Mike Verano is a licensed professional counselor, licensed marriage and family therapist and thymic cancer survivor with over 30 years experience in the mental health field.  Mike has had articles published in national and international magazines and is the author of 

The Zen of Cancer: A Mindful Journey From Illness to Wellness

. In addition, he maintains the blog, Confessions of a Pacifist in the War on Cancer. He and his wife, Kathy, live in Lanexa, Virginia.

Mike Verano

Ten years ago, as I was approaching my first follow-up scan, I asked a seasoned cancer survivor if the anxiety of going through these rituals ever got easier. Without hesitation, she smiled and said "no." The full impact of that statement hit me square in the solar plexus (a place very close to where my thymic cancer originated) as I prepared for a PET scan. Due to this being a follow-up to a follow-up scan, to see if the report of "a mild uptake in a non-enlarged lymph node," my 

In what was clearly both a mindless moment and Freudian slip, my original scan had to be scrapped when, heading back to the mobile scan unit, the tech asked me the standard, "have you had anything to eat in the last six hours?" question. Innocently, or so I thought, I responded that I had only had a breath mint on the way in in order not to blow my quarantined, non-brushed breath all over her. Her face immediately turned into, what I can only describe as the "oh shit!" look. She went on to educate me on all things PET and glucose related. The short of it was that I had to reschedule and go through the stress of the build up all over again.

Two weeks later, sans sweets of any kind, I headed back for what my mind was telling me was going to be my last scan - either because it would be negative and I would never put myself through this again, or cancer was back and my next appointment was going to be with the chemo chair.

I'm fairly certain I'm not the only cancer survivor who believes that they have developed the super-power of being able to read people's body language and thoughts. As I got up from what seemed like an unusually long time in the scanner (surely a sign that they had found something and had to make sure they got a clear picture) I noticed that the once friendly and welcoming faces seemed all business. In my altered state of consciousness, I was certain this meant they all saw something and could no longer make eye contact with me.

That weekend was, due to my own making, worse than my original diagnosis as I contemplated having to go through treatment, this time knowing full-well what that meant. When the message finally came Monday morning that the scan was negative and that my oncologist would see me for my regular appointment in 6 months, my first thought was, "no you won't because I'm not going through this again."

Since that day I have kick-started the internal debate over when is it the right time to stop with the oncology "stuff" an go back to living a life of blissful ignorance of not knowing what body parts are lighting up when radioactive sugar is introduced. Surely, ten years is enough! If, as some suggest, stress can cause cancer, then certainly the stress of 

 is only putting me at greater risk. However, isn't early detection the next best thing to prevention? And on and on it goes.

So was it my last scan? I almost want to put it to a vote - see what other survivors think - knowing in my heart (and sometimes in my head) that I hold the ultimate veto power.

Articles

Ten years ago, as I was approaching my first follow-up scan, I asked a seasoned cancer survivor if the anxiety of going through these rituals ever got easier. Without hesitation, she smiled and said "no."

The Last Scan?

 contributors have mentioned, these COVID-19 days are very reminiscent of cancer treatment. The concerns about depleted immune systems, the avoidance of all things possibly contaminated, the fears, both rational and irrational and the overriding question of whether life would ever return to normal. All flooded back as news about coronavirus spread.

I have purposely tried to keep in the front of my mind the lessons learned from survivorship— the understanding that fears grow the more we attend them, that not every twinge, ache and pain means the beast returned. I have returned to breathing techniques meant to calm an over-active amygdala and the distracting effects of concentrating on tasks at hand. However, in the back of my mind, the dark recesses where I placed the more troublesome aspects of cancer and its treatments, there rises the occasional whisper of doubt, "did I survive cancer only to succumb to what will surely become the new "C" word? Does my reduction in lung capacity due to surgery and radiation put me on the shortlist for who COVID-19 is stalking?"

However, cancer taught me that wrestling with these dark thoughts is useless. While living ill, as a patient, only makes wellness seem like a mirage. The antidote was and still is living with a purpose. Not a divine calling - although if you've heard that voice, God bless - but pointing oneself toward something meaningful beyond the small needs of the ego.

"Choose purpose, not panic," is how I heard it described recently.

In all my years of psycho-therapeutic practice, nothing has seemed so meaningful, useful and even necessary. The skeptic would point out that choosing not to panic is just not an option right now— panic happens. While it's true that panic is a byproduct of uncertainty, threats to self and others and dire forecasts, the good news is that the two are mutually exclusive. Purpose turns panic back to its original source as simply energy&mdash; with panic the energy lodges in the body and disturbs its equilibrium. Purpose directs the energy outward and when tied to a beneficent cause, the experience is that of being connected to a deeper source as worry for self becomes compassion for others.

Like a cancer diagnosis, the pandemic scare touches everyone in some way. Perhaps, those of us who entered survivorship through the cancer door can assist those who are currently seeking comfort, understanding and support as this current crisis unfolds. While the mechanics of cancer and COVID-19 are dissimilar, the human reaction remains the same. As does the call to alleviate suffering in ourselves and others.

Who better to point the way than those of us who have walked that road?

Purpose directs the energy outward, and when tied to a beneficent cause, the experience is that of being connected to a deeper source&mdash; worry for self becomes compassion for others.

Surviving With Purpose

Once cancer enters our lives, the aging process takes on a whole new meaning. While it's true that each passing year marks another triumph of survivorship, it's also true that the remnants of our cancer journeys can be felt deep in aging bones.

One often hears survivors of serious illnesses say that they would not let their illnesses define them. While the sentiment expressed can be emotionally uplifting, the reality is that our illnesses do define us in the same way that we are shaped by all of our experiences. The good news is that while our cancer diagnoses are handed to us, we have the ultimate hand in molding our new selves through our thoughts, attitudes and actions.

It would be unrealistic to suggest that one is ever completely free of the shadow of cancer — after all, shadows are the direct result of light. Likewise, it's unwise to ignore the impact that both the history and possible return of cancer has on our life's course. For those of us who have been impacted by such challenges, learning to live somewhere between the cold reality of illness and the warm glow of a life lived in spite of limitations is what's called for. We learn to push on through chronic pains, degenerative symptoms and the battle with side effects that last much longer than actual treatment protocols. Ideally, we learn that living well is a side-effect free antidote to becoming grumpy old men and women.

Taking cancer and aging head-on does not mean we do battle with them, since we understand this only puts us at war with ourselves. Nor do we surrender to a life half lived, feeling cheated by the salt in the wound of a life-altering illness happening during our "golden years." Ironically, as we begin to come to terms with the failings of the physical body, many of us become acutely aware of the energizing spirit which has been ever-present and, in many cases, the very force that pulled us through life's most challenging moments.

It would be unrealistic to suggest that one is ever completely free of the shadow of cancer – after all, shadows are the direct result of light.

On Cancer and Aging, Part 2

As a psychotherapist, cancer survivor and card-carrying member of AARP, I often find myself meeting with clients with whom I share the common concern of what happens when the aging process is complicated by a life-altering illness. While most people accept the inevitable aches and pains associated with growing older, adjusting to the impact of something like cancer can often lead to the sense that aging itself is a disease. I often joke in training classes on aging that with every new candle on my birthday cake, a new medicine bottle shows up in my cabinet.

Like many people my age, the first item packed for any extended vacation is not the swimming trunks and suntan lotion, but the items from my in-home apothecary. The myriad of lotions, tonics, remedies, capsules etc. are constant reminders of the wisdom that aging is not for the weak of heart (and if you have a weak heart there is a medication for that too).

Coping with the physical challenges left by cancer treatment has a profound psychological impact that can strain the limits of one's psyche. Depression and/or anxiety are common responses. The (often literal) battle scars from surgeries are no longer seen as badges of honor and a life well-lived, but cruel reminders of organs no longer there, alterations of the natural order of things and the replacement of organic parts with modern-age mechanics.

For those of us who have faced the challenge of cancer, the age-old issue of quality or quantity is not some philosophical luxury but, very often, an actual accounting of pros and cons. Like many of the cancer survivors I have spoken with, I was both surprised and disappointed by how quickly my sense of being happy to still be alive was replaced with the moans and groans of new ailments.

It's been challenging to watch as the survivor's smile has been replaced with the nervous "what's next?" twitch. Confronted with the dual threat of "normal aging" and serious illness, the mantra, "you're only as old as you feel" falls on slowly deafening ears. Likewise, the sagely advice to stop lamenting what one has lost and be grateful for what one still has is about as useful as counting sheep to bring on sleep. This is not to say that in my personal and professional life I espouse cynicism and pessimism. I know enough about neuropsychology and physiology to understand that a negative mind frame only tenses the body thus limiting blood flow and increasing the experience of chronic pain. These days, I find pragmatism — thinking of, or dealing with, problems in a practical way, rather than by using theory or abstract principles – as the most useful approach to growing old after cancer.

I often joke in training classes on aging that with every new candle on my birthday cake, a new medicine bottle shows up in my cabinet.

Mike Verano | Contributors

The Last Scan?

Surviving With Purpose

On Cancer and Aging, Part 2

On Aging and Cancer, Part 1

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