EP.10: AFTER CANCER: DR. WENDY HARPHAM, HAPPY IN A STORM

At the age of 36 and as a mother of three with a busy solo practice in internal medicine Wendy Harpham M.D. was diagnosed with stage three non-Hodgkin’s lymphoma, and just like that, the Doctor becomes the patient.

Now, from both sides of the stethoscope, Wendy uses her unique perspective to help patients become healthy survivors, survivors who get good care and live as fully as possible.

Dr. Wendy Harpham is a fellow of American College of Physicians, a best selling author of six books on cancer (Happiness in A Storm is the one I read), a patient advocate and nationally recognized speaker. Now a 26-year cancer survivor with seven recurrences since, Dr. Harpham has a lot to say about dealing with such a diagnosis and still live a full, happy life.

Wendy has something I cannot explain; you have to listen to understand. Her passion inspired me.

I think a big part of fear are the unknowns in what you fear and Dr. Harpham shines a bright light on a very dark thing; she gives hope.

To those of you who do not have cancer. There are many reasons I think you should listen but here are just three.

  1. Statistically, one out of two of you reading this will likely hear “you have cancer” in your lifetime.
  2. You probably know someone who has cancer or has recently been diagnosed.
  3. This is a lesson in dealing with any severe life challenge. Cancer doesn’t own the bad medical news category.

I’m going to do something a little different with this show post.  I’ve asked another cancer survivor and my good friend, Ron Sparks to listen to this episode and write up his thoughts and share them here.  

Enter Ron.

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Hello fellow listeners.  I’m Ron Sparks and I too, am a cancer survivor.  I was diagnosed in August of 2008 with Stage III head and neck cancer – squamous cell carcinoma – with the primary tumor located in my left tonsil.  By the time I was diagnosed, my HPV-caused cancer had spread to my lymph nodes. My battle included surgery, chemo, radiation, feeding tubes, and hospital stays.  

Listening to this podcast really highlighted a lot of the struggle all cancer patients go through and, seen through the lens of a doctor with cancer, it provides a perspective that is unique and compelling. Below I’ve highlighted some – for me at least – of the most thought-provoking segments in the podcast. 

Your knowledge helps you let go of unfounded fears and lets you advocate for yourself – Dr. Wendy Harpham 

At [4:42] and [6:08] Dr. Harpham makes some key observations that, I think, every cancer patient – and those who support them – should take to heart.  Foremost among them is that knowledge is power.  Dr. Harpham had the advantage of having years of education and medical practice under her belt in disciplines that were very relevant to her cancer.  The rest of us don’t have that and, as a result, are spared some of the hard truths that she had to face. Conversely, we who are not Doctors scramble to educate ourselves as quickly as we can so we can become effective partners in our treatment plan with our care team.

In today’s world, there’s often more misinformation than there is correct information when it comes to medical conditions online, and that makes the process of educating yourself fraught with risk.  Yet it is necessary. As Dr. Harpham says “your knowledge helps you let go of unfounded fears and lets you advocate yourself for yourself.”

In my case, my research into the effectiveness of a fine needle aspiration in diagnosing cancer led me to doubt the result and insist on another biopsy – this time using an 18-gauge needle.  This was entirely unnecessary; I had cancer, but I was desperately looking for a mistake where there was none.  

Education is key.  Knowledge is power.  You are the best advocate for yourself, but you can also be your worst enemy.  It’s a razor’s edge we walk on as we educate ourselves about the disease that is killing us and often, our heightened emotional state can lead us to make rash decisions.  

Keep hoping, keep trying, you never know what the future holds in terms of new treatments… and I expected my “life expectancy” to not be what it is – Dr. Wendy Harpham

At [10:53] Dr. Harpham hints at the depression that nearly all cancer patients experience.  It can be easy to be overwhelmed and allow fear and of future unknowns, to affect our todays.  I remember clearly sitting in the chemo chair, with toxic chemicals coursing through my body, thinking to myself, “This is my life now. This is all that I am.” I hated that thought. Eventually, I fought my way past that and allowed myself to not be defined by my cancer any longer.  And that gift to myself, hoping that one day I might beat this thing, carried me along  – even as I held the realities of my condition.

I am living with many aftereffects of treatments….but I love my life. I’m so grateful to be here and do what I can do -Dr. Wendy Harpham

[11:47]  This really struck home for me.  One thing they don’t tell you, or we tend to brush aside in the middle of the fight for survival, is that there’s inevitably going to be some undesired side effects from treatment.  I’m eight years out from diagnosis and deal, every day, with the effects of my treatments. Like Dr. Harpham, I have a depressed immune system and don’t heal as quickly.

But the best part of what she said here was “I love my life.  I’m so grateful to be here.  I do what I can do.  I don’t think about what I can’t do.”  This should be the mantra for every cancer survivor because this mindset is something we can all adopt even as we leave cancer behind.  But it’s also something we tend to forget from time-to-time when limitations alter our lifestyle.

A survivor is defined as ‘from the the moment of diagnosis, and for the balance of life, a person diagnosed with cancer is a survivor – Dr. Wendy Harpham 

[13:09] This really gave me pause. I quickly hit a weird guilt – a kind of “imposter syndrome” – as I was going through my treatments.  While the term “cancer victim” was disempowering as Dr. Harpham said, the term “survivor” felt like an unrealistic expectation to me.  I didn’t feel like a survivor and, in fact, I refused to use the term until I was over five-years past diagnosis.  

There is an x-factor to outlook, attitude, and determination that is difficult to account for in long-term survivorship.  We know stress is a killer and stress management is a strategy not well-promoted to cancer patients.  Diet and exercise during treatments also has some unquantifiable effect.  But aside from managing my stress and light workouts, I felt powerless.  My only choice was to listen, or not, to my doctors.  

So the term “survivor” was hard to swallow because I felt like I was enduring – not surviving.  When paired with the word “fighter,” I ran.  Being a fighter implied that I had control over something when I felt like I had no control.  Calling me a survivor or a fighter just flared up a huge sense of imposter syndrome for me, and I wasn’t sure how to handle it.

Dr. Harpham is right though – my life, my perception of life, improved dramatically once I allowed myself to feel like a “healthy” survivor.  Once I accepted and embraced my role in creating a quality of life I felt like I deserved, I made my life better. And the made all the difference in the world.

A healthy survivor is defined by how you live your life – Dr. Wendy Harpham

[16:03] This all day long.  Like Dr. Harpham, I deal all day every day, with the side effects of my treatments.  Part of healthy survivorship is to not ignore your body, adjust to the realities of what you can and cannot do, and find a life that enables you to live fully and with as much contentment as you deserve.  

Yes, I still panic for a moment when a weird pain pops up or when I get a sore throat for no reason.  Yes, I still tend to see cancer lurking behind every cough and illness.  I have what I call “cancer PTSD.”  But, also, knowing this – I take steps to alleviate and confront my feelings of fear and anxiety.  I try not to let a fear of an unknown future that may or may not occur, impact the quality of my life today.  If there’s one thing being a cancer patient teaches you – it teaches you the value of living in the moment and squeezing the most out of everyone.

I blurted out and shocked me when it came out of my mouth, that I said ‘I’m usually good at things, why can’t I do cancer right?’ From a very deep subconscious part of me I felt responsible for my illness – Dr. Wendy Harpham

[19:27] Perfect articulation of one of the biggest emotional issues most of us deal with.  I felt this in spades.  My cancer, caused by HPV, was very clearly my fault.  I made poor choices in partners.  Additionally, I was going through a very dark and stressful time in my life just prior to my diagnosis, and I knew, subconsciously, that if I had better managed my stress my body would have probably “fought off” cancer.

This feeling is a fallacy based on the illusion of total control. We convince ourselves that we control events that are out of our control.  As a cancer patient, I had to learn very quickly what I could, and could not control.  And the list of things I control is surprisingly small.  Once we realize this, we can learn to stop blaming ourselves.

When people feel like the treatment (alone) cures them and it’s not their own body, they can feel passive and powerless – Dr. Wendy Harpham 

[33:48]. Well, this is a kick in the backside. This really got me thinking, again, about my own experience.  I never felt like a “survivor” or “fighter” because I felt like I was enduring, and was along for the ride, as my medical team leveraged their expertise on my disease. But now, I realize that’s not entirely true.  I did eat better (when I could still eat and not have to get fed via a feeding tube).  I did exercise and help my circulation.  I did manage my stress.  I took an active role in my health, even as I failed to recognize the benefits of it.  These things are on my side of the control ledger. 

This segment, more than any other so far, has made me re-evaluate my experience.  I mentioned an “x-factor” above that may or may not have impacted my long term survivorship and morbidity.  There’s truth to helping your body help you.  I just never really articulated it until now.

I think, looking back, that I knew I could not “will” or “wish” my body to heal and that, outside of clean living, my survivorship was a matter of chance and the expertise of my medical team.  This caused me to bury the concept of the body’s natural healing abilities in my mind.  I shied away from anything that gave “false hope.”  And, as a result, I may have stopped myself from really recognizing that there were things I could do to help my body heal.

You don’t want to put your life on hold while you’re going through treatment – Dr. Wendy Harpham

[40:32] This. I can’t stress enough how true this is.  Life changes with a cancer diagnosis, but life does not end.  I worked until I couldn’t work anymore.  I went engagement ring shopping for my then girlfriend (now my wife).  I had to take my mom with me, and I was so embarrassed I was forced to use a scooter because I was so weak, but I was not going to let this disease stop me from proposing to my girlfriend.  

On New Years Day, 2009, I could barely walk from my treatments.  I could barely speak from the radiation wounds in my throat.  I had a feeding tube in my stomach – and yet I managed to take my girlfriend to the local botanical gardens, struggle my way to the rose garden, and propose to her on bended knee.

Life changes when you have cancer.  It does not stop.  Keep your mind healthy and keep living.  Dr. Harpham truly understands the importance of this.

My illness has taught me to live in the moment because of my heightened awareness of the uncertainty of life – Dr. Wendy Harpham

This is one of the most powerful statements in a podcast full of powerful statements, and I want every listener to walk away contemplating it.

Some of the happiest days of my life were during my treatments.  When there may be no tomorrow, you have no choice but to live in the moment. To live today.  A cancer patient learns to understand this and recognizes that most of our anxiety comes from worrying about futures that may or may not happen.  By letting those go, and by just enjoying the moment you find yourself in, you can find true happiness and contentment.

And this is how I know anxiety is mostly a self-imposed illusion.  Before cancer, I struggled with stress and anxiety. Now, eight years post diagnosis, I struggle with stress and anxiety.  During treatments, I had no stress and anxiety.

Dr. Harpham hits the nail on the head here.  One of the keys to healthy survivorship is to learn how to live fully as much as possible within each moment.  To paraphrase Dr Harpham, cancer does not make your life uncertain, it just exposes the uncertainty that was already there.

I had to grieve my losses to see what remained, and then embrace the life I had – Dr. Wendy Harpham

[43:40]  I felt a kinship to Dr. Harpham here.  The dissonance of cancer treatments often is that when you emerge on the other side, you’re a different person.  The vision of who you were is difficult to reconcile with who you are.  We have to grieve what was lost so we can move on and recognize what you do have.  This took a long time for me.  And, honestly, I feel it’s something I revisit fairly regularly.  

 

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2 Responses

  1. “A survivor is defined as ‘from the the moment of diagnosis, and for the balance of life, a person diagnosed with cancer is a survivor”
    Technically, a cancer survivor is a person who has cancer and is still living. This means that you become a survivor once the cancer has developed and that will always happen before diagnosis and, in some cases, at a time before you know there is a problem. Though you are already a survivor, life will not change until diagnosis – unless the cancer has already progressed to a point where changes have to be made before you are officially diagnosed.

  2. This also means that a person with a low grade cancer who doesn’t have symptoms will not know he is a survivor for a long time, and he may never know ii as he may die of something else. Your life may not change, even though you are a survivor. This is the controversy about prostate cancer screening. You get screened early, they find a slightly elevated PSA and recommend biopsy leading to possible unnecessary treatment. Even if you decide against treatment at that time, your life will be changing! – The controversy, of course, is that the neglect of early screening may lead to a late diagnosis where treatment options are difficult. – Note: this is specifically true for prostate cancer, other cancers may be different.

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