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Lions Roar : May 2015
may desire support but at the same time may be concerned with thoughts such as: What will he think of me? Will she still love me? Will they pity me? 2. Life of Uncertainty Even people whose cancer is “cured” fear that a few undetected cells remain, wait- ing to grow. For the past 12 years, I’ve lived with cancer. It’s remained under control, but nonetheless the experience has been a cross between riding an end- less rollercoaster and being caught in a fun house where goblins pop out. Not knowing if the cancer is “really gone” cre- ates anxiety even when seemingly innoc- uous things occur. For me, any kind of bone pain sets off alarms. For someone with breast cancer, it could be a normal calcification lump in her breast tissue. 3. A World of Accumulated Losses Cancer is tied to loss, and with its pro- gression losses accumulate. Some losses may not be significant, but others result in identity changes. For someone who’s jogged everyday for 40 years, it will be crushing when medication makes even walking difficult. For a professional musi- cian whose dexterity has diminished, it will feel catastrophic to not be able to play the piano. When my treatments resulted in an inability to sleep for more than a few continuous hours, I found it particularly difficult to face not being coherent enough to write. Our world shrinks as losses accumulate. Telling someone with cancer that they haven’t changed isn’t reassuring. Most people don’t think of themselves in terms of an unchangeable core, but rather as someone with values, experi- ences, and skills—that’s our identity. As the cancer strips away parts of it, the cancer patient experiences changes. Say- ing that they’re the same person doesn’t alter their experience. 4. Pain A patient once said to me, “I never know how long the pain will last, or when it will begin again. No matter what I’m doing, I’m either waiting for it to go away or to start again.” Sometimes the anticipation of pain is more debilitating than the experience of it. Imagine having to do something that causes pain, such as standing or moving, day after day dozens of times a day. On good days—days without much pain—you’d feel jubilation but also fear the end of the reprieve. Then on bad days, you’d be afraid of the pain persisting forever. Both anticipa- tion and the actual pain can change personalities. 5. Death As our minds and bodies change with the growth of cancer, death no longer resides on the distant horizon. It becomes an approaching appointment. When I received my cancer diagnosis, I no longer thought about death in theoretical terms. It became real and frightening. Instead of having years to address my regrets and complete my goals, I suddenly understood that I had a limited amount of time. A cancer diagnosis inevitably involves concerns about death and the journey toward it. TO RELATE SKILLFULLY to someone with cancer, understanding their world is an important step, but transforming understanding into skillful behaviors isn’t automatic. Don’t be afraid to fail when you try to help. Your loved one or friend will appreciate your efforts and will provide feedback if you give them permission. Use statements such as, “If I do something that isn’t help- ful, please tell me.” Less than skillful behavior is appreciated more than no action. A closing thought: don’t expect sta- bility in cancer’s progression or in the thoughts, emotions, or relationships of a cancer patient. Think impermanence, and you’re on your way toward trans- forming your compassion into skillful and helpful behaviors. ♦ PEARLPIRIE 10 DOS & DON’TS OF CANCER 1. Be compassionate without being a cheerleader, since an initial cancer prognosis is often uncertain. Don’t proselytize. 2. Be definite in your offers to help. Ask, “Would you like to shop for groceries tomorrow?” rather than, “Call me if you need anything.” 3. Accept that a cancer patient will reorder their priorities. Facing the possibility of dying changes what’s important. 4. Don’t tell your friend or loved one they are the same person they were before the diagnosis. They don’t feel that way. 5. Sometimes the greatest support you can provide is silently witnessing dif- ficult emotional and physical events. 6. Be prepared to accept a shrinking of your friend or loved one’s world with each new loss. 7. Accept it when they’re having treat- ment you disagree with. 8. Graciously accept their gratitude for something that you don’t consider a big deal. 9. Don’t initiate conversations about dying. Your friend or loved one will do it when they’re ready. 10. If you don’t know how to be helpful, ask. —Stan Goldberg SHAMBHALA SUN MAY 2015 22 CULTURE • LIFE • PRACTICE