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Encouragement

  

Support > Patient-to-Patient Support or Getting Started > Encouragement

Last update: 04/28/2008

 

Encouragement . . .  see also menu below

Probably nothing in life is more stressful than the diagnosis of a cancer, and it makes you wonder if we were meant to know (wired to know) too much about dangerous medical conditions - considering that during the majority of human evolution there were no diagnostic tests. 

What I think needs to be conveyed to the newly diagnosed (and their caregivers) is that blood cancers are generally more treatable/curable than other cancers, ... reversible even at advanced stages.

Depending on the type and grade, a lymphoma may be cured or it may be managed well - treated minimally as needed. 

There are about 30 or 40 types of lymphomas, but the two main categories are indolent (slow growing) and aggressive. The aggressive type (DLBCL, Burkitt's, etc.) is treated with intent to cure. For the indolent type (follicular, MALT, etc.) the approach to treatment varies considerably - sometimes, but not commonly, treatment is never required. 

Lymphomas are systemic conditions ... the cell of origin being a lymphocytes, an immune cells, which by design can migrate anywhere in the body to fight infection. 

Normal lymphocytes react to an infection by increasing in number in order to disable a pathogen (bacteria, virus, fungus, etc). When the job is done, these cells self destruct or differentiate into other forms of lymphocytes. Indeed, when evaluating enlarged lymph glands it can be challenging for the pathologist to distinguish between benign reactive conditions and a lymphoma.

Lymphoma cells are abnormal lymphocytes that act similarly but have lost growth and survival controls. These cells (all clones of one cell) either grow too fast, or fail to self-destruct - the growth and survival is independent of immune function, or at least partially. 

See for more detail: http://www.lymphomation.org/about-lay.htm

The good news is that lymphocytes, normal and abnormal, are generally highly sensitive to systemic therapies and radiotherapy. Consider how quickly normal blood counts drop in response to chemotherapy, even at low doses. Also, unlike solid cancers, there is a reserve of stem cells which will replenish the supply of blood cells after treatment, and these cells are less sensitive to standard therapies for lymphomas. 

See for treatment types: http://www.lymphomation.org/treatment-types.htm

I hope this little overview helps to relieve anxiety a bit. This is not to say that lymphomas are not life-threatening conditions ... they most certainly are, or can be. And the risk varies by type, and within types - sometimes, for example, follicular NHL never needs treatment, but for most it does. But unlike other cancers, current therapies can be very effective, sometimes curative, and the outlook for additional clinical advances is genuinely bright. 

Karl Schwartz (President, Patients Against Lymphoma)

Carol Lee on adjusting to the diagnosis  From Despair to Peace 
Most I stay positive?   (A Positive Outlook is Overrated)
Lana on positive thinking Positive Thinking

Also read: THE TYRANNY OF POSITIVE THINKING -  PDF
Andrew J M ... poetic allegory  the resolving of fear stemming from the diagnosis of MALT lymphoma
Paul Klein ... sage advice & humor Who gets cancer?  Why me!
10 Commandments for Cancer Survival
LovesToRead What Cancer Can't Do and My Journey with Lymphoma
Support groups & Patient stories & Help Support Groups Make a Difference | Subscribing to Groups Page 

Patient Stories  |  Anxiety & Depression - Psychosocial support

Living with the "beast" -  Tips, Patients Helping Patients

Ken: having this type of cancer isn't "THE END"

Encouraging Treatment Developments  Lymphomas versus solid cancers 

Incurable but treatable indolent lymphomas?  

Research has and is continuing to making a difference

NEW: Tarzan - Another vine waiting for me

Essential reading

Patient recommended Books 
 

How to Talk to Partners - Allan Grossman

Dr. Jerome Groopman, author of ‘The Anatomy of Hope,’ discusses "True hope" and it's importance to survival - MSNBC  "When a patient finds true hope, it's very different than optimism."

Kevin Berry guidance called - Unpanic 

  1. Stop Panicking
  2. Activate Your Network
  3. You Are In Charge
 
Jay Gould's encouraging essay: The Median isn't the Message 
 
What To Do When You Don’t Know What To Do: 
  
10 Bright Ideas For Cancer Survivors and Caregivers - Cancer Crusaders - PDF 


The Shock of Diagnosis:

The diagnosis of cancer and setbacks in treatment can sometimes trigger the following strong feelings and emotions:

Shock, and disbelief

Paralyzing fear and anxiety of the future

A preoccupation with the word "cancer"

A heightened awareness to any physical aches and pains

Grief for what is thought to be the loss of your life goals and plans.

Concern about the unspoken and yet obvious reactions of others who know of your diagnosis

Becoming overwhelmed by the enormity of decisions to be made, some of which must be made very quickly

Feelings that this is unfair to yourself and to your loved ones

Confusion and lack of control and feelings of uncertainty
 

Must I keep a positive outlook?

I believe that there is no one right way to cope with all of the pain of living. 
As an academic psychologist, I know that people have different temperaments, 
and if we are prevented from coping in our own way, be it "positive" or "negative," we function less well.

 (A Positive Outlook is Overrated)

I hate when people try to blame the patient so it's good to know we don't 
have to stay positive all the time or risk dooming ourselves to an earlier demise.

That being said, I believe there are lots of pluses to trying to stay positive as much as possible. 
I figure that cancer may eventually take me (notice the word may, I'm still not willing to
 treat it as inevitable, still hoping to die in my sleep when I'm an old lady). 
If I waste today worrying about that future then I'm wasting the time I know I do have--now. 
At the end of my life I don't want to look back and see that I let cancer steal the time that I did have.

That doesn't mean that I don't have the occasional melt-down pity party. 
So it's good to know that those moments aren't going to hasten my departure.

--------------------
Sylvia

But Shock and Disbelief often Subsides ...

The diagnosis of cancer is impossible to describe to others ... who have not experienced it.

It takes your breath away, and you may feel that you are drifting away from the world. 
Events, sounds, and the day-to-day preoccupations of life may lose meaning.

The sadness and confusion you feel can be overwhelming ... 
as you grieve the loss of your dreams and expectations.

Please know that these feelings are normal and that they will subside when 
you learn about your disease ...  and begin to realize 
that life can be rewarding, full, and enriching after the diagnosis.

Indeed, many patients report finding themselves through the experience. 

 But this ‘good news’ will take some time.

 - Karl Schwartz (caregiver) & Carol Lee (survivor)

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How do I get support without feeling like I’m a failure at handling this?

Support Groups Make a Difference:

If you look, you will find a community of individuals who have been where you are now and who are willing to help you understand the many choices that you will face. 

See the Support Groups page for a list of online support groups to which you can easily subscribe or unsubscribe with one click.  The wisdom of many of those who have traveled this same road has been gained one step at a time, and these fellow-travelers will help you as you take those steps for yourself.  

 Do I have to be a ‘joiner’ or reveal everything about myself if I join an online support group?

You don’t have to be ‘a joiner’ to do this, because, while you can post questions by e-mail, it is perfectly fine to remain anonymous and just read what others are sharing (this is sometimes called ‘lurking’).  Most members do not post, or do not post often.

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Lymphomas versus "solid" cancers

It's common to be diagnosed with lymphoma at an advanced stage (III or IV) and with bone marrow involvement. While this might seem alarming, you should know that advanced stages of lymphoma can be treated successfully, and that lymphoma in the bone marrow is as reversible as lymphoma anywhere in the body.

One way to understand this is to compare lymphoma with a so-called solid tumor, such as a prostate cancer.  Here the cell of origin does not normally exist anywhere but in the prostate.  So when you find malignant prostate cells in the lymph nodes, or in the bone marrow, you have a big problem.  Compare with blood cells that we expect to move anywhere in the lymphatic or circulatory system, including the nursery for these cells, the bone marrow.

Another favorable aspect of blood cancers is that they are generally much more sensitive to treatment than "solid" tumors, probably because blood cells are more poised to self-destruct, and they can also regenerate more readily from stem cells in the marrow.  Consider that the main side effect of chemotherapies is a drop in blood counts, but not the destruction of normal prostate or breast cells ...

We're not suggesting that lymphoma is not a life-threatening disease.  It is.  But we know that many types of lymphomas can be managed well, other types can be cured, and the potential to make additional progress against this family of diseases is real. 

Incurable but treatable indolent lymphomas?

Carol Lee (a lay person with MALT lymphoma) explained:

In the case of low-grade lymphomas, the word 'incurable' does not mean what we would commonly believe. I think 'incurable' is usually associated with  'fatal', perhaps...can't be fixed, it's going to get you, etc.  What 'incurable but treatable' means is that low-grade lymphomas can be  treated along the way, with most people experiencing remissions during which  the lymphoma is not at all active or causing any harm. 

It is my understanding that (for now) it cannot be said that a low-grade lymphoma will be totally cured, because the cells divide so slowly that treatments can't get every last one of the little buggers, as they may with  aggressive, rapidly dividing, cancer cells. But that does not mean that it can't be cured so you will die from it--as is true in other cancers, like  metastatic cancers, for example, that can be treated but not finally cured  and which are terminal.

I hope that makes sense. I also know when we first knew 'incurable' that was very frightening--mostly because of what that word means when applied to the other cancers.

Treatments are Getting Better, and the Best is Yet to Come

Please realize that very talented professionals and institutions are working to solve the problem of lymphoma, and that the experts are optimistic are truly optimistic that we will cure many more cancers and better manage others in the near future.   

Aggressive lymphomas can be treated effectively and is often cured with standard therapies that have been improved, and will continue to improve.  

Indolent (slow-growing) lymphomas—while generally not curable with standard therapies, there is much we can do to manage this form of the disease. Better therapies with lower toxicity are in development.  New treatment agents like Rituxan that target specific receptors on malignant cells are available now. And many experts believe that we will be able to cure indolent lymphomas if not control it - as we would a chronic condition such as diabetes - now and even better in the near future.

NOTE: The five-year relative survival rate for non-Hodgkin's lymphoma patients has 
risen from 31% in 1960 to 52% in 2001. - LLS  

Improved survival of follicular lymphoma patients in the surveillance, 
epidemiology, and end-results (SEER) program. ASCO 2004 ~ Abstract No: 6578 

More New treatments 

Aggressive combination treatments, such as CHOP and Rituxan, are producing durable disease free remissions and a hope for a cure in some patients with indolent lymphomas. 

New treatments such as Bexxar and Zevalin can work as well as chemotherapy, without many of the wide-spread side effects associated with chemotherapy. 

New agents and investigational immune-based therapies, such as Idiotype vaccines, are available to patients who participate in clinical trials.  Additionally, research into identifying molecular targets in lymphoma give more reason to be hopeful.  

Daily we read of advances in the science of understanding and treating lymphoma, which have already led to a growing list of promising therapies and targets for treatment and the National Biospecimen Network is sure to accelerate the rapid progress we have seen in just the last eight years:  Rituxan, Zevalin, Bexxar approved, and many dozens of new and exciting treatment candidates under development and FDA assessment.

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Is there anything else I can do to help myself?

Life-Style Changes?

Many patients make life-style changes after diagnosis to help them tolerate treatments, improve their general health, to possibly slow progression or enhance treatment efficacy and safety, and to improve quality of life.  

To help with these goals, we've created a Life style page, which includes information on natural medicine and diet. We include links to supporting studies so that you and your doctor can decide if a particular supplement or life-style change is safe and appropriate for you. 

Resources:

“You have cancer,” says the doctor, and your life is turned upside down.

For a free magazine subscription--go to www.curetoday.com 

"I have found the magazine CURE to be a wonderful source of information and inspiration. I found mine in my oncologist's waiting room and quickly filled out the mailer for my free subscription to start. Since receiving it, I have shared it with others who were equally surprised at the wide coverage of new discoveries, coping skills we can develop, nutrition tips and just general cancer related information." 

June, nhl survivor

 

  on A Positive Outlook is Overrated NPR

The Tyranny of Positive ThinkingPDF

I got really depressed when people said I should think positive. I thought, "If that's what I have to do to survive, I'm never going to make it."

How to Talk to Partners - Allan Grossman
Dr. Jerome Groopman, author of ‘The Anatomy of Hope,’ discusses "True hope" and it's importance to survival - MSNBC

"When a patient finds true hope, it's very different than optimism."

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Disclaimer:  The information presented on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright © 2004,  All Rights Reserved.