ACKNOWLEDGE YOUR GRIEF

Life is difficult. This is a great truth, one of the greatest truths.

— M. Scott Peck, The Road Less Travelled

A day you will never forget is the day you are diagnosed with cancer. It happened to me, and my first reaction was to cry for days.

Life consists of ups and downs. Cancer is one of the biggest shocks we can be challenged by. Being faced with your own mortality changes your life overnight.

Bad things do happen to good people. This usually happens in a random and inexplicable way.

Why me?

The first noble truth of Buddhism is to live is to suffer.

Accept that life is tough and sit with the dark moments. Give yourself permission to cry, swear, be angry, break things, or do all of the above, repeatedly. You may want to sulk or, as I prefer to say, have a big sook!

Acknowledge that life will never be the same.

You may need to stay in this dark stage for a while.

Everyone's experience is individual. There are no rules.

Give yourself enough time to grieve for the dramatic change in your life.

All emotions are okay: being overwhelmed, furious, bitter, twisted, envious, devastated, resentful, and traumatised.

You may find yourself travelling in and out of the stages of grief. There are usually five stages. They can occur in any order, for varying lengths of time, and sometimes all in one day.

Cancer forces vulnerability upon you. You most likely have a distrust of your body now, and you have to relearn to trust it.

The key is to find acceptance of your situation and be strengthened by this.

Easier said than done!

I write now in hindsight after being through cancer. I used old skills and found new ways to counteract the grief, the uncertainty, and the fear. I was offered and accepted a lot of help. I learnt to move on with greater gratitude and purpose. This was not easy, but it has changed me for the better.

I have also drawn upon insights from others who continue to live well with cancer. I hope that some of these strategies may improve your well-being along the way.

CHOOSE NOT TO LET YOUR ILLNESS DEFINE YOU

Only through experience of trial and suffering can the soul be strengthened, vision cleared, ambition inspired and success achieved.

— Helen Keller

Woe is me.

It is completely normal to be sad when you have cancer. Sadness turns to depression when people don't feel they have a way forward. Up to 40 per cent of people with cancer become clinically depressed. Research shows that women with breast cancer whose depression improves live longer.

You can choose not to become a "victim" of your situation.

Stay involved in your everyday life activities as much as possible. You may have to say yes to fewer invitations, avoid large crowds, sit rather than stand, or leave social events early. As we are social creatures by nature, it is better to stay connected with people during difficult times.

Time magazine reported in 2016 that during illness social supports can help people manage with painful treatments and aid recovery from cancer.

You can actually choose the lens with which you perceive your illness. Some people choose to languish, and some people manage to flourish.

Think about what might replenish your body, mind, and soul.

Consider the importance of self-compassion. One of the world leaders in self-compassion, Kristin Nef, emphasizes the importance of treating yourself with as much kindness and care as you would show your best friend.

Don't give in to helplessness, and notice if you feel this way. Look for help to find positive directions ahead.

Avoid focussing on why things are so terrible for you. You are not your disease, so don't let it define you.

Even on the worst day imaginable, you have a choice on how you approach it.

Plan in some guilty pleasures to balance out the bad times.

Lahna Catalino at the University of California has studied the pursuit of happiness. She found that positivity prioritisers, or those people who savour positive situations, have greater resources and experience more positive emotions.

Reflect on how people might feel when you walk into a room. They may feel uplifted, inspired, and interested. They may feel sorry for you if you continually complain and feel helpless. No one wants to be around a "misery guts." People will follow your lead if you respond in a more positive manner. Their response will follow suit from your mood.

Perhaps consider that the cancer experience may be an opportunity to become a better person.

MAKE YOUR CANCER A PROJECT

What is true for one may not be true for another, and a gift exists for each of us in discovering who we are, uniquely, as we find our way back into life.

— Maria Sirois

Think of your illness as a time-limited project rather than a journey with a disease.

The treatment phase may be a twelve-month secondment from your usual life. Something like a gap year or a new job.

It may also be an ongoing project in which you have to customise your life to suit.

If you enjoy exercising, you could consider cancer to be a physical challenge like climbing a mountain or going on a trek. Your body is doing the equivalent of running a marathon, so perhaps imagine the treatment phase as a long-term sporting event.

Don't give in and be a passive recipient of treatment. Having a strong fighting spirit has been shown to translate to better outcomes during cancer.

Adopting an active approach to dealing with any stressful situation helps us cope better.

Having a sense of control will strengthen your well-being.

People develop grit and resilience rather than inherit it. This is a practised quality.

Belief plus effort and perseverance helps with recovery.

A New Frontier

We now know that we are not stuck with the genes we are born with. Epigenetics, meaning "control above the genes," is the study of how genes can be regulated. We are learning more about how genes can be switched on and off again.

Meditation has already been shown to switch off disease-causing genes.

Epigenetics will be a source of future discovery that may help address many medical mysteries and lead to further cures for cancer and other diseases.

There are stories of spectacular recoveries.

Imagine being one of them.

DE-STRESS YOUR LIFE

No one saves us but ourselves.

— Buddha

Cancer induces a long-term stress reaction where the body continually activates the fight-or-flight response. This response is designed to deal with short-term stressors on the body. Chronic stress further suppresses the immune system. If there's ever a time you need your immune system to help you, it's when you have been diagnosed with cancer.

Reducing stress has to be an important goal.

Take regular time out to rest or spend time away from the demands of life.

Tips to Become More Resilient

• Give yourself permission to put yourself first.

• Outsource what you can to people who offer.

• Don't sweat the small stuff. Think about what is important to you right now.

• Aim to control the things you can control and let go of things you can't control.

• Is yes your automatic default position?

Think twice before you say yes to people. Say no more readily.

• Settle for things not being perfect. Lower your expectations bar.

• Healthy, happy successful people simplify their lives.

• Avoid watching the news. It can have a toxic effect. If you really need news, just read headlines rather than details.

• Avoid freestyle Googling of cancer topics. This can be very unsettling and is rarely uplifting.

Massage

I recommend having as many massages as possible. Massage is most often not to be avoided during cancer. It is very beneficial. Don't let a massage therapist tell you that massage will spread the cancer. Get the go-ahead from your doctor before booking. This will mean you have a ready-made answer if a day spa suggests it can't treat you.

Touch releases oxytocin, sometimes known as the hormone of peace and trust. Oxytocin also counteracts the effect of the stress hormone cortisol.

If you're not up to a full conventional massage or can't lie on your stomach, find any part of your body that can be massaged, even if it's only your feet.

You may find bare scalp massage to be one of the most wonderful restorative experiences ever. I did, and it was seriously the only good thing about losing my hair!

After chemotherapy, you will never have to listen to a friend complain about a "bad hair" day ever again.

HARNESS YOUR PEOPLE POWER

Friendship doubles joy and cuts grief in half. — Francis Bacon

The best predictor of well-being and happiness is the time you spend with other people in positive relationships.

Rally your troops.

Visitors are good for you.

Choose your people wisely.

Focus on positive-energy people.

Avoid the impact of negative nellies.

Set the conversation yourself. Friends and loved ones will be interested in your experience and keen to talk if you are. Most people won't ask you directly about your cancer. They will follow your lead.

Consider carefully if you have the desire to cocoon yourself away from the world and avoid your support people. Sometimes the tendency is to "go to ground." This is totally understandable, but it is best to find a balance. The evidence is overwhelming that connection with loved ones and good friends is strengthening and supportive for those experiencing cancer.

Chances are you won't feel like contacting people, but maybe put the word out through a central friend or inner circle that you are happy for others to contact you.

Accept offers of meals readily. Not only do you benefit from the practical support but also from the huge dose of goodwill that comes with it. If someone offers to coordinate a food roster say, "Yes, please."

If you're not up to seeing people that day, leave a cooler or drop box at the front door with a note. People will understand.

Feel the love, and accept support.

Text or email people if it's easier. Lots of phone calls can be overwhelming and tiring.

Let people help if they offer. It's so much harder to do it alone. People want to help you in some way. It's their way of showing that they care. Some people show their love by doing things.

Phone uplifting or funny friends when you need a boost. Avoid your doom-and-gloom friends and family if you are not in the right frame of mind to deal with them.

Combine a catch-up with a friend with a nature walk.

If you enjoy social media, consider making a secret Facebook group to update family and friends. You'll be surprised how much support and encouragement this brings.

Make frequent lunch dates or coffee catch-ups happen.

Consider joining a cancer support group. They do not suit everyone. Notice how you feel afterwards. Hopefully you are energised or uplifted. If not maybe it's not for you.

A hug lasting more than twenty seconds will release oxytocin into your body and give you a feel-good boost.

LINK WITH YOUR LOVED ONES

In time of test, family is best.

— Burmese proverb

Your family, and especially your partner, are going through a major challenge with you during your life-threatening illness. This can be the case even more so when the affected member of the family is the primary carer. Roles within families will change and routine is usually disrupted.

Carers also have an increased risk of developing anxiety and depression. So much focus is put on the person with the cancer that the needs of a partner may sometimes be overlooked. Studies have shown that spouses of breast cancer patients experienced as much distress as their wives. Spouses of colon cancer patients experienced even more distress.

Loved ones need to consider their own well-being and actively draw upon their supports. This might include a trusted friend or two to check in with how they are faring.

Try not to attend important medical appointments on your own. Important information may be forgotten or misunderstood. Take a partner or friend to take notes and to debrief with afterwards.

Remember that accepting practical help from your friends to deal with daily demands can also be of great benefit to your partner or family.

Relationships have a greater likelihood of being negatively challenged as a result of cancer.

Relationships can also be improved by deeper sharing of fears, hopes, and dreams. The major determinant of happiness over the lifespan has been proven to be the quality of people's close relationships.

If at all possible, keep children's routines as similar to normal as possible. Children will benefit from age-appropriate explanations of what you are going through.

Honesty is the best policy for children, but they can be spared unnecessary details. Kids are often more resilient than we imagine.

TAKE CONTROL OF YOUR THOUGHTS

Everything can be taken from a man but one thing: the last of the human freedoms — to choose one's attitude in any given set of circumstances, to choose one's own way.

— Victor Frankl, Man's Search for Meaning

Your thoughts are transient. They come and go. It is normal for intrusive thoughts and images to predominate when you are diagnosed with cancer.

You have the choice to recognise and regulate your thoughts. You don't even have to believe your thoughts.

The major impact from your thoughts comes from your subconscious. This is said to dominate up to 95 per cent of the time. It is predicted that an individual has at least 60,000 thoughts per day. This translates to a lot of potential negative energy in your body if you don't tap into your inner thoughts.

Notice your inner voice or your subconscious thoughts.

What is its tone?

Is it sad?

Is it worried?

Is it anxious?

What message is it giving you?

Don't believe everything you think.

Perhaps ask your doctors what they think you should reasonably worry about, such as aches, pains, or other symptoms.

Avoid thinking traps.

• Recognise the futility of what-if thoughts. Notice if you are prone to doing this, and redirect your attention.

• Try visualizing positive outcomes instead.

• Do not assume that the worst-case scenario will be your outcome. People may do this in an attempt to protect themselves from disappointment if the worst-case scenario does come true. There may be very low likelihood that this will be the case, and this approach adds a lot of needless anxiety to a situation.

Look to shift your inner attention to something you appreciate or that restores you.

Set aside a time each day to remember a past time in your life when you were at your happiest.

You are always stronger and braver than you think you are.

Cancer treatment often interferes with your thinking and memory capacity. This is a common side effect of chemotherapy and radiotherapy. This can be very frustrating. You may find yourself not being able to remember names and numbers. This is most commonly a temporary problem that improves slowly over time.

You can retrain your mind as if it is a muscle.

Don't underestimate your ability to rise above your difficulties. Focus on the things you can control, including the following:

* what you think about

* how you react

* what you eat

* how you exercise

* how you induce your relaxation response

USE THE POWER OF YOUR PLACEBO

The tools of our consciousness — including our beliefs, prayers, thoughts, intentions, and faith — often correlate much more strongly with our health, longevity, and happiness than our genes do.

— Dawson Church

Placebo response is when people experience an improvement in their symptoms from a perceived benefit rather than from a direct physical benefit. This has been proven to contribute to up to 80 per cent of an individual's improvement.

Psychoneuroimmunology is the effect of thoughts and emotions on the immune system. There are (to this point) over one hundred identified genes in the human body that are activated by thoughts, feelings, and experiences. These genes have a huge impact on our bodies' resistance to disease.