The Bell Curve or Normal Distribution
Where the numbers shown represent the percentage of the whole
The time factors will differ for different cancers and the exact shape of the curve may vary too. But the idea is clear. When a large number of people with a given cancer are tracked, most die around the same time. This is the statistic most prognoses are based upon. Maybe if the doctor is optimistic, it is pushed a little to the right; pessimistic, a little to the left. But the message is clear. This represents statistics.
If you or someone you love have been diagnosed with the same cancer as many other people, their history is interesting and points to what is possible, but not to what is certain. You are a statistically unique event. You could fall anywhere on the curve. That is a statistical fact. That is reality.
The big question then is, what affects where you end up on the graph? Is it simply a matter of statistics and random chance, or will what you do influence the outcome?
Back to horse racing again. If you were interested to back a horse in a race and you knew it was not being fed well, how would you feel? What if it was not well trained? How about if it was one of those horses that did not enjoy racing? Surely, these factors affect the outcome.
So too with cancer. If you embrace a good treatment, what direction will that head you in? If you eat well, will that take you right or left on the graph? Eat badly? If you remain filled with fear and dread, or if you develop a positive, committed approach, what is likely?
Given that everyone is a statistically unique event, everyone therefore deserves to be treated uniquely, to be regarded uniquely. Whether you have been diagnosed with cancer or are helping someone through cancer, your situation is unique. No one else has exactly the same situation as you. No one else has exactly the same body. Your emotions will be different, the state of your mind is bound to vary, and your spiritual realities differ. You are unique.
So two women diagnosed with breast cancer may be described as having the same disease, breast cancer. Just as two men with prostate cancer may both be said to have prostate cancer. Same label, very different situations, very different possibilities. Maybe it is more useful to say one woman by the name of Jane who is diagnosed with breast cancer has Jane’s disease, another Mary’s disease—they could well be that different.
Again, while statistics are useful to generalize, you need a large group for statistics to be useful. The key point is this:
Individuals do not behave statistically. Individuals behave individually.
We are all individuals. If you want an average outcome, do what the average does. If you want a unique outcome, an extraordinary outcome, be logical, regard yourself as you are, unique, and do something extraordinary!
Moving on from diagnosis and prognosis, what about the treatment options? How do you develop a comprehensive treatment plan that is most likely to work and take account of your individuality, your personally unique situation? How to move beyond generalizations and standard treatments, to taking account of individual needs? How do you personalize the appropriate response for your particular situation?
Again, we rely on logic for the framework and then aim to draw on experience, wisdom and insight for the details.
Nearly everyone in the Western world will be diagnosed and consider initial treatment within the conventional Western medical framework. This makes good sense and is as it should be.
Given that the diagnosis and prognosis will be provided by the best medical people available, it is they who will recommend an initial treatment plan. This too makes good sense. Certainly if there were a simple, medical solution to cancer, one piece of surgery, one pill we could take that ensured a cure, we would all do it. You would be a fool not to. But it is not so simple.
Definitions • Curative Treatment, Palliative Care or Living with Cancer?
While the medical treatment of cancer tends to focus on one of two outcomes, to be curative or to be palliative, there is a third option. Let us be clear with the definitions.
Curative Treatment
Curative treatment involves more than what many people imagine it to be, which is to be free of cancer after five years. Actually, curative treatment aims to render the person clinically free of detectable cancer and restore the person to their normal life expectancy.
Palliative Care
On the other hand, palliative care is an umbrella term for assisting those approaching death—a fundamental need and right. It is generally used in the context that death is imminent and inevitable and aims to make dying as easy and comfortable as possible.
Palliative Treatment—Living with Cancer
Palliative treatment is a specific but integral part of palliative care. Palliative treatment can be more interventionist. It is noncurative by definition but aims to extend life, ameliorate symptoms, and increase quality of life in situations where a cure is not medically feasible.
The lines between palliative care and palliative treatment can often be blurred, but these days, palliative treatment is often called living with cancer.
While overall survival rates in the conventional management of cancer may not have improved all that much, in recent years many people are living longer with cancer. This can involve significantly slowing the progression of the disease, minimizing any side effects and maximizing all the quality of life issues. Palliative chemotherapy often plays a significant part in conventional medicine’s management of palliative treatment.
What to do When a Medical Cure is Likely
Now the logic. If a person is offered medical treatment for cancer where there is a high probability of a cure, then, in my view, what to do is fairly straightforward. Embrace that treatment as your main focus while you go through whatever it entails. The common treatment options are surgery—which often comes first—then maybe chemotherapy and/or radiotherapy.
However, right at the start or even better still, before you start your treatment there is more to do. As soon as possible, review your lifestyle and do whatever you can to complement and support the treatment with your own efforts. The details of what this entails follow in the subsequent chapters. Lifestyle medicine will have your body and your mind in the optimal state to get the best out of any treatments and to minimize the potential for any side effects.
When it comes to the complementary, traditional and alternative options, there may well be useful things to consider that will support your body’s healing capacity, minimize or manage side effects and have other useful benefits. These options will be discussed in later chapters as well.
The Choices When a Medical Cure is not so Likely
However, what if a cure is not so likely from the medical point of view? What if at first diagnosis, or further down the track, it becomes clear that a medically based cure is improbable? What if palliative care or living with cancer is all that remains medically? There are three options.
1. Acknowledge Death as the Likely Outcome
This is probably not the option you are opting for if reading this book. However, we do need to recognize