Life after colon cancer

Question: There's now increasing attention being paid to the physical, emotional and financial issues that cancer survivors face. Which ones affect you?

Answer: All three. The physical and emotional were the same for me. You hear the phrase body-mind medicine being the same thing. I’ve always looked at it as being a little off — since when did someone decree that the mind is not part of the body? How can we not include the brain as part of the body? If there are severe physical issues there are emotional issues, despite what you may call them. To me, they were married and intertwined and I couldn’t separate them.

Eventually, the healthier I became the more time I had to worry about the financial impact of cancer. There is a chapter in the book about insurance issues and how cancer survivors begin to return to their jobs and their lives to be full-fledged workers again. I quote someone who came back to work from colorectal cancer, and someone asked if they could catch it. Or if you work for a small company, there will be whisperings, "will all our insurance premiums go up?"

When I got healthier and the bills started coming in, I remember thinking, "at what point am I going to hit the $300,000 mark in billings?" Fortunately I didn’t have to pay all that myself. But the financial side is a real concern. The numbers do get scary.

There are some big legislative acts that help cancer survivors, which in theory keep folks from being discriminated against. The first one is the Americans with Disabilities Act. Some states require the sale of health insurance to people no matter what their past histories are. There are also the Family and Medical Leave Act and the Health Insurance Portability and Accountability Act. Together those laws can help you think about lessening the burdens of insurance and repairing your financial health once you’re out of the worst of the treatment and suffering.

Question: We know now that cancer is the No. 1 killer of Americans under 85. So sooner or later, most of us will know someone with cancer or even be diagnosed with it ourselves. It’s not an easy thing to talk about. Do you have any advice on how to approach it?

Answer: Most people don’t rehearse when they’re talking to a cancer patient. I do know it would help a lot of families and cancer patients who are at their worst if the people who talk to them did rehearse.

The one question that’s become lingua franca: does it run in your family? Think through that question. If it does and a grandparent or a sister or a mother had it, then that means you are a marked individual, you have bad biology. If it doesn’t run in the family, you’ve just asked a question that leads the patient to start thinking, "Did I do something wrong, did I eat something or drink something, did I live in the wrong area of the country, did my lifestyle cause cancer because it's not in my biology?" My question is, how does it help the patient to ask that? How do you ease a family’s or patient’s burden? That may not be the best question to ask.

I do offer in the book things you might be able to say or do. Don’t ever say, "I know how you feel." You don’t, even if you have had the same disease.

The better question to ask if you’re uncomfortable is, "When you’re thinking about this, what helps you get through the darker times?" Whether it’s prayer or limited exercise or things they may do or create, just asking them what helps them get through the darker times is a way to have a conversation rather than a misinformed accusation.

Question: And, finally, any parting thoughts for the patients who are battling colon cancer right now?

Answer: There is a family of treatments now and that is extremely good news. In the last few years, there have been major drug advances, including Avastin and Erbitux, that can extend life when used in combinations with the drugs 5-FU and Camptosar. It’s happening so fast and not all doctors have experience with these combinations, but that’s a great message for patients and their families to have.

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