About the Healing Circle
The Healing Circle is a sacred space based on the foundation of love, kindness and respect. It offers a “haven” to cancer patients, survivors and caregivers; it helps them to share their feelings and experiences in their journey with Cancer. Our role is to hear everyone with compassion and treat each person with equal honour. Wherever needed, we keep them confidential. We believe that we possess the guiding spirit within us and rely on the power of silence to access it.
About the Speaker
Ms. Shilpa Mazumder is a clinical psychologist with an MBA in Healthcare Operations. She has worked with hospitals like Tata Memorial and KEM. Ms Mazumdar received training in Advanced Mindfulness from MBSR and Palliative Care from Stanford University. Ms. Shilpa Mazumder explains “Cancer”: She says that Cancer is a group of diseases, and there are more than 100 types of Cancer. Our body cells grow, age, damage, and eventually die. This is a routine biological process. However, the problem arrives when abnormal or damaged cells do not die. New cells get formed, though not needed. These extra cells continue to divide continuously. There is no end to their proliferation, which may create a growth called a “tumour”. This tumour is of two types – benign and malignant. Benign tumours are non-cancerous, whereas malignant tumours are cancerous. Even though benign tumours are non-cancerous, they can be life-threatening if found in the brain. There are several tests, like CT Scan, PET Scan, Mammogram, CBC, Tumor Markers, Colonoscopy, etc., to determine whether the tumour is cancerous.
Cancer Treatments Available
1. Surgery refers to a surgical procedure that removes the tumour. 2. Chemotherapy: A drug that kills cancer cells. 3. Radiotherapy High power energy/radio beams are given to kill cancer cells. 4. Bone Marrow Transplant: A medical procedure to replace damaged bone marrow with a new one. New blood stem cells are transplanted, which can produce new blood cells and promote new growth of bone marrow. These stem cells can be used from one’s or a donor’s cells. 5. Hormone therapy Hormones that feed cancer cells are either removed from the body or blocked. 6. Immuno/Biological Therapy: The person’s immune system is boosted or strengthened to fight cancer cells. 7. Targeted Drug Therapy: The particular abnormalities in the cancer cells are targeted for therapy. 8. Cryo Ablation: A thin, wand-like needle is inserted through the skin directly into the cancerous tumour to freeze the tissues. This is done repeatedly to kill the cancerous cells. 9. Radio-frequency Ablation Electrical energy is used through a needle to kill the cancer cells by giving them heat. 10. Clinical Trials Thousands of cancer clinical trials are underway to treat Cancer.
The Significance of Wellness
Our emotional or mental wellness refers to the conscious and self-directed decisions we make while facing problems. It is always active in our mind consciously or subconsciously. Ensuring a healthy mental wellness is more like a preventive measure. There are eight dimensions of wellness surrounding us at all times: 1. Emotional 2. Occupational 3. Intellectual/psychological 4. Environmental 5. Financial 6. Social 7. Spiritual 8. Physical Wellness – Exercise, nutrition, sleep, etc., are covered under physical wellness. Certain hormones, such as endorphins, are released in the body through exercise. These help to fight the Pain. Following healthy and balanced nutrition can help to prevent or overcome several vital issues. We may often neglect sleep, but sleep is essential for body rejuvenation. Environmental Wellness – Healthy air, water, food and biodiversity are covered under physical wellness. Especially during COVID, gaining fresh air, water, and food is all the more critical.
Wellness and Wellbeing
There is a thin line of difference between wellness and well-being. Wellness is a preventive measure we seek, whereas well-being is a state in which we feel happy. For patients, their perception of life is essential, which refers to their well-being. In wellness, there are certain conditions, but in wellbeing, there are no such conditions. As our wellness improves, it begins to impact our well-being, too. Wellbeing is very personal, whereas wellness is often a shared phenomenon. Wellbeing promotes self-growth, whereas, in wellness, we move in a particular area with a problem.
Problems Associated with Cancer
Physical Cancer generally affects the state of physical wellness. It makes you feel fatigued and affects your appetite, weight and sleep. Many people living with cancer also experience Nausea and tingling sensations. Some feel Pain, and in many hospitals, patients receive sessions on Pain management. They may be asked the type of Pain they are experiencing. Is it accumulated Pain or shooting Pain? Is their medication for Pain working? Some patients face dryness, ulcers in the mouth, and constipation too. Social – Cancer affects not just the patient but the entire family. Each of their roles and responsibilities changes and develops. Sometimes, patients feel affected by their baldness. So, they stop going out. This also leads to social isolation. You may have to move to another city for better treatment. This may affect you financially. Spiritual – This is a neglected aspect of care, but has an equal impact on health. Religion is one part of spirituality, but walking in the woods, being near nature and enjoying it are part of spirituality. It helps you connect with a higher power. When your loved ones are there for you, giving you strength and taking care of you, spiritual wellness plays an important role. What you live for, what wishes you have, what matters for you, in which dimension of your life you have to work, and and how you want to move forward are all part of spirituality, and it helps patients recover and heal.
When Cancer is diagnosed, first there comes denial and then anger. We often question ourselves, “Why me?”, “We haven’t done anything wrong; we haven’t smoked or drank.” Some get into a depression, thinking about what is to be done now. Then, slowly, we accept: “Okay, we are diagnosed with cancer, so what next needs to be done.” Everyone faces this cycle; some come out and accept everything early, while some take time. We get scared when we have doctor appointments or medical tests. Many things go into your mind, like “What will happen to our plans? How will we manage things financially? What treatment should be taken? How to cope with Pain? ” So, all these things make you anxious and trigger you mentally and emotionally.
Emotions are like waves; sometimes, we are delighted, sometimes sad and disappointed, and then again, we get motivated and happy. So, emotions are not static. Feelings come and go. These are not permanent things, so the good part is that we don’t have to make permanent decisions based on these. We have to feel accepted, heal and move forward with life. This is our growth in experiencing and receiving all our emotions together. The brain consists of 3 parts:- Reptile brain, which is very basic and believes in fear, flight and fight. The animal brain has emotions like anger and drives fear and aggression—hThe humanbrain,is very complex and creative, with problem-solving and strategies. When we fear something, we either try to run away or think we will be part of it. At that time, our front brain becomes foggy. So, when stressed, we are advised to meditate and engage in other mindful exercises that can give clarity and peace. Other aspects attached to emotional wellness are Altered cognition, Helplessnes,s Hopelessness, Guilt, Shame, Regret Unresolved guilt, Forgiveness, and Hopelessness – The way you are touched by reality matters. We should have real hope; it is like an inner drive. It offers you light in dark times.Having real hope and a fundamental outlook helps better. Shame – Have compassion and empathy for yourself too. It is okay if you get Cancer. It is nothing to be ashamed about, as it is not your fault. Regret – Some get under the thinking that there are things left undone. “Now I don’t have much time left to do them.” It creates regret and anger, which stops us from moving forward. So, the main coping mechanisms for these situations are forgiving yourself and having gratitude. Forgive yourself and others around you, and have gratitude for life. Mental Wellness – There is a Tetris effect – mentally, what you repeatedly do, you become one. Everything starts with the way you think and how your thoughts are. When you think one thought repeatedly, it becomes your desire, which becomes your belief system. It is like a camera lens; it sees everything and then enters the frame. Likewise, your thoughts focus through the same frame. Then comes learning what you saw, how many new words you learned, which cities have cancer treatment, and how much knowledge you gained. This kind of learning has nothing to do with your education; you gain experiential learning in this journey. Then comes problem-solving,
Questions on the Cancer Journey
Generally, patients have questions, like what treatment they should take, how the procedure will go, how it will work for them, etc. Then, in between, sometimes doctors change the treatment goal. So, the question arrives: Why is my treatment being changed? How should you come for follow-ups if there is a recurrence? How would we get to know that Cancer reappeared? What thoughts should we have on this journey? How should we move forward if we recover or our treatment is complete? What precautions should we take to prevent a relapse? These are some common questions.
Care for Caregivers
Majorly, this area is neglected. Everyone focuses on patients; no one thinks of caregivers who are always with the patient, day and night, ignoring their health, food, career, job, studies, and their medical issues. Caregivers neglect their problems, but they must take care of themselves first. During a flight journey, it is said that you should put on your oxygen mask first and then help others. Likewise, if a caregiver is not healthy or taking care of oneself, how would they be able to take care of their patients? It is not selfish. Caregivers need to care for themselves to serve their near and dear ones better. Caring is rewarding; if you get to take care of your loved ones, give them love, however, not at the cost of your health. It is okay sometimes to say no. It is okay to ask for help and divide your work amongst the family members so that everyone can get a break to do their work. Self-care is essential for all.
The Way Ahead
No matter where the patient is, s/he should be comfortable. When we see patients experiencing Pain, Nausea, constipation, etc., we make them feel comfortable. Look at the areas where they face an issue, and then comfort them. Quality of life has many dimensions, like Financial status, Education, Health, How and where you live. All these areas make up your quality of life. You should ensure that your condition does not deteriorate. If there is anything at all, you should immediately go to your primary care doctor and inform them that these are the areas where you are facing difficulties. We advise patients to continue with their social life. Never be in a state of isolation or withdrawal. It is good to be part of social events because that will reassure you that people want you. Your oxytocin and serotonin will give you a real rush (those are the happy hormones, you see). They will make you feel good about your self-esteem; what you think and feel about yourself is, after all, very important. Your self-esteem will boost up your confidence and problem-solving ability by a higher degree. Advanced care is also a critical area. You should talk about it if something happens to you, what future plans you want, your bank account, your will, your insurance, and so on. If you are in a condition where you cannot make decisions, then decide who will decide for you. Most importantly, “who will decide if you want to be on life support or not?” These are covered under advanced care, which is very much ignored in India. Those around us generally feel that we do not want to talk, but it is important to talk and focus on planning that in case something should happen to you, then who will take decisions on your behalf, in terms of medical, family, investment, etc.
Cancer patients or survivors can have a gratitude jar, in which they can write daily that who helped them, or write a letter for your loved ones, forgiving letters, and things that make them feel grateful. They should engage themselves in activities that make them feel happy, that is, hobbies like painting, reading, meditation, or any other new habit. Such activities decrease Stress levels and increase coping levels.
Set a goal for living What you want to do? For whom you want to live? What is your passion? How healthily you wish to live?
Make complicated things simple Keep your thoughts simple Learn to forgive Express gratitude Have self-compassion Prioritize your relations Develop a happy state Try serenity prayers Form a mission in your life You should have something in your life apart from Cancer. That should also be part of your daily activity, because the disease is just one area. You have to see yourself as a person. If you focus on the disease too much, you will miss the person in you. Along with that, focus on the other dimensions that trigger that person in you. Try joining support groups; they help you take and share your experience and knowledge with people you can feel one.
Meeting an end to your life care is not the end of your life. It is a part of living your usual life; what is with you. In the area of your disease, in which part you have Pain and seek what we can do to reduce that. In the area of spirituality, identify where you want to connect with people; ask for forgiveness and show gratitude to those who have been a part of your life. In your personal area, make peace with yourself. Life is never fair, but from this journey, what you are taking, and what legacy you are giving to your children, friends, dear ones that is what matters. In the areas of legality, check your insurance, who would take care of you if you are not in a position to make decisions, who will decide on your behalf, how your family would be taken care, etc.