Information reflections suggestions for smart cancer care
Take up the challenge
We usually think that the most important thing about curing cancer is relying on the best specialists or finding the most effective remedies or maybe the most advanced ones, those freshly baked by research. These things are important but probably it is more important to ensure that we pursue an intelligent treatment.
An intelligent approach to cancer care is more likely to be successful: we may live longer and better live the time that we have left.
If we limit ourselves to do what it is usually done when treating cases similar to ours, the care is not intelligent but rather mechanical.
First question: do we always keep in mind the objectives of the treatment?
We undergo a treatment because we want to go on living and being well, not for other reasons that don’t concern us. Do we always remember this? Are we always clear that these are the things that we want?
In oncology it is common to repeat that the goals of cancer care, specifically of metastatic cancer, are overall survival (OS) and quality of life (QOL), that is, managing to prolong life time as much as possible and, at the same time, allow people affected by cancer to live in the best possible way. Sometimes these wise intentions are forgotten or substituted by others.
Second question: are we still making decisions autonomously?
When we are ill, social and psychological factors make us less able to be masters of ourselves, leaving others to decide for us. But if we want to manage well our cancer care, it is advisable for us to keep our decision-making autonomy. Medicine, as it is today, asks the sick person to be dependent, to rely on experts who will think and decide for them following technical guidelines. This approach to health care is based on modern medical science that is more interested in the biological aspects of the disease than in the sick person’s life and is characterized by a complex organization of specialized professionals and hospitals.
Third question: are we well-informed?
If we want to take care of ourselves in an intelligent way, we must be well-informed about our disease and able to follow and participate in technical discussions with our specialists.
Not limiting ourselves to the opinion of the physician who is treating us and asking for a second opinion is already a way to better understand our situation. It is good practice to do this not only in the beginning but every time that the situation changes and there is an important decision to make. It is better to ask for a second opinion online, not only because in this way we can avoid to travel in vain but also because doctors work better when interacting remotely.
Fourth question: are we taking all the available options into consideration?
To make sure that we follow an intelligent treatment, it is appropriate that, at each step, we ask ourselves whether there are other possible therapies a part from those that we have been offered. It may happen that we will then follow different routes or that we will do exactly what we have been told, but it is always useful to assess further alternatives.
The choice of undertaking either a chemotherapeutic regimen or another regimen is usually not an obvious one. In the same way, one cannot take for granted which type of intervention or which technique to use, in case one chooses surgery as a solution. Moreover, chemotherapy, surgery, radiotherapy and molecular targeted therapies are not the only weapons at our disposal. There are less aggressive treatments.
Nowadays there are non-aggressive therapies that are not only effective but also well tolerated by the body, thus able to safeguard the quality of our life.
Among these mild therapies, hormone therapy is used regularly to treat breast and prostate cancer, although sometimes not as often and as well as it could be. Other mild treatments, though, are often underestimated, unused or misused.
Fifth question: are we managing our mind well?
We cannot trust our mind. Like all human minds, our mind tends to produce distorted thoughts and struggles to think objectively. The human mind is by its nature a social mind, made to be able to deal with others rather then to analyze problems rationally, especially biological or medical problems. If need be we are able to think objectively but this requires a significant effort.
Since antiquity, philosophers have agreed that the common human line of reasoning is defective and full of fallacies, as they say in the logical-philosophical tradition. Scientific psychology has extensively demonstrated this: it has showed that we all make errors in reasoning irrespective of our education level, skills and intelligence. It has also described in detail the cognitive biases, namely the systematic distortions created by our mind and has analyzed their mechanisms and main reasons. To see first-hand that this is how our mind works, if we have never done this, let’s try the Wason test.
Sixth question: are we managing the relationships with our loved ones well?
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The adventure of Helen who, together with Leonard, her husband who is a doctor, fights metastatic cancer. A story of intelligent cancer care. The book tells it and illustrates the things that this type of care can teach about the philosophy of the cure, traditional therapies, light therapies available today and the small secrets to manage the mind and the relation with oncologists.
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When cancer appears in our lives both we and our loved ones are under shocked. We get the impression that something has radically and permanently changed. This happens because usually we live in the illusion that life is made of positive events and cancer destroys this illusion. In psychology, this illusion is known as the positivity bias or Pollyanna effect, so called from the name of the protagonist of the novel by Eleanor Porter. It usually helps us to live life with enthusiasm and hope but it makes us feel unprepared when we are faced by negative events that also constitute part of our life, like cancer.
Because of the positivity bias, it often happens that the way our loved ones relate to us changes: we are now different in their eyes and they think that they have to treat us differently from before. This does not help us to cure cancer intelligently.
Seventh question: are we managing the relationship with doctors well?
Relations we build with doctors are also important. They are our interlocutors of that scientific, professional and organized medicine that is offering us cancer therapies. It can easily happen that we need to manage problems that may emerge in our relationship with doctors. They might not appreciate our effort to retain independence for a number of reasons, like the fear of losing control over us and the treatment we are following or the difficulty of committing to take part in discussions that go beyond what they are used to. They might feel uncomfortable with the idea that we carry out some research on our own and explore potential therapeutic alternatives. The fact that we do these things may be perceived as a threat to their professional standing or can make them feel uncomfortable simply because they have to make an effort to study and think more than it is usually required of them.
Eighth question: are we using cancer as an opportunity to grow?
In order to ensure an intelligent approach to cancer care we have a lot to do and to learn. The main part of the job revolves around its psychological and social aspects and, especially, managing ourselves and the relations we build with others and with institutions. There is a general tendency to think that the psychological and social aspects of curing cancer are optional. With different degrees of awareness, one thinks that dealing with these aspects is an additional treatment, something that adds to the actual biological cure. This is a mistake.
There cannot be a successful biological cure without careful consideration of psychological and social aspects. In fact, choices only on the surface are merely technical ones. They are always related, with different degrees, to the psychological and social contexts. An intelligent approach to the treatment of cancer is one that always takes this into consideration and during which the minds of the people involved in the game, communication and the relations between them are well managed. Cancer challenges us and provokes us to become better at what human beings already excel at: to live our psychological and social experiences intelligently.
In order to be able to manage our mind and the relations with our loved ones and with doctors we must become a little bit like psychologists or, at least, learn something about the psychology of cancer and have a general idea about those psycho-social dynamics that generally come with this disease.
If we want to pursue an intelligent cancer care, we must also learn how to research using a scientific approach and how to discuss with specialists about what we discover. We must also learn how to be independent in our decision-making process in spite of all the pressures to renounce this. Furthermore, cancer asks us to make considered and complex decisions while always keeping in mind the results we want to achieve.
Therefore, cancer is an opportunity for personal growth. After all, we always grow if we truly live our life. In psychology they talk about resilience to indicate the ability to transform negative events in opportunities to become stronger like some hit resistant materials.