Change, Fear and Acceptance in A Cancer Diagnosis

When something big happened at my kids' elementary school, the principal, in response to parents' concerns, said, "You are afraid of change." I remember bristling at her dismissal, at her efforts to make our fears fall into the categories of uneducated, unsophisticated and misguided.

This happened about nine years ago and it still comes back to me whenever I'm confronted by change. In some ways, the effect of those long-ago words is a positive—hearing her voice in my head forces me to look at what is happening around me or in my life and question if it is fear that's guiding my response or thoughtfulness.

As a cancer patient, and maybe even especially as a metastatic cancer patient, there are a lot of opportunities to think about change. Like other people with chronic diseases (I’m going to dare to call it chronic, which for this patient is a big deal), I do not have an end in sight for treatment. I am nearing two-and-a-half years in active treatment and every visit to the hospital is an exercise in accepting change. There are new nurses, new desk staff, construction starts and ends, and, most of all, there are new patients.

I definitely do not count as a new patient anymore, but even as an "old timer" In my treatment, I am forced to accept change with each visit since I do not have a "regular" as a chemotherapy nurse. I've never asked if this is because of the nature of my disease or if all patients at my particular hospital are treated similarly. The effect of not having a regular nurse is both good — I eventually meet all the new nurses and can greet those I already know, and bad—I don't have someone who I know will be treating me when I come in. I have to search out the familiar, friendly faces and catch their eyes as they focus on others.

For most of us, it's reassuring to have patterns we can expect and to be secure in the knowledge that things will not change in unexpected ways. A cancer diagnosis throws all of that at the wall and then steps on it as it crashes to the floor. No wonder cancer patients sometimes explain how they feel as experiencing post-traumatic stress. Living in constant fear and uncertainty of any type does a number on you. Living with fear and uncertainty year after year is not sustainable, yet that is what the person with metastatic disease must do. It’s either learn to live with it and accept it or live in denial.

So I've become even more active in listening to that principal's words from long ago. I think it is natural to fear change, in part because the word itself is so often associated with something negative. When there's a "positive change,” we name it: "I got a new job!" or "I won the lottery!" But when it is a negative change, we simply call it change or try to shield ourselves from what we're actually feeling. We say, "It's a new opportunity" instead of admitting how scared we are that a treatment stopped working.

But I think acknowledging that fear in real words while still working to accept whatever change is ahead is worth the effort. Change we can’t control is scary. There's a reason we are afraid when confronted by it. That doesn't mean we shouldn't think deeply about what a particular change means and move forward. Even a cancer diagnosis, as big a change as it is and as scary as it is, can be accepted into the makeup of a person. I know that's true because even as I face fear and uncertainty and change, I eventually — usually — reach acceptance. Acceptance won't save my life, but it will allow me to enjoy the love I have for it.