advanced cancer Archives - The Practical Caregiver Guides

There once was a woman who had no shoes. She had a fancy car. She had money. She wanted for nothing. But she had no shoes, at least none that have ever been worn.

Beware! She’s loose among us. You will recognize her by her shoes. Her soles are unmarked. There is not a scuff, not a scratch, not a drop of mud, nor a rain drop, nor a single tear upon them.

How can this be, you wonder? I will tell you. It’s because she has no soul. She has never walked a mile in anyone’s shoes, not even her own.

In this day and age of endless rancor and bitter attacks, we have forgotten to be civilized, and as a result, the most vulnerable among us have suffered grievous harm to the heart and emotional distress for the soul. Case in point?

I have a very dear friend who has struggled with cancer, cancer treatment, and a myriad of complications for several years now. She happens to be one of the finest people I know. She’s a teacher, whose wise counsel has shaped many minds. She’s a mentor to children whose lives have been torn apart by circumstances beyond their control. She’s a loving and kind daughter, who cares for parents now challenged with their own health issues. She’s a writer, whose eloquent voice has inspired so many of us. She’s a musician, whose songs have delighted crowds. And now, she’s a human being who deserves to be defended in the face of an unconscionable attack.

She was recently out in public, hoping to have a pleasant time after suffering through more physical pain than any person should have to endure. Slowly making her way from the curb onto the sidewalk, she was assailed by verbal abuse that spewed forth from the mouth of the woman with no shoes.

Just imagine how much energy it required for my friend to put one foot in front of the other as those words stung. Picture the effort she made to move each leg as her heart filled with tears. There she was, minding her own business, determined to get on with the business of living her life. And what did she get for it? A vicious insult so outrageous that I will not even repeat the gist of it, because it was so very wrong. This kind, tender-hearted soul was attacked by a mean, self-absorbed woman with no shoes. For those of us who love her, our frustration with the injustice of it all knows no bounds.

My sweet friend is a woman of many shoes. She is the light in a dark world. Every sole of every shoe she has worn is marked not only by her own experience, but by the depth of her love, compassion, and wisdom. She has a closet filled with these relics of her journey through life, and each pair has a story to tell.

The woman with no shoes has made no mark of her time here on Earth. Tis a poor, loveless creature that has never known the joy of being, an empty soul that has never known the treasure of having real love shone upon her. I have no doubt that love is all around her, but until she puts on a pair of shoes that belong to another human being, she will see and hear nothing.

Every time we learn from the people around us, we are made better by it. Every time we put ourselves aside and we seek to see the world from another’s perspective, we grow in wisdom and compassion. It’s not enough to recognize the differences that separate us. We must take that understanding and make sense of it. Who we are and what we do defines us as human beings. It is our responsibility to make the world a better place, not through tearing it apart, but by shaping it with loving hands.

If the woman with no shoes had taken a single step in any one of my friend’s shoes, she could have been transformed. That’s how powerful and profound my dear friend’s wisdom is. To embrace life with such zeal in the face of overwhelming adversity has created a superhuman spirit that knows no bounds. We need more superheroes in this day of nasty, vile, antisocial interactions.

But to be a superhero, you must walk in many, many shoes. Not just the comfortable ones. Not just the ones that fit, or look good, or attract compliments. You must slip on the ones that pinch to learn about the pain of being narrow-minded and the ones that are too big to understand how much room you have to grow. Your journey begins and ends with you, and how far you are willing to go is something you must decide. When you become tired of the endless bitterness and rancor, put on a new pair of shoes. And as you wear out each subsequent pair, take what you have learned and share the wisdom. That is the power of shoes that have been worn well.

There was a time when a Stage 4 cancer diagnosis meant a patient only had days, weeks, or maybe a month or two left of living. But over the last decade, with so many advances in treatments, more and more people are living with Stage 4 cancers.

But what does it take to do that?

For the patient:

1. A great medical team that keeps up with physical issues
2. Good support for daily living, medical treatments, and complications
3. Palliative care that enables the patient to be as active and comfortable as possible, by managing pain, addressing social, psychological, and physical challenges

That makes it sound easy to survive Stage 4 cancer, doesn’t it? As long as you have doctors, nurses, and other professionals on board, it’s a slam dunk. Only it’s not.

It’s also about what the patient brings to Stage 4 cancer. What are you willing to sacrifice to survive? How much work are you willing to put into your effort? And who will be at your side while you do it?

Imagine needing to have ongoing chemotherapy treatments that knock you off your feet. Not only do you have to psych yourself up to get to the cancer center for those, you also have to deal with the side effects (short and long term), the complications, and even the logistics of living with Stage 4 cancer.

Not everyone is willing, able, or capable of undergoing such a rigorous and challenging life. But for those who are, their work as survivors is nothing short of amazing. And every time someone accepts the challenge of living with Stage 4 cancer, we creep closer to the treatments that will one day eliminate the disease.

Surviving Stage 4 cancer means having a strategy, a plan. You can’t just wing it. You can’t just meander through your day. You have to be highly motivated to push on through the sometimes daunting challenges. Is it worth it? That’s a question that only the person with the cancer can decide. If you’re talking about surviving, you’re really talking about living.

To live with Stage 4 cancer, you need to:

1. Engage in meaningful activities that enhance your quality of life
2. Have a sense that you are able to manage the challenges in your life to your benefit
3. Feel emotionally, mentally, and physically connected to people that matter to you
4. Have a team of people who can support your true needs and give you what you need to go on

One of the most important things I have learned from Stage 4 survivors is that what we supporters say and do matters. We need to take our cues from the people who are struggling. We can’t assume to know that magic pill that will make it all better.

— It’s not our job to push treatments or give advice. That’s what the medical experts are doing, and they have far more experience in the field than we do.

— Good listening skills are important for supporters of Stage 4 cancer survivors. Recognize the need to vent when things go wrong. Understand the emotions that are strained and realize the toll of the physical, mental, and even emotional challenges of being a Stage 4 cancer survivor.

— When in doubt, offer your love, your thoughts and prayers, your good wishes, your hugs (real or virtual).

— Always open the door to hope. Hope for less pain. Hope for a better day. Hope for success. Hope for positive tests.

Why are these things important? When a person is facing such challenges, it’s the little things that will matter most. An MRI that isn’t all negative is better than an MRI that shows a massive tumor. A complication that has a potentially good outcome is better than one that is devastating and untreatable. When we supporters focus on the positives, we encourage hope in a heart that has already taken a beating. When we recognize that the complications are scary, rotten, disappointing, we share our loved one’s concerns. By balancing our own reactions in an even-handed way, by understanding how very challenging it is to manage Stage 4 cancer, we become the light that shines in that dark hour.

The truth is that Stage 4 cancer survivors live with stress, fear, and worry every day in one form or another. Every new ache or pain could signal a spread of the disease. Sometimes there is a new tumor here, a new tumor there. But the treatments that are currently being used in advanced cancer management often mean Stage 4 survivors are gaining ground.

Who knows whether doctors will soon add a Stage 5 to reflect the new treatments that allow the people we love to continue living with the disease at Stage 4 for years, not months. I think that day will come.

In the meantime, if you know someone who is living with Stage 4 cancer, be sure that you fit your support to that person’s real needs. When in doubt, ask what the person really wants from supporters. Is it encouragement? Is it acceptance? Is it a ride to treatment? Is it the chance to forget that cancer has wreaked havoc with one’s life?

If you really love someone with Stage 4 cancer, reach out and be prepared for the realities of cancer management. It’s scary at times, it’s constantly challenging, and it’s critical that we be there to offer meaningful support. Cancer isn’t for the faint of heart. But for our heroes who insist on surviving it to the best of their ability, our job is to make the quality of that life a priority. Joy, love, laughter, acceptance, and appreciation for the good days is what gets a survivor through the bad times. Those of us who love people with Stage 4 cancer know that our lives are better, richer, and fuller because of them. They live with little miracles every day that open our eyes to what matters most. Love.