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Winter 2005/2006 Volume 6, Issue 7:
The Yin and Yang of Long-Term Survivorship
By Rosanne Kalick
Philosophers in the Han dynasty (207 BCE to 9 AD) developed the concept of Yin and Yang, the idea that everything in the universe has its opposite. If this is so, where does cancer fit into this ancient method of understanding life?

Philosophers in the Han dynasty (207 BCE to 9 AD) developed the concept of Yin and Yang, the idea that everything in the universe has its opposite. These opposites are interdependent—we cannot have day without night, winter without summer. If this is so, where does cancer fit into this ancient method of understanding life? Can the concept of Yin and Yang help us deal with the complexities of life with multiple myeloma?

In the fall of 1993, I went for a routine physical. Initial blood work indicated anemia. I had run five miles just before the test, and I wondered whether that run could have affected the result. However, retesting confirmed the anemia. A 24-hour urine test indicated excess protein, and a bone marrow biopsy verified the diagnosis—multiple myeloma.

The 11th edition of Merriam-Webster's Collegiate Dictionary defines a whammy as a supernatural power bringing bad luck. What an accurate description of multiple myeloma! Myeloma was my first whammy.

Two stem cell transplants, four and a half years of Interferon, and years of Aredia followed. At the end of treatment, I was in "excellent partial remission," not complete remission because I still had an M spike of 0.5.

Seven years after the myeloma diagnosis, I went for a routine mammography. That mammography revealed malignancies in both breasts—my double whammy. Thanks to the miracles of science, I had lived long enough to develop a second primary cancer.

Dr. Sundar Jagannath, my oncologist at St. Vincent's in New York City, was extraordinarily supportive and set up consultations with breast cancer specialists. Because of all the chemo I had previously, a tumor committee met to consider my treatment options. I had a double mastectomy followed by more chemotherapy.

Then, three years ago, I was at the theater, watching a one-woman show. For a brief period, the actress had two heads. I had two more incidents of double vision during the next few weeks. When, on a routine visit to my ophthalmologist, I mentioned the episodes, he paused and said, "You either have a brain tumor or you've had a stroke." Tests did show I had had a small stroke. Was there a connection between the transplants and the stroke? Was I more prone to a stroke than someone who had never had cancer? Was it a disparate event? Whatever the cause, it was my triple whammy.

I needed a metaphor to help me deal with these health issues. The concept of Yin and Yang has been useful for me. I'm not saying it will work for everyone, but I think we need a construct to help us deal with the myriad cancer issues we face, especially now that long-term survivorship is more and more a reality. For many, religious faith is their working framework, and I am not suggesting that Yin and Yang is a substitute for religion. If anything, it may complement one's faith.

If, for example, Yin is myeloma, then what is Yang? While I cannot deny my cancers, I think of Yang as my non-cancer life. If Yin is the fact that I am afraid I'll have another stroke, that the myeloma will reemerge, that the breast cancer will metastasize, then Yang is that I've lived to see five grandchildren born, that I'm enjoying my retirement, that I co-chair a multiple myeloma support group, that I volunteer on two cancer hotlines—that my life is full.

If Yin is a "Why me?" approach to myeloma, then Yang may be a "Why not me?" response. "Why me" wastes energy and is non-productive. We can turn that energy outward. When I meet newly diagnosed patients, I try to encourage them to become their own advocates. At a support group meeting, my sense is that when we learn together, when we share experiences, when we discuss options, we all gain strength. We cannot say, "You will go into remission." We can say, "You are not alone." If Yin is our disconnect from what had been our pre-myeloma life, Yang is our connection to those who become part of our myeloma family.

If Yin is the reality that I have permanent neuropathy in my toes, then Yang is that, in spite of that fact, I can still walk three miles several times a week. If Yin is the fact that I've gained 15 pounds in five years because of the breast cancer medication I take, then Yang is that I've just passed my five-year survival period for that cancer. If Yin is the reality that multiple myeloma is a "monster," Yang may be the support we get from IMF seminars and from the interactions we have with other cancer survivors.

Even being positive about cancer can contain a Yin and Yang. I can only speak for myself, but I cannot be positive all the time. Dr. Jimmie Holland, a psychiatrist specializing in psycho-oncology at Memorial Sloan-Kettering Cancer Center, in her book, The Human Side of Cancer, writes of "the tyranny of positive thinking." She encourages patients to accept their feelings about cancer. There are times we are positive, yet we must acknowledge those times when the cancer life is overwhelming.

There are times when I get discouraged. Emotional cancer fatigue is as real as the fatigue from chemotherapy. I'm angry that so many I know have lost their cancer battle. Whether it's healthy or not, I think of cancer every day. However, I also know that researchers are making great strides in terms of new treatments. I know that we have doctors who treat us as individuals and who celebrate our small victories. I know many who are living a full life in spite of multiple myeloma.

As someone who has lived with cancer for twelve years, I'm still learning and still struggling. I believe we must celebrate life. I believe we must tell the people we love that we love them. I believe we must give back, however we define that—by contributions of money, of time, of our presence when others are diagnosed with cancer. Above all, I believe we must never deny hope.

Clearly, cancer transforms one's life. We cannot make up for our lost dreams, our disabilities, or the frustrations, fears, and angst that is routine in our myeloma life. However, we can create new dreams, perhaps more realistic ones. We can laugh, and many of us can still work. I'm learning to do now what I had planned to do "later on." Later on is NOW for us. In our pre-cancer lives, many of us thought we had more control of our lives than we really did. Cancer reminds us of how fragile life is.

But if Yin is what we cannot do; Yang must be what we can still do. We must not allow the disease define who we are. One of the challenges I face every day is to remember that I AM NOT MY CANCER. I am a mother, a grandmother, a friend, a member of two book clubs, and someone who loves the movies, and the theater, and ice cream. Since my first diagnosis, I've traveled to Morocco, Mexico, Italy, Israel, Maine, and Charleston. There is life before cancer; there is life during cancer; there is life after cancer.

As cancer research and treatment progresses, more and more of us will become "long-term survivors." Perhaps the metaphor of Yin and Yang can help others to achieve a cancer balance. We must find ways to celebrate life in spite of our cancer. If we don't, then myeloma wins, no matter what our lab reports say. We have multiple myeloma; multiple myeloma should not have us.

Note: Rosanne Kalick is the author of "Cancer Etiquette: What to Say, What to Do When Someone You Know or Love Has Cancer".©2005. If you buy the book online at http://amazon.myeloma.org, a percentage of your purchase will go to support IMF programs and services. Direct inquiries can be emailed to Rosanne Kalick at rklibrary@optonline.net.

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