This book is about actions! 

Actions you can take from the very beginning and continue all the way through a cancer patient's recovery. What is important is to do the things that will really help the patient. Make them feel better now and in the long run. Try to help them have a better chance of succeeding in the fight against their disease.

In order to be a true helper, start out trying to understand how the patient feels. That is not what they say or how they act, but their true deep down feelings. To do this you must understand what they are going through.

They have been told they have cancer. It is impossible to appreciate the gravity of that short statement if you have not yourself been told this. Cancer is the most feared disease in America. All our life, we have been raised to understand that cancer kills. We have been told it is a horrible disease accompanied by pain, suffering and treatments that are probably worse than the disease itself. Even though we might not recall them at the moment, our subconscious recalls individuals who have had cancer, all of whom suffered and died. Supposedly cancer means pain and imminent death.

This is probably the first time the patient has had to seriously face their own mortality. Sure, we're all told from childhood that someday we will all die. But that is someday. Now they are told that someday is here. Wow! No matter what the age of the patient, it is like trying to get a child to leave a game arcade. They want to play just one more game. It is not unnatural to think about dying, but the important thing is to concentrate on living. 

How suddenly their whole life changed! Cancer is often discovered by a doctor looking for the cause of a minor complaint or accidentally on a routine physical exam. One instant they are perfect or have a small complaint and the next they are told they have cancer, a term they know to be painfully fatal.

Next come all the psychological reactions. These are not isolated or occasional events, but in talking with cancer patients, happen universally to all those diagnosed. "Why me?" "What did I do to cause this?" "What did I do to deserve this?" "Who did I hurt?" "Where did I go wrong?" "So many others will be hurt because I have failed." The guilt trip is immense!

"I'm so angry." "Why now?" "Just when things are starting to break for me." "Just when I'm starting to succeed." "Just when I'm starting to have fun." "There's no justice in this world." This anger is often vented at the health care system, at oneself and those who help the patient including the supporter.

Talk about being scared! From every standpoint this is the most frightening thing that has ever happened. What is being scared? It is not knowing the future and fearing what it might be. And that fear has no bounds. It runs from death to treatments, to incapacity, to not knowing where to turn, to financial burden, to exposing their body and their thoughts, to who is going to care for others, to everything imaginable. 

And isolation! "No one else has such a bad problem." "Everyone else is so happy and going about their business." "This is so rare." "I don't want to burden others with my problems." "I don't believe anyone else wants to be around me." "No one really cares." "I can't count on anyone." "They give me lip service but they really don't mean it." "I can't trust anyone anymore." "Maybe I can curl up in a corner and it will go away." 

Then there is denial. "They made a mistake." "I really don't have cancer." "You read about these medical errors all the time." "I feel too good to be that sick." "Maybe the doctor got the wrong X-rays or maybe he mis-read them." "Should I just forget about it and see what happens?" 

The list goes on and on. These are the universal feelings of every individual we have talked with who had cancer. These feelings are normal, natural and expected. A supporter will have comparable reactions. It's okay, and we should not feel guilty about it.

Whether the outlook for recovery is good or poor, the days go by, one at a time, and the patient and family must learn to live each one. It's not always easy. On learning the diagnosis, some decide that death is inevitable, and there is nothing to do but give up and wait. They are not the first to feel that way.

Orville Kelly, a newspaperman, described his initial battle with the specter of death. "I began to isolate myself from the rest of the world. I spent much time in bed, even though I was physically able to walk and drive. I thought about my own impending funeral and it made me very sad." These feelings continued from his first hospitalization through the first outpatient chemotherapy treatment. On the way home from that treatment, he was haunted by memories of the happy past, when "everything was all right." Then it occurred to Kelly, "I wasn't dead yet. I was able to drive my automobile. Why couldn't I return home to barbecue ribs?" He did, that very night. He began to talk to his wife and children about his fears and anxieties. And he became so frustrated at the feelings he had kept locked up inside himself that he wrote the newspaper article that led to the founding of Make Today Count, the mutual help group that now includes several hundred local chapters.

Each person must work through individual feelings of possible death, fear and isolation in his or her own good time. It is hard to overcome these feelings if they are never confronted head on, but it is an ongoing struggle. One day brings feelings of confidence, the next day despair. Many people find it helps considerably if they strive to return, both as individuals and as a family, to their normal lives.

Only when you thoroughly understand the patient, can you help. They are out there cold and alone in a totally strange place they have never seen and don't know where they are going or what they are supposed to do. With that in mind, where do you start out to help?

First, understand some truisms about cancer:

1. Cancer is the most curable of all chronic diseases.

2. There is no type of cancer for which there are no treatments!

3. There is no type of cancer from which some people have not been cured!

Next, make a list of things not to do:

1. Sympathy for the sake of sympathy doesn't help anyone. Show your compassion followed by a positive, constructive statement. An example would be, "I'm sorry you have to go through this ordeal, but be grateful that it was caught at this time and medical treatments have advanced so greatly."

2. Tears and sorrow are for the dead, not the living. When you are with the patient, cry with the patient, not for the patient. It can lead to meaningful conversations.

3. Never lie or state anything that is not a fact. It will ruin your credibility and come back to haunt you. For example, never say "I know you are going to get well." You can't possibly know that and the patient realizes it. Therefore, anything else you said with that would be ignored. However, it is possible to state any negative comments in a positive and constructive vein. "It's very serious, but we're going to do everything in our power to beat it" is an example.

4. There are no secrets from a cancer patient. Be totally open and honest, but with tact and optimism.

5. Do not classify in your own mind the patient as a statistic. This can cause you to harbor false feelings and your feelings have a way of coming through.

6. Do not encourage a feeling of futility. The patient's actions might make a difference in the outcome and will make a difference in the quality of their life.

7. Do not discourage work, prayer, exercise or diet.

8. Do not make a prognosis.

9. Do not make decisions for the patient that the patient is capable of making.

10. Do not fail to express love, caring and concern. Let the patient know how much you are hurting and the anger you are also feeling.

To summarize, your friend or relative is going through a traumatic time in their life. They don't need your sympathy. They need your help, support and direction. Do not say, "John, it is so terrible" or "John, it's such a shame." Do say, "John, we're going to do everything we can to try to get you healthy again."

Chapter 2 Making a decision to fight