When being “right” does no good…
Kathryn E. Vinson, MS, CCRC
A friend recently told me of an article he read that stated that some people with preventable cancers avoid going to the doctor and getting diagnosed, despite the presence of symptoms. It seems incredible that anyone would avoid diagnosis and treatment, but sadly it is happening. But why would anyone do this? In many cases, it is because they don’t want to hear “I told you so.”
In my family we talk a lot about the choices that we make and how those choices influence our lives. Whether we are discussing if we go out to eat or stay in, what major to undertake in college, or our health and lifestyle choices, these choices can all have profound impacts on our lives. Some of these impacts are positive, and some are negative, but in all cases the old cliché holds true – hindsight is 20/20. Let’s takes some time today to talk about preventable diseases, screening, and our reactions to those around us when they receive a devastating diagnosis.
What the numbers tell us
When we talk about choices and our health, its easy to point out the major hazards – smoking, obesity, too much red meat, excessive drinking. The vast majority of us know that these things are bad for us, but a lot of us still continue down these paths. They increase the risk of not only multiple cancers, but other conditions such as emphysema, COPD, liver disease, diabetes, heart disease, and many others. Looking at cancer, we all know that early diagnosis is key. Here are some survival rates of various cancers when found early versus late stage disease.
|Cancer Type||Stage 0 or I (regional disease)||Stage IVa-IVb (distant disease)|
|Lung Cancer (non-small cell)||60%||6%|
|Prostate Cancer||Almost 100%||30%|
Clearly, early detection is key – that is why I also bring up cancers such as breast and prostate, as well as those that are more commonly thought of as preventable. Skipping mammograms and avoiding prostate exams can be just as dangerous as smoking or consuming too much red meat.
When there is more to the story
It is fairly easy for people on the outside looking in to say, “Well, they knew the risks, but did it anyway.” But, from the inside looking out – it isn’t quite that simple. No two cancer patients are the same, and the events that lead to the development of the disease and their diagnosis vary greatly. There may be many reasons that a person might avoid the doctor and a diagnosis. Let me give you a couple of examples.
Just prior to my grandfather’s death following a fight with lung cancer, he looked at my mom and asked “Joni, did I quit smoking too late?” Mom shrugged and said, “Maybe, but what good does it do to go down that road right now?” The simple answer was yes, a lifetime of smoking caused his cancer. But its deeper than that. He was a WWII veteran that survived Iwo Jima, Bougainville, and Guam. Although he was never diagnosed, his having PTSD was an almost certainty. He told us that during the war, when a man would display anxiety, someone would throw him a pack of cigarettes as a method to soothe nerves. This coping mechanism is one that lasted his entire life. Do we throw stones at a veteran for an addiction that was formed before anyone knew about the dangers of smoking? While Grandpa didn’t avoid his diagnosis, it would have been easy for people to place the blame on his shoulders alone. Like Mom said – what good would that do?
Another instance I want to share with you is that of my best friend’s grandmother. Fran’s Granny had been having problems with her GI tract for a long time. Fran had many conversations with her, urging her to go to the doctor and be honest about her symptoms; however, Granny was an old-fashioned southern lady that couldn’t bring herself to discuss bowel movements and the like with a doctor, especially a male doctor. She told Fran that to do so would be “unseemly.” When she was finally diagnosed with colon cancer, there was little that could be done aside from comfort care. Granny had lived a life of “a proper lady.” In her mindset, it would be not only undignified, but bordering on wrong to discuss bathroom issues, especially with a man.
In both of these instances, it would have been easy for anyone to say “I told you so.” My grandfather could have quit smoking twenty years earlier when the dangers of smoking came to be known. Fran’s Granny could have gone to the doctor immediately when her symptoms began. Maybe it would have made a difference, maybe not. Both of these people were fighting deeply ingrained thought patterns and feelings.
Sadly, cases like these are not uncommon. Ladies refusing mammograms or pap smears due to discomfort. Men forgoing prostate checks due to embarrassment. And there is the ever present – I just didn’t have time. Another common reason that people give for not having screenings is lack of symptoms. Remember than many diseases are silent in their earliest stages – but can be found via regular screening examinations.
The cost of screenings is also a concern to many people. Please know that in the US, routine screenings are covered by most health insurers. If your physician feels, for one reason or another, that screening earlier than routine guidelines is necessary, he or she can include this information in filing a claim. If you are uninsured or underinsured, talk with your doctor’s office about reduced rates, cash prices, and payment plans. Many areas also have charitable groups that fund screening for those in need. Don’t let the cost of a test take away your future.
Holding your tongue
Remember when we were kids and our parents told us, “If you can’t say anything nice, don’t say anything at all”? I think that is such an important thing to remember when a loved one receives a cancer diagnosis (or the diagnosis of another disease) happens. Is your anger justified? Sure it is, just like the patient’s anger is completely understandable. You have the right to a whole host of emotions and that is perfectly normal. But trust me when I tell you that everything you feel, the patient feels ten-fold. They know how you feel, because they feel even worse. Before you deliver a lecture on life choices, or the dreaded “I told you to stop…” take a deep breath and ask yourself – what good is it going to do? Are you saying these things to help the patient, or to blow off some steam for yourself?
Be there for your loved one. Listen to them. My grandpa apologized to us so many times over the course of his illness. The best thing to do is just give a hug, hold their hand, or kiss their forehead and maybe say, “I know you are, but its okay.” And mean it. Forgive. Your loved one needs to hear it. Forgiveness isn’t one sided. It heals on both sides and that is so important.
Let it go
With all that being said, caregivers and other family members do need to be able to vent. Whatever emotions you may be feeling should not be kept inside. Find someone that you can discuss frustrations, sadness, anger, etc. with in a free and open manner. Holding in emotions can wreak havoc on our immune systems. If you are a caregiver, please take a look at our page dedicated to Caregiver support.
We can’t change the past, but we can learn from it. Not only learning about healthy lifestyle choices and prioritizing screenings, but we can also learn from our reactions. I don’t think there is a single person among us who hasn’t reacted poorly in the past to various situations. While we can’t erase those moments, we can learn from them and do better in the future.
Strive to be a person that others can come to with their concerns. Be an advocate for cancer screenings. Turn your emotions into something productive.
As always, much love, many prayers, and abundant blessings to all of the warriors out there!