsy. I insisted on lumpectomy. And I had the science on my side.”
Today, many more breast cancer patients are taking matters into their own hands, demanding full knowledge and explanation of treatment options. Thankfully, the amount of treatment information now available is significant. The key is questioning and demanding hard evidence regarding the effectiveness of suggested treatments, chemotherapy in early-stage breast cancer being the prime example. So while 96 out of 100 patients still opt for conventional treatments, the treatment decision is more informed today than ever before.
Importantly, cancer survivors do not stop with conventional medical treatment. Cancer survivors take charge of the management of their entire medical program. They choose doctors in whom they have confidence, often researching online for their academic background and clinical record. Survivors tend to give consent only to treatment programs in which they have confidence and even a conviction. Plus, survivors aggressively integrate complementary and even some alternative approaches with conventional medical care.
Breast cancer survivors are active patients, involved with each decision, making certain they are fully informed and understand each component of their treatment and recovery program.
Conventional medicine, yes. Patient in control, even more.
Following medical care, dietary changes are the most common strategy adopted by cancer survivors. The increasing importance of nutrition in cancer recovery has been one of the most significant shifts in the last decade.
Marissa was told by her doctor to eat whatever she wanted. “I knew intuitively that was not correct. In fact, fifty-one years of a high-fat diet prior to diagnosis was probably part of the reason I now had breast cancer. So I changed.”
It’s all so basic. Viewing food as medicine means fundamental nutritional shifts that include:
- Whole foods;
- Low in fat, salt and sugar; and
- Emphasizing vegetables, fresh fruits and whole grains.
Among the survivors the single major dietary shift is consuming foods that are less processed. Prepared foods, no matter how convenient, tend to deliver calories with less nutrition than their fresh counterparts. In practice, cancer survivors spend most of their grocery shopping time in the produce section of their local market.
Nutritional supplements, while clearly not taking the place of a whole food diet, are widely employed by cancer survivors. While there exists a lack of consensus in actual practice, survivors recognize the role of vitamin, mineral and herbal supplements in the management of breast cancer. Thankfully, better science is producing evidence to support nutrition as a central element in cancer recovery.
Cancer survivors eat with greater awareness. You can observe the marked increase in “Nutritional IQ” just in the past ten years. Nutrition, not simply calories, has become the emerging battle cry of cancer patients in Western cultures. And survivors typically carry the attitude that diet is something they “get” to do, as opposed to “have” to do. High-level nutrition contributes significantly to breast cancer survival. Cancer Recovery’s Nutrition as Medicine guidelines outline an excellent plan.
Survivors engage in physical exercise virtually every day. Cancer Recovery Group was the very first cancer charity to document the benefits of exercise over thirty years ago. Today, the science is catching up with the survivors’ practices and confirming its efficacy.
Nearly nine out of ten cancer survivors surveyed affirm the role of regular physical exercise in their own journey. There are bikers, swimmers, joggers and walkers—lots of walkers. A brisk 30-40 minute walk each day, or strength training every other day, is ideal for many.
Carleen is now a thirteen-year breast cancer survivor. She shared, “My turning point? When I started to exercise, I started to get well again.” It is an experience shared with hundreds-ofthousands of breast cancer survivors.
In our interviews, the most inspiring are the patients who started exercise programs even while confined to hospitals beds or wheelchairs. In spite of physical limits, these people exercised.
Believe it: physical exercise needs to be part of your breast cancer recovery program.
More than any other single practice, survivors embrace beliefs which generate attitudes that, in turn, create emotions that nurture healing. Allow me to repeat: beliefs precede attitudes which result in emotions. This is the powerful mind-body connection.
Do beliefs and attitudes actually heal? Survivors see a direct link. They choose beliefs and attitudes about illness and wellness that empower. The most fundamental and empowering belief is that cancer does not mean death.
It’s sad but true that much of the world still considers cancer and death to be synonymous.
Survivors emphatically reject that belief; in fact, they stake their lives on it.
This does not translate into denial, some “be-positive-against-all-evidence” thinking. Nor is it just will power. It’s a warrior’s attitude that survivors demonstrate. There is a marked toughmindedness in the cancer survivor community, a “feistiness,” as actress and breast cancer survivor Suzanne Somers once described it. You see it everywhere.
Survivors come to grips with this truth—cancer may or may not mean death. This set of beliefs, attitudes and resulting emotions carry a vastly different outlook from either the super-positive or hopelessly negative patients. “Yes, I may die,” said Chris, a thirty-something California housewife. “But I also may live. In fact, I am going to live to the fullest. I am not going to die of fear and hopelessness.”
That attitude correlates with survivorship. The beliefs extend to medical treatments and potential side effects. Survivors tend to envision their treatments as highly effective. They further believe side effects will be minimal and manageable. Apply these healing attitudes to your own core recovery program.
You will not be surprised to learn survivors believe they have the absolute central role in the recovery process. This belief and resulting attitude is at complete odds with millions of other cancer patients who defer virtually every question to their doctors. Not survivors.
It’s surprising: survivors have a love/hate relationship with their medical team. They want the best of care and respect those healthcare professionals who speak truth, patiently explaining what evidence supports their treatment recommendations and what outcomes can be expected. But if that information is not freely forthcoming, survivors can be exceptionally confrontational. Survivors check and re-check physician recommendations, often challenging tests, treatments and prognoses. Many survivors change doctors in search of those who are better trusted.
Survivors invest time and emotional energy in relationships that nurture them. They also invest less time and energy in relationships which are toxic. While this may seem to be a benign practice, it has some surprising health implications that survivors consider important.
Loving relationships with friends, relatives, lovers, spouses, children, co-workers and employees—or the lack of those relationships—build us up or tear us down. Survivors tend to become “relationship sensitive,” examining, perhaps for the first time in their lives, how they get along with other people. It is quite common for survivors to put difficult relationships “on hold,” especially during any debilitating treatments. This does not mean survivors exile toxic people from their lives for all time. But it certainly signals reduced emotional investment in those relationships.
Breast cancer tends to give patients the permission to examine a wide variety of life choices, especially their network of social support. Changes are often made.
I personally worked with Tina, a breast cancer patient who had a long-standing difficult relationship with her mother. “I was always being criticized. And during treatment, I needed encouragement. So I told her no more visits or phone calls until I called her. It was over three months before I contacted her. But I needed room to focus on healing.”
Tina’s example is very helpful because much of the work of getting well again takes place within one’s social support network. The last thing a breast cancer patient needs is a toxic person second-guessing and criticizing every decision.
New and important research is now demonstrating the health benefits of supportive relationships. Survivors have at least one person with whom they can share anything—everything—without fear of judgment or condemnation. That is a powerful healing elixir.
Cancer survivors embrace a more spiritual perspective. They repeatedly speak of seeing life differently now compared with prior to their brush with death. This spiritual outlook stands in marked contrast to other cancer patients who obsess over a body that may be riddled with disease or mourn endlessly over dreams that are hopelessly derailed. Survivors seem to be able to grasp the high value of now—the simple and readily available life that is theirs in spite of cancer.
This more spiritual perspective is not an issue of religion. Many survivors reject traditional religious practices. It’s the old adage: just because you sit in a garage does not mean you will become a car. And just because you sit in a church or synagogue does not mean you will become more spiritual. And clearly, no single doctrine or creed brings pre-packaged answers to
Nor does this spirituality simply consist of bland platitudes. Instead, the transformation is typically seen as an inner peace, a serenity, a quiet confidence, a more grateful and joyful way of living. In a very real sense, they have come to let God work in and through them. Celeste, a breast cancer survivor, explained the essential nature of the spiritual walk. She said, “Now, when I walk into a room, I am there serving as God’s representative.” For millions of cancer survivors, this is the apex of the healing journey.
This is our framework for recovery. Each of these six strategies is important, even essential, to breast cancer survival. However, they are not always equal. Timing is one issue. If the decision is made to consider and commence a recommended medical treatment, nearly all the emphasis is on that area. Once in place, survivors tend to let the doctors treat while they move on to implement programs that include nutrition, exercise, attitude and the range of holistic aspects of getting well again.
Implementation of one principle typically follows another at the appropriate time. Few survivors make simultaneous wholesale changes. Those who do attempt to change too much too quickly often meet with temporary defeat and have to start again.
Each principle has its important place in survival. Many breast cancer survivors note that solving a relationship issue may have been just as important in their recovery as medical treatment. Adopting a healthy nutritional program and making a commitment to daily exercise may be on par with the contribution of radiation or chemotherapy.
Breast cancer recovery becomes a healing symphony. The survivors believe they have earned their return to health, aligning themselves with their own immense healing capacity. “The music of my healing springs from within,” said Brandi. “I simply had to release it.”
So let’s summarize. The integration of these six key strategies creates the framework for patients to follow in the breast cancer recovery journey:
The cancer survival pyramid is the context, the strategic plan. It’s your roadmap. Consult it often.