Stories of Hope
The call came several days ago. Close friend. Cancer. Not again... I am overwhelmed by what feels like an epidemic of cancer--and by fear, sadness, and the potential loss that I associate with the "C" word. A diagnosis of cancer is unquestionably an overwhelming trauma. But how we respond to the diagnosis may be predictive of the choices we make about this disease and how it ultimately impacts us. Whether with defense or surrender, each of us responds in our own unique way. As I consider all the friends I know who've fought a noble battle with this frightening foe, some living well beyond what the numbers would predict, my mind turns in another direction. Hope.
Webster's Dictionary defines hope as a "desire accompanied by expectation of, or belief in, fulfillment." Hope offers an alternative to hopelessness, which is defined as "having no expectation of good or success, despairing, not susceptible of remedy or cure, incurable, desperate, impossible." There is little doubt that hope can be of immeasurable value to people facing life-threatening disease. But are there grounds for such optimism?
To answer, we need only consider those people who have somehow beaten the odds. Just as some people succumb to disease more rapidly than average, some live much longer than the mean. What about these survivors? Do they give us reason for hope? What can we learn about healing from individuals who represent the positive end of a probability distribution? Can we learn to be survivors?
Such questions have been on the mind of Caryle Hirshberg for more than twenty years. This researcher began at IONS by collecting cases of spontaneous remissions, in partnership with her friend and colleague, Brendan O'Regan. "We believed that if human beings possess usually untapped powers of self-repair that can affect the dissolution of a tumor, it is of vital importance that it be investigated and understood."
As word got out that the researchers were collecting information on remission and extended survival, IONS began to receive mail. One letter came from a woman who was diagnosed with lung cancer. Her letter began, "I'm so grateful that research is being done in the area of spontaneous remission. . . . Statistics gave me 6-8 months without treatment, but only 18 months with treatment. That was six years ago. . . . Even in your research in medical journals, you will still miss a lot of us who are surviving quite happily and with an insight that has to come when one looks death in the eye."
Today, research on spontaneous remission and extended survival has gained some momentum. Programs are underway across the United States, Canada, Europe, and Australia. In Germany, for example, investigators are continuing to collect cases of remissions and extended survivors--hoping to find patterns across the isolated reports. An updated summary of O'Regan and Hirshberg's work, The Spontaneous Remission Bibliography, is now available in a searchable online database on the IONS website (www.noetic.org).And more interest has developed in approaches that facilitate healing, rather than restricting the focus to disease.
"Hope is a waking dream" --ARISTOTLE
Of course, there are no easy answers, no fixed set of behaviors, attitudes, beliefs, or personality characteristics that predict survival. And yet, it is clear that each person can and does influence the outcome. As pointed out by Hirshberg: "If psychosocial factors can account for, for instance, even 5% of the equation of success, that 5% may be sufficient to make a difference between recovery and death."
What have we learned from these various studies and case collections? In a search for patterns, researchers have identified similarities in how survivors account for their hopeful situations. Such similarities do not represent a recipe for survival, but illuminate a set of possibilities. Some of these patterns are outlined here:
■ Many people demonstrate a strong sense of self-sufficiency, and an internal locus of control. They feel in charge. Commitment and self-efficacy pervade their beliefs, behaviors, and attitudes. For example, after being informed he had a grave prognosis following a diagnosis of metastatic pancreatic cancer, one man--after a period of depression, fear, sorrow, and loss--rallied and exclaimed, "That's what they say, now let me see what I can do."
■ Most survivors give greater weight to intangible factors, such as attitude changes, new meaning in life, an enhanced appreciation for nature, and strong connections to partners, friends, and health practitioners, than to the treatments they received.
■ Many people report that a strong, supportive, and trusted relationship with one other person, a partner, was considered extremely significant.
■ Spiritual faith, religious conviction, belief in and surrender to a higher power are prominent in many survivors' stories. Some report that prayer, either their own or the prayers of others, contributed significantly to their survival.
■ Flexibility and a willingness to try anything that makes sense, or to make changes when something doesn't seem to be working, characterized many people's approach.
■ People report that they no longer feel it is necessary to deny their feelings. One minute fearful, the next joyful, the full gamut of emotions is acceptable to them. Survivors also display increased appreciation for humor and more uninhibited laughter.
To date, much of medicine has focused on the degenerative aspects of cancer. But what about our mysterious capacities to heal, even in the face of adversity? While remission remains the exception to the rule, there is much to learn from the survivors of cancer that may lead to the creation of new treatment programs and to the very redefinition of the outcomes of cancer. We need only recall the prophetic words of Paracelsus, the "Father of Modern Medicine," who said, "Ills of the body may be cured by physical remedies or by the power of the spirit acting through the soul."
If one can choose, I choose hope.
(This essay first appeared in the July/August 2004 issue of Spirituality & Health.)
MARILYN SCHLITZ, PHD is Vice-President for Research and Education 
