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September 4, 2008

Life lessons from the trenches of cancer survival

http://www.jewishjournal.com/so_cal_medicine/article/life_lessons_from_the_trenches_of_cancer_survival_20080903

On my neck there's a large, upside-down L-shaped scar. One leg of the L runs from my right shoulder blade upward to just below my right ear; the other leg takes a 90-degree turn, following the jaw line to my chin. The right side of my neck -- the inside of the L -- looks as if it's had glands, cartilage and muscle scooped out, leaving a tough, bumpy, uneven cavity. After the surgery, a friend joked that I should put Silly Putty on my neck.

No Silly Putty, no cosmetic surgery. My neck has remained exactly as it was after the operation. It's a souvenir of squamous cell carcinoma -- cancer -- which started in the right tonsil and metastasized to the lymph nodes, diagnosed and treated 15 years ago.

The day I was told that I had throat cancer, I was furious. There was no logic to it. I'd never smoked, didn't drink, hadn't eaten red meat in more than 25 years. So why me?

There was only one way to deal with my fury. I went out and had a real hot dog with sauerkraut. Much better than those meat-free -- and taste-free -- soy dogs I'd eaten for so long. With each bite, I looked up at the heavens and shook my fist: There! Take that!

In fact, it's that semidefiant attitude that helped me get through the punishing treatment: massive amounts of throat radiation followed by a radical neck dissection.

Bernie Siegel -- the oncologist whose tapes I'd listen to in the car while going back and forth to the hospital -- says that one should be a "good-bad patient": question everything and demand honesty and clear explanations from health-care professionals.

But, Siegel stresses, once you decide on a treatment, stick with it.

Here's something that helped me: Although I was optimistic, I didn't see treatment as an attempt to "beat" cancer. Right from the beginning I thought of cancer as my teacher, an experience I was going to learn from.

What did I learn? For one thing, when you accept help from others -- which was hard for me -- it not only makes you feel better, it also makes the person helping you feel better. When I started treatment, my older son, Rafi, was just finishing his freshman year at an Ivy League school. He took a year off to help me. He didn't think of it this way at the time, but when he looks back on it now, he says that he cherishes that year.

After I was diagnosed, I was called and visited by many well-meaning people who suggested alternative treatments: from special diets to fasting to massive doses of vitamins. I listened politely and then plunged full bore into the most up-to-date medical treatment available. Oh, I used some unconventional techniques to complement treatment, but not as a substitute for Western medicine.

While going through radiation treatment, I meditated every day. This involved breath control and visualization until I'd reach a state of self-hypnosis. While in a trance, I'd imagine a kind of Pac-Man figure entering my body and eating my cancer cells.

Did it help? Who knows? It felt good, and that's what counts. Meditation -- or prayer or yoga -- certainly can't hurt, so long as it's not used in place of standard treatment.

While you're going through treatment, be easy on yourself. If you want to be alone, then be alone. If you don't want to talk to anyone, then don't. Recognize your limits, and don't let anyone talk you out of them. If, however, you want to interact with family and friends, then by all means do so. And when you're tired, kick them out. Be strict about this.

The medical facility where I received treatment is one of the most prestigious in the world, but some staff members had a lousy bedside manner. One resident -- I thought of him as Dr. Worst-Case-Scenario -- would always give me his gloomiest predictions.

I never let it affect me. The way I look at it, the job of any medical facility is to provide the most skilled, cutting-edge treatment, and that's it. But that's more than enough. If you need happy talk and hand-holding, that's what family and friends are for.

How can you find the right medical center for you? Ask others in your area who have gone through similar treatment. Talk to your family physician. Consult magazines that rate hospitals and treatment centers. One source is the annual issue of U.S. News & World Report that lists each medical specialty and ranks facilities throughout the country. You can access last year's rankings via its Web site or at your local library.

Some years back, Norman Cousins wrote about the healing power of laughter. It worked for me. Forget subtle humor. You want the fall-on-the-floor-bust-a-gut-roaring kind: early Woody Allen movies or Peter Sellers as Inspector Clouseau. There are times, though, when other types of movies work, too. During the worst moment of treatment, my pain was eased by watching Fred Astaire and Ginger Rogers glide across the dance floor.

Make no mistake: Cancer -- and its treatment -- can be horrendous. I wasn't able to eat, I had no energy. Every day I was faced with my own mortality. But that helped me put priorities in place: seize the day and all that.

Once I recuperated from treatment, I made my own bucket list. After having lived what I felt had been a self-indulgent life, I was now determined to try something different. So I worked for the Shoah Foundation, which assures that Holocaust survivors' testimonies become a permanent record.

I joined groups that explore life; reconnected with friends and family; published many articles -- and a book -- on topics close to my heart; volunteered as a writing coach for inner-city kids. And I've been a mentor for others going through cancer treatment, sharing what I learned, trying to make a difficult journey a little easier.

Nowadays when I look at my neck -- at the scar, bumps and cavities -- I feel nothing but gratitude: It's a reminder of the treatment that saved my life.

And it's a reminder that having gotten cancer in the first place also saved my life.

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