Attitude

In my clinical practice, I have been impressed that the men who seem to do best are those who fully confront the implications of their disease and take an active part in developing the treatment plan. An article about a breast cancer patient in the Journal of the American Medical Association, July 28, 1999 beautifully captures the idea: "Facing the worst and tackling it head-on is not an admission of defeat or a sign that the patient is giving up. Rather, it conveys determination to deal with whatever comes along, a state of mind that has been referred to as fighting spirit." The author makes an important distinction "Realistic optimism" is not the same as blind hope. Speaking of women with breast cancer, the author notes that "optimistic women appear to accept more readily the reality of the challenge they face, whereas pessimistic women try to push this reality away." The article then recounts how breast cancer patients who exhibited this attitude had a significantly lower risk of recurrent cancer than women who felt stoic or helpless. 

I think one reason these patients do better is that an honest assessment of the disease is the first step in formulating the most effective treatment plan. The formulation of a realistic treatment plan is in itself, the best defense against a sense of hopelessness and an effective antidote to depression. I have taken these lessons to heart. In fact, I did experience enormous relief when I finally established my treatment plan. 

I have joined one of the cancer patient support groups in the hospital where I work. Before my first meeting, I removed my white coat and put on a sport coat and went from physician to patient. I am still new to the support group, but I know I am going to benefit from my involvement. 

I have chosen an aggressive treatment plan that offers me the best chance for cure. Despite this effort, the cancer may still return. For the rest of my life, I must always be alert to this possibility. It is a challenge to live with this fact and still live life to its fullest.

Reference:
D. Spiegel. "A 43-Year-old Woman Coping with Cancer" Journal of the American Medical Association 282: 371-378, 1999.