How Does Cancer Change People for the Better?

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What is Positive Change or Posttraumatic Growth?

Cancer can be life transforming. iStockphoto.com/Stock photo©Delpixart

"I wouldn't wish cancer on anyone, but looking back, there are ways that I'm a better person than if I'd never had cancer."  -  Anonymous

Have you heard anyone say that they are a better person or enjoy life more since being diagnosed with cancer? Chances are, it's more than wishful thinking. Research tells us that most people experience some degree of "posttraumatic growth." Many words and phrases have been used to describe these changes after cancer, such as: 

  • Silver linings
  • The benefits of cancer
  • "What cancer has taught me"
  • Meaning making, sense-making, or benefit finding
  • Life transforming changes
  • The blessings of cancer, or even
  • The gift of cancer

Certainly, nobody would go through cancer by choice, but for the 14.5 million (and growing) people in the U.S. who have experienced the threat to life that is cancer, it may be of some consolation to know that often, there really are silver linings.

While not everyone who develops cancer experiences positive personal growth, roughly one-half to two-thirds of survivors admit to some positive changes. Usually, people can find more positive change the longer it has been since their diagnosis. For purposes of this article, We will use the most common definition of a cancer survivor. ​A cancer survivor is anyone with cancer, from the day they are diagnosed, and through the rest of their lives.  

Posttraumatic growth occurs in many situations which are life-threatening or bring great stress, including cancer. Studies have found evidence of personal growth in people with all types of cancer and all stages of the disease, though the extent and type of change is unique to each person. While the term posttraumatic growth is relatively new, the concept of suffering leading to transformation goes back to the beginning of the written word and is spoken of in most of the great religions of the world.

The following pages describe several types of positive changes noted in research. As you read through these "benefits," think about how cancer has touched your life. Don't miss the final pages, however, which describe these changes in the words of cancer survivors, followed by tips on promoting your own posttraumatic growth.

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Appreciation for Life

Renewed joy and appreciation of life. iStockphoto.com/Stock photo©kieferpix

 "I want to live each day to the fullest!"

 "I've learned to stop and smell the roses."

Most studies on posttraumatic growth in cancer patients have found a renewed appreciation of life to be one of the most common silver linings.

It can be difficult to describe this feeling to someone who has not lived with cancer (or any other similarly stressful or life-threatening condition.) I could call it genuine joy - but again, those are simply words.  

It is the look in the eyes of people at the annual LUNGevity HOPE Summit - many who have never met another lung cancer survivor - now in a room literally full of lung cancer survivors. And of these survivors, knowing many are present only because of advances in cancer treatment that have taken place in just the past year or two.

It is what we see in the unhindered joy of a two-year-old seeing a new bird, or the ocean, or even a ladybug for the first time. That kind of child-like awe and wonder.

Lung cancer survivor Jim Morrison captures this newborn appreciation for life beautifully in his book To See Another Sunrise. The sunrise welcoming in a new day is but one aspect of life that is no longer taken for granted after cancer.

Why don't we appreciate life to this degree before cancer? Well, some fortunate people do.  But many of us see a little less clearly because some of our focus is directed towards the past or directed towards the future. With cancer, people can often live more easily in the moment. Why? There is the unspoken thought that this moment may be all we have.

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Enriched Relationships

Deepening relationships after a diagnosis of cancer. iStockphoto.com/Stock photo©GlobalStock

 "I never would have been as close to my husband if I'd never had cancer."

 "When you have cancer, you find out who your real friends are."

There is one thing that doesn't change with a diagnosis of cancer, that being that there will be change. People that were once casual acquaintances may become your most deeply trusted friends, while some of your  previously close friendships may fade away. Good relationships are strengthened, and poor relationships are let go.

Among relationships that are strengthened, cancer survivors often feel a greater emotional connection. Cancer provides a unique opportunity to be vulnerable and express deeper feelings. This openness can lead to warmer, more intimate friendships.

The deepening of relationships that is common among cancer survivors goes in both directions. Many people with cancer realize--sometimes for the very first time--how important they are to others, and how much their friends and loved ones truly care. At the same time, cancer survivors often develop greater empathy, leading to their loved ones feeling more loved and cared for as well. 

It's important to point out that positive growth is not the same as having a positive attitude.  In fact, depth in relationships is often seen in the ability to openly express the negative emotions that go along with a diagnosis of cancer.

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Compassion for others

Deeper compassion for others is common in cancer survivors. iStockphoto.com/Stock photo©Martinen

 "I want to help others like they have helped me."

Both empathy, the ability to step into another's shoes, and compassion, the heartfelt caring for another, are common among people who have experienced cancer.

Even if you were compassionate and an empath before your diagnosis, personally experiencing the stress of cancer may heighten your awareness of the trials another may be going through.  

If you haven't noted an obvious increase in your sense of compassion, you may still identify with some of the stories of increased empathy I hear so often among survivors. Things such as TV commercials showing hungry children leading to an hour of tears.  I first noticed this in my own life when, finding an injured robin in my yard, I broke speed limits in tears as I rushed it to our local wildlife rehabilitation center.  

Thankfully this silver lining is one that keeps on giving. I've had several people tell me that the best way they know to cope with the anxiety and uncertainty that goes along with "scanxiety" and fear of recurrence, is reaching out to help others coping with cancer.

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Empowerment

Tackling cancer can lead to a sense of empowerment. iStockphoto.com/Stock photo©Yuryimaging

"I feel like I can do anything now."

"I used to get physically ill when I had to speak in front of a group, but now it's not a problem."

A lung cancer survivor once told me that being diagnosed with lung cancer was like having to solve the hardest problems on a test, in a class she didn't want to take, and her life depended on it. She then told me she was considering taking calculus for fun; she despised math when she was in school but thought that now it would be a piece of cake. 

A diagnosis of cancer forces survivors to develop problem solving skills and coping strategies unlike anything before. Cancer is a crash course in navigation that starts with on-the-job immersion training the day you are diagnosed and requires charting a sometimes erratic course through treatments and specialists.  

It's a blessing that for many cancer survivors, these newly developed and honed skills can be helpful in facing challenges unrelated to cancer as well. Studies tell us that the skills gained in navigating cancer carry through to other parts of our lives. The resourcefulness that is a by-product of negotiating your way through treatment can help in managing normal life hurdles from preparing a recipe to helping your child choose a college. And the coping skills that come from living even a short while with cancer--well--they are something most of us can benefit from each and every day.

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Strength and Humility

A new awareness of strength and greater acceptance of limitations. iStockphoto.com/Stock photo©Voyagerix

 "I had no idea how strong I could be before I had cancer."

A favorite T-shirt I've seen on some cancer survivors proclaims:"You never know how strong you are until being strong is the only choice you have." Not everyone with cancer would go so far as Nietzsche did in saying, "What doesn't kill you makes you stronger," but many cancer survivors speak of finding "hidden strength" they didn't know they had prior to their diagnosis.

This sense of strength comes with humility - understanding your own limitations, and a greater acceptance of your vulnerability. In other words, most cancer survivors wouldn't consider posing as Popeye. What we often see is a quiet strength--a strength that not only helps survivors cope in other areas of life requiring humble strength, but casts a welcoming and supportive impression to newly diagnosed cancer patients who meet them. In fact, in addition to granting the feeling that "you are not alone," this is likely one of the benefits of cancer support groups.

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Wisdom and Priorities

iStockphoto.com/Stock photo©cacaroot

"Now I now what's important and what's not."

"I've learned to just say no!"

Many people note a profound change in priorities following a diagnosis of cancer. Items that were once delegated to "someday" are transferred from the bottom of the list to the top. Previously urgent activities, seem less urgent. And moderately important activities? They may be eliminated completely.

This change in priorities is not just a temporary change in rank of daily activities due to treatment schedules, but is instead, often, a lasting change in life philosophy. What is important before cancer is different from what is important after cancer.

Work-life balance changes for many people living with cancer. At first, some of the changes may be necessary because of treatment, but lasting changes stem from a change in priorities. If you have been working 60-hour workweeks telling your family you will cut back on work and spend more time with family "someday," that someday may be now. This is true not just for people with advanced cancers with an uncertain survival, but for many people with early-stage cancers as well.This is true not just for people with advanced cancers with an uncertain survival, but for many people with early-stage cancers as well.

One less-than-obvious benefit of prioritizing as a "benefit" of cancer, is that many survivors are able to release long-standing grudges and resentments. It's not just a desire to restore peace, but as one cancer survivor told me: "I realized how much time it takes to hold and maintain a grudge against my mother, and I no longer want to waste that time and energy." Of course, not all resentments are released, and learning to let go to live well with cancer is an ongoing exercise for anyone who interacts with other less-than-perfect humans.

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Health Consciousness and Self Care

Health conscious cancer survivors. iStockphoto.com/Stock photo©monkeybusinessimages

"I really want to take care of myself now."

"I've decided to get rid of processed foods in my diet." 

Studies tell us that a common positive change in cancer survivors is a desire to be more health conscious. Perhaps it is the realization that we aren't immune to cancer, or a desire to prolong life or lower the risk of recurrence, but many survivors adopt a healthy diet and try to increase their daily exercise (within the confines of treatment.) 

An increase in physical health consciousness is common, but many survivors also report an increased awareness of emotional health as well. Important relationships are nurtured, and negative relationships are evaluated. One cancer survivor told me: "I realized I had a lot of friends who were "emotional vampires" and having cancer helped me learn how and when to end a toxic friendship, without the drama.

Responding to many patients desire to incorporate mind-body therapies into their healing process, many cancer centers now provide integrative cancer treatments such as meditation, massage therapy, yoga, and acupuncture, and creative outlets, such as art therapy.

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New Possiblities

Cancer can open your eyes to new possibilities. iStockphoto.com/Stock photo©sad444

"I always said that "tomorrow" I would take time to play the piano and travel to Europe.  Now I have, and I'm looking at the next items in my bucket list."

This "silver lining" may not be intuitive. Why would a diagnosis of cancer--especially if it's a cancer with a poor prognosis--be a door to new possibilities? If you're having a hard time picturing cancer this way, ask yourself: "Is there anyone you would not have met if you didn't have cancer?  Is there any place you would not have gone if you did not have cancer? Are there any new activities you would not have tried if you did not have cancer?"

Most of us meet new people during our cancer journey. It may be at the cancer clinic or in a support group. It may be neighbors or casual acquaintances who seem to come out of the woodwork, often because they or a loved one have experienced cancer. It may be simply that the role you play in your family changes.

When you meet new people, you meet people who enjoy different experiences, and this opens up new possibilities. An example in my own life is a group of breast cancer survivors who now enjoy fly fishing together.

Certainly, early on the new activities and experiences of cancer treatment are something you could live without. Yet even during treatment survivors often begin-- or finally get to--activities they enjoy. It may be that now you are reading those novels you always wished you had time to read.

As time goes on, and with your priority list having changed, you may be looking at items on your bucket list--that dream list of things you've always hoped to do before you die. Why wait?

What have you always wanted to do? Play the piano? Learn to play golf? Travel?

Many of us with cancer understand the benefits of a bucket list. If you haven't started one, today is a good day to begin. And keep in mind: if you get to the end of your bucket list, you can always start a new one.

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Deepening Spirituality

Spiritual growth in people with cancer. iStockphoto.com/Stock photo©raeva

An increased depth of spirituality is very common among people living with cancer.

The National Cancer Society defines spirituality as a person's belief about the meaning of life. For some people, spirituality is expressed through organized religion, for others, this dimension is experienced through the arts, communing with nature, or quiet meditation.  

For those with religious faith, this faith often deepens during treatment. For those who express their spirituality through the arts, they often feel more connected to others who express themselves in this way. For those who love nature, the depth of feeling during a walk in the woods may increase.

It's not that spirituality isn't present for people before cancer. Rather, the "wake-up" call of cancer may be the push that results in life values and life activities becoming more closely intertwined

As an added benefit to this "benefit," spirituality may even play a role in cancer outcome according to a few small studies.

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Cancer Patients Who Have Found Silver LInings

Growth and transformation in cancer survivors. iStockphoto.com/Stock photo©Cathy Kiefer

 I've shared some of the research, but there is nothing like hearing about the positive personal growth with cancer from people who have been there.

In Cancer as Rebirth which she shared in CURE magazine, Tori Tomalia shares her feelings at the second anniversary of her diagnosis of stage 4 lung cancer. She shares the agony as she is shocked by her diagnosis, yet looks back at the positive changes over the past 2 years: "I found a new voice." She says: "A new person has arisen from the ashes. A person who is not afraid to take chances, be bold or speak up." And she clearly has a new appreciation for life: "And someone who understands the painful, beautiful brevity of our time here on Earth."

In this Collection of Lung Cancer Stories, you will find people who have suffered through the trauma of diagnosis, and the pain and fear of treatments and uncertainty. People who at the same time have developed a love for daily life and compassion for others beyond what they knew before cancer. None of us would choose this journey given the chance, but it's my hope that in hearing the stories of others, and what research is telling us, that those silver linings will bring you comfort during the storm.

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Finding Benefits in Your Own Cancer Journey

Finding silver linings in your own cancer journey. iStockphoto.com/Stock photo©2jenn

 You may have identified with some of the research on posttraumatic stress, or perhaps you saw yourself in some of the stories from other cancer survivors who have found silver linings in their journeys. Thankfully studies are also looking at ways that people can maximize their personal growth through their cancer journey. On the other hand, you may be feeling discouraged, and may not even want to think about anything that could be positive about having cancer. I get it - I've been there. During that time a dear friend shared with me this quote: ​"Make a game of finding the hidden blessing in a challenging situation."  - Catherine Sternberg

Here are some ideas on finding and growing the positives:

  • Continue to look for the silver linings.  Some people with cancer don't realize the positive changes that have taken place until they take a close look. Consider journaling your cancer journey. You may wish to ask your loved ones how they have seen you grow since your diagnosis.
  • Check out these tips for savoring your life and for learning to savor the moment.
  • Think about how your most important relationships have improved over the course of your cancer journey thus far. Talk to those people about your feelings.
  • Think of something you would do now that you wouldn't have considered doing before cancer. Or, think of someone you had the chance to meet that you otherwise would not likely have met.
  • Are there things that are more important or less important to you now since you were diagnosed?
  • Becoming more health conscious is not only empowering but may reduce the risk of recurrence for some cancers. Check out the American Institute for Cancer Research Guidelines for Cancer Survivors.

Sources:

American Institute for Cancer Research. Guidelines for Cancer Survivors. Updated 05/22/15. http://www.aicr.org/patients-survivors/aicrs-guidelines-for-cancer.html

Andrykowski, M., Steffens, R., Bush, H., and T. Tucker. Reports of ‘growth’ in survivors of non-small cell lung cancer and healthy controls: what is the value-added by the cancer experience?. Psychooncology. 2013. 22(10):2214-9.

Cormio, C., Romito, F., Viscanti, G., Turaccio, M., Lorusso, V., and V. Mattioli. Psychological well-being and posttraumatic growth in caregivers of cancer patients. Frontiers in Psychology. 2014. 5:1342.

Coscarelli, A. Posttraumatic Growth and Cancer. Simms/Mann UCLA Center for Integrative Oncology. Accessed 06/09/15. http://www.simmsmanncenter.ucla.edu/index.php/resources/articles-from-the-director/finding-benefit-post-traumatic-growth-and-cancer/

Li, Y., Yeh, P., Chen, H., Chang, Y., Pi, S., and C. Fang. Posttraumatic growth and demoralization after cancer: The effects of patients’ meaning-making. Palliative and Supportive Care. 2015 Mar 5. (Epub ahead of print)

Mols, F., Vingerhoets, A., Coebergh, J., and L. van e Poll-Franse. Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors. Psychology and Health. 2009. 24(5):583-95.

Moore, A. et al. A prospective study of posttraumatic growth as assessed by self-report and family caregiver in the context of advanced cancer. Psychooncology. 2011. 20(5):479-87.

Morris, B., Shakespeare-Finch, J., and J. Scott. Posttraumatic growth after cancer: the importance of health-related benefits and newfound compassion for others. Supportive Care in Cancer. 2012. 20(4):749-6.

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