Uncertainty and No Promises

Hester Hill Schnipper, LICSW, OSW-C, Program Manager, Oncology Social Work

JUNE 02, 2017

We all know that we are mortal, but most of us don't really believe it. Or we didn't used to believe. A cancer diagnosis has a way of bringing that fact, the None of us get out of this world alive fact, very close. All of a sudden, we are really thinking about the number of our days and the real possibility that it may be smaller than we had naively assumed it would be.

Yes, any of us could be hit by a bus today. No matter how many times people remind us of that fact, it does not help a bit. We could still be hit by a bus or a falling tree limb or a ceiling tile in a tunnel, but that is not so likely. It is much more likely that we can now name our killer.

How do we live with that? Time helps as long as it is the safe passage of healthy time. If we go through cancer treatment and stay well, the fear slowly moves from right in front of our faces to the side of our heads to behind us to further and further behind us. However, it takes very little to bring it right back to the front and center position. A new ache or pain or hearing of a friend's death or a concerned look on a doctor's face, and we are right back there.

I tell my patients that the first goal is to slowly get to a place where you can believe something like: There is a chance that I might possibly/maybe/perhaps survive this cancer It goes from there. The real goal is to live as though the cancer will not return. If it does, we will have to deal with it then and months of anxiety won't have helped at all. And, whether or not it comes back, we don't need to give it the power to wreck our lives.

From Cure Today:

Uncertainty: This Is Cancer's Horrible, Helpful Ongoing Consequence By: Barbara Tako

As a cancer patient or survivor, there is a cancer-enhanced awareness of your own mortality and what might be lurking within your body. You live with constant nasty uncertainty. Will the cancer get me? When? How bad will it be? Long-term ongoing uncertainty is hard for people. We want to know. We want to be in control. When we think we know our life, we think we are in control of our life.

Cancer, because it doesn’t always go away and because it sometimes comes back, takes away control. People want to know. We want results and knowledge—like whether or not our medical tests show a problem. We want to know if we got the job we interviewed for. We want to know gender of the new baby. Did we get the home where we extended an offer? Certainty gives knowledge, which gives us power to act decisively. Every day people decide how they want to proceed based on certainty, and maybe it isn’t even real certainty, but it is based on feelings of certainty and knowledge of their own reality. People like to move forward and make plans.

Uncertainty, on the other hand, eats away at us. We don’t really know what our reality is. This unknowing generates stress and gives us constant doubt. Doubts create worries and worries create fear—an ongoing fear. Will or has the cancer come back? Uncertainty just wears people down. No one wants to live with long-term uncertainty, yet cancer survivors do just that.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
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