Thoughts from a Doctor…..

Excerpts by Dr Anthony Perre, Cancer Treatment Centers of America (CTCA)

PART 1 “As a Doctor, I Thought I Knew Cancer Inside and Out. Then I Found I had it”. ‘Now that I’ve been through cancer, my life seems to be full of clichés. What doesn’t kill you only makes you stronger. There’s no time like the present. And especially pertinent for me, never judge another until you walk a mile in their shoes. I know now that these aren’t just clever sayings – they’re wonderfully true and full of life lessons.

At the age of 38, I was diagnosed with Hodgkin’s Lymphoma. The road ahead included chemo and radiotherapy. Because I am a doctor, I thought I knew what to expect. And, on the medical/physical side of things – I was pretty spot on. But there was a whole other aspect to surviving cancer that I was nearly clueless about: the extensive range of emotion I’d experience, plus the psychological toll. The things that came into play long after the final treatment. The things I now consider to be some of the biggest challenges to survivorship…. To living life as fully as possible after cancer.

One of my favourite examples is when a patient gets to ring the ‘end-of-treatment’ bell. Most patients on their last day of chemo or radiation are surrounded by nurses and loved ones as they ring a celebratory bell. I’d heard this bell ring dozens of times and always thought, ‘What a happy moment; that patient’s ordeal is done’. For eight weeks, I counted down my treatments, crossing each date off my calendar as I completed another round of chemo.

Finally! The last day had arrived and it was my turn to ring the bell. But I wasn’t feeling the elation I expected. Yes, I was relieved, but I remember feeling a little panicky and anxious. ‘What if the treatments haven’t worked?’ And believe me, these feelings didn’t go away after the scans gave me the all clear. There was always a voice in the back of my head whispering, ’you’re fine now, but it can come back you know’. Moreover, I experienced what I’d call separation anxiety from my oncology care team. All during treatment, I was under a microscope, everyone was on the lookout for the cancer and firing on all cylinders to send it packing. But what now? Who’s looking out for me?’

PART 2  “Despite being a physician in a cancer hospital, I wasn’t superman. I experienced all of what you hear about if you’re close to someone with cancer”.‘I remember the real and strong anxiety that hit a few days before a scan and needing my wife to ‘talk me down’. I was frustrated with the fatigue, months after I thought I should have been over it. I’d survived cancer, but the quality of life I wanted just wasn’t there yet. Everyone was saying to me, with the best of intentions, “You made it! You’re cancer-free. You must be so happy”. And while of course I was grateful, I felt very guilty for not being completely satisfied…. yet.

This was a time when I also learned what survivorship is all about. For me, it meant taking a step back and asking myself why I went through all that treatment in the first place. I wanted to be able to continue to do the things that I enjoy in life and to discover more pleasures. I chose to see my diagnosis as a temporary roadblock to planning my life, not as the inability to ever make another plan. I realised these things were possible as long as I didn’t let my fear and anxiety get in the way. I just had to ask for and accept help and support. I realised that life is too short to allow over-thinking to get in the way of doing’.

PART 3 “Experiencing all that comes with a cancer diagnosis has made me a much better doctor”.‘We aren’t taught about addressing personal ad emotional concerns in med school. But, because I experienced them, when I see patients today, I can anticipate and discuss important issues they might be having like, “ Will I have to leave my job?” and, “Why have my relationships changed?” and “I haven’t had a drop of chemo yet, so where is the nausea coming from (anticipatory nausea was a big factor for me)?” and “My last scan was clear, so why all this anxiety?” I can broach these subjects with knowledge, compassion and empathy. I can validate their feelings. While no two cancer journeys are alike, I can relate and provide assurance that my patient is not alone.

As physicians, we should all appreciate and strive to be excellent clinicians. However, for a patient to be made whole, they require their emotional, psychological and spiritual needs to be met as well as their physical ones’.

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