Cancer Diagnosis

A number of years ago one of the most popular songs on the radio instructed us to "don't worry, be happy." It was a nice sentiment but we understand that life is not that simple. I fear that in writing this month's column on emotional health and breast cancer that it may sound like "don't worry, be happy." I assure you it isn't. Any concern surrounding breast cancer evokes many emotional responses most of which are not positive. A diagnosis of cancer throws an individual on an emotional roller coaster ride that they are seldom prepared for. Yet the research done on cancer and emotional is overwhelming: those who have a positive and realistic outlook on dealing with their cancer have a significantly better prognosis that those who do not.

Greer and Watson (1984) studied the response of those diagnosed with cancer and came up with four types:

• Fighting spirit: people who accepted their diagnosis, but were optimistic, sought out information and resources, and were determined to fight the disease. This group exhibited a sense of control, commitment, and ability to face the challenge
• Positive avoidance: those who rejected or minimized the diagnosis.
• Fatalism: those who accepted the diagnosis but did not believe they could do anything about it.
• Helpless/hopeless: those who were overwhelmed and consumed by cancer.

Participants were followed up five and 10 years later and it was found that those in the first group were significantly more likely to be alive and disease-free than any of the other groups.

Regardless of how resilient one is, a diagnosis of breast cancer comes as a significant blow. It not only attacks a woman's health, but it attacks her self-image, her sexuality, and her self-esteem. In her book Promoting a Fighting Spirit (Jossey-Bass, 1996), Linda Seligman points out that in order to get a fighting spirit, it is essential to have the support of a professional counsellor. Counselling helps the individual deal with the anxiety, anger, and depression that often accompany a diagnosis of cancer. In short, it helps promote emotional health. It also teaches patients much needed stress relaxations techniques. Through cognitive behavior therapy, meditation, and mindfulness patients learn to reduce the excess stress caused by cancer, which boosts their immune system's ability to fight the disease.

Another critical component in dealing with breast cancer is having a network of social support. David Spiegel (2001) randomly assigned 86 women with breast cancer to one of two groups. One group received only medical treatment, while the other who received identical medical intervention also formed small support groups. Those in the support groups lived, on average, twice as long as those who did not have support.

Finally, research shows that those who have a religious, philosophical, or spiritual framework to help them understand what they are going through those who have a deep seeded hope also do much better. They are better able to deal with suffering and the trials brought on by a diagnosis of cancer. They understand that while physical health is important, ultimately no one lives forever. Thus they have a hope, which garners a fighting spirit, but their faith acts as a buffer from the stress of the threat of death.

A diagnosis of cancer is never good news, but by reaching down and finding the fighter that exists in all of us, we take a major step toward our own healing.