As my cancer journey seems set to enter yet another new phase, I have become fascinated by the idea of a second chance at life. I try to be careful not to leap too far into optimism, but for sure each time I see the oncologist he sounds more and more positive, so perhaps I could be lucky enough to enjoy significantly more time on this planet before the cancer returns. A year ago, we were unwilling to plan more than a week or two in advance, but now we seem comfortable thinking ahead a whole year or even longer. Does that make me a cancer survivor, or like somebody who has recovered from a near death experience? Probably not yet, and maybe not ever, but I have found it an interesting concept to explore.
I have but one more chemotherapy cycle to endure in this phase of treatment, in the middle of March. Then an MRI early in April will be followed by another appointment with the oncologist. He tells me that if all remains clear then treatment will not just taper, it will essentially stop. We would move to monitoring only, still with MRI’s but at a lower frequency, and with no special medication. Being able to say goodbye to nausea, fatigue and loss of appetite, not to mention regular lab trips, would certainly warrant a celebration, and was beyond my wildest dreams not so long ago.
I had assumed that the period after treatment stopped might be especially dangerous. Once we stopped zapping at the cancer remnants, it felt like giving it an open invitation to return with a vengeance. But the oncologist told us that this was not really the case. Of course, I will always run heightened risks compared with somebody who has never had a glioma, but these risks are not as high as I might think and not especially high in the period after the end of treatment.
So, once I felt better after last week’s chemo, I started researching topics life cancer and near-death survivors. From the beginning I have been curious about how cancer may have changed me, partly to give me an opportunity to understand and perhaps remedy any unconscious imposition my behaviour may be imposing on loved ones. Reading a few articles and short research papers, there do indeed seem to be some common themes for how people change, and I find that a lot of these resonate with my own feelings.
What has become a seminal paper about second chancers identified nine values or attitudes that appeared significantly more prevalent among the survivor group than the general population, based on a detailed questionnaire completed by many study participants. The second chancers declared a greater appreciation for life, and a higher level of self-acceptance. They felt that they demonstrated a greater level of concern for others but less interest in worldly achievement for themselves, and showed a higher level of engagement of planetary and social affairs. They followed a life quest or search for purpose more intensely, and demonstrated higher levels of both spirituality and religiosity. Finally the second chancer group showed what the study termed a higher appreciation of death, which I took to mean that they were prepared to contemplate death rather than demonstrate avoidance of the topic, and that they may have reached a level of acceptance and peace about its inevitability and certain randomness about when it might occur.
I found this list fascinating, and it led me down various rabbit holes. The first was to attempt some sort of self-assessment. Lo and behold, I think that I would fit the second chancer profile quite closely overall, and more closely than I would have before my cancer diagnosis. I think I have learned to live more in the present, to appreciate life and its awesomeness and to accept my own fate, trivial in the wider picture but still powerful. I think I am marginally more concerned for others than previously, even if kindness remains a challenge for me. I feel I already had some maturity of opinion when it comes to spiritual and religious matters, and these positions may have deepened somewhat. Appreciation of death certainly fits the new me very well. Worldly achievement has not mattered a lot to me for some time now. I do find myself searching for purpose a bit more than previously. The only one from the list why I feel myself moving in the opposite direction is my engagement in wider society, which I something I consciously try to disengage from now, especially living in the USA in 2024.
If I am indeed a good fit for the second chancer profile, what does this imply? I cannot really even claim to be second chancer yet, so soon after diagnosis. But perhaps the fit implies that I have made good emotional progress in accepting my situation and making the best of it. That emotional analysis we were sucked into at the start may have worked wonders after all, and this sort of self-analysis might be helping too. I have certainly been lucky in my wider life situation, especially the existence of strong relationships in my life.
I do sense that most of the attitudes on the second chancer list are healthy ones. That led me to second study, which examined how this same list of attributes changed over time. If this list characterises second chancers after ten years, does it still hold true after twenty? The answer from the second study was a resounding yes. Eight of the nine descriptions still hold, equally strongly. The only exception is the engagement in societal causes, which seems to diminish over time, compared with a control group. I noted smugly how this was the one attribute that did not apply to me, at least in my self-assessment. Does that make me, a second chance rookie, more typical of a twenty-year veteran survivor than a ten-year one? That seems to be the case. It probably means nothing at all, but I can’t think of any interpretation that would be anything but positive.
Does fitting the survivor profile make longer survival more likely? That is a complex statistical question, but it does feel possible. If it is true, does it make the profile a valid goal for therapy, whether self-therapy or the professional kind? And if so, the value could accrue to anyone, so why wait for a near-death experience? Again, that feels possible, even if some of the attributes feel like outputs rather than inputs, and therefore not things we can work on. As an example of this, it seems to be accepted that maintaining a positive attitude helps one face cancer, but there is no point in telling somebody to have a positive attitude, since that attitude is a result of many inputs, several of which we cannot control. Telling me to have a positive attitude is about as helpful as telling me to sing without vibrato – I can acknowledge the goals but lack the tools to achieve them.
My last rabbit hole was to compare the theory with my own anecdotal evidence. It has surprised me how many of the people who have reached out to me and piqued my interest since my diagnosis are second chancers themselves or are very close to one. I hear many personal stories nowadays. Some I follow with only a shallow interest, such as the ubiquitous tales of grannies who smoked like chimneys but lived to ripe old ages, and the tales that claim miracles or divine intervention. But I feel privileged to have become privy to some of the other stories, and I have frequently been moved by them. And the purveyors of such stories do generally seem to fit the survivor profile from the studies.
That leads me to one more tentative but optimistic conclusion. Survivors, and others sharing the second chancer profile, do seem to be interesting people, people who can make my own life richer. If I manage to graduate out of the rookie class, I can only assume that I am likely to come across more such people and more of their interesting revelations. That is yet one more reason to celebrate.
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