Does positivity cure cancer?

16 months on from my diagnosis for a borderline operable Stage 2b Pancreatic Adenocarcinoma, from which half of patients die within 12 weeks, I gave a talk for the Professional Speaking Association called ‘Refresh Your Perspective’.

One of the questions from the audience has really stayed with me, and I’ve been running the longer version of the answer I wanted to give. So, here it is, for the person who asked, and for anyone else asking themselves the same question. Here’s my take on the overwhelming narrative that links better cancer outcomes with the positivity of the patient.

I think this might be true at the extremes, but it’s my belief that for the vast majority of patients it’s a narrative that is actually damaging to their mental health, and to their memory.

Confirmation Bias!

“The tendency to interpret new evidence as confirmation of one’s existing beliefs or theories.”

I think people want there to be a link between positivity and cancer outcomes, because it gives a sense of having some control. The idea that strength of mind or strength of character can overcome this vile disease looks to me like a pretty classic human psychological tendency to see pattern and order, where there is none. We want to think we have control, and so we see causal links where they may not exist.

History is written by the winners…

‘His Story’ is just that. The stories we read of people living beyond their cancer diagnoses, or overcoming other massive health challenges, to achieve amazing things, are written by those that survived. More than that, by people who survived and chose to tell their story.

And, I’m part of that. My talk did talk about the positive, practical, purposeful actions I’ve taken. It was, of course, the edited highlights. A talk that focused on my hours of wailing, my months of doing nothing on the sofa but eating jelly babies, the horrible jealously I experienced seeing my peers continuing to do their thing, the ugly anger in running the why me? question in my mind, the gripping fear that all was lost for my business, and deep deep sadness in understanding the likely long term impact of the trauma on my loved ones (whatever my outcome), and the daily fear that it’s coming back — wouldn’t have made for an uplifting lunchtime talk!

By their very nature, survivor stories don’t include testimony from those that didn’t make it. I know from my short experience within the cancer community, that those who die are no less positive, have no less desire to live, fought no less, than me.

Further than that, the people that tend to choose to share their journeys are positive, eloquent, vocal people. I’d be willing to bet that there are just as many pessimistic, inarticulate, quiet people that survive… we just won’t see them blogging, speaking, or campaigning any time soon, because it was never in their nature to do so.

A good cancer patient…

This is such a perpetuated persona that I used it in my answer. I said that there are people “who did everything right and still died.” This is because there’s a very strong picture in the world of a good cancer patient and a bad cancer patient.

A good cancer patient accepts their diagnosis, has a positive mental attitude, sees the learning in the process, and converts any anger into positive and productive actions.

It must then follow that a bad cancer patient struggles to accept their diagnosis, is depressed or feels negative about their position, sees futility in what they’re going through, and doesn’t choose to be productive.

There’s an undercurrent in this that somehow suggests that the bad patient caused their own demise.

But, is it true?

But, what if this is true… what if cancer patients that do the right things do actually outlive those that don’t?

Anecdotally, the link can appear true. It’s even perpetuated by medics. How would you even start to study this?

It’s my belief (not evidenced by anything other than my life experience and perspective) that there is some truth to it, but only at the extremes. I do think there are people who ‘give up’ — who see no reason to live, and that this can accelerate an illness. Equally, you see people beating unfeasible odds to reach the date of a child’s wedding, or other milestone — seemingly willing themselves to make it.

But, for the vast vast majority of people, these extremes don’t exist. For these people, the negative or positive impact of mental attitude is a very small part of a much wider set of variables.

Not mutually exclusive

One of the issues I see is that positivity and negativity are often presented as mutually exclusive, binary, positions. You are either a positive person, or you are a negative person. I don’t think this is true, unless there’s a mental health issue also at play.

A person who is always negative is likely to be clinically depressed. This will then manifest in not taking care of yourself and destructive behaviours that can absolutely damage your health. But, equally, a person who is always positive is probably delusional. This may lead them to not face their diagnosis, put faith in unproven treatments, and not be honest with loved ones about their likely outcome.

The truth for the majority of humankind is that we are capable of being both scared witless and also taking positive actions. We can be deeply sad, and also experience joy.

My point is that cancer patients will have periods of both, and that this is ok. It’s more than ok, it’s entirely natural. To feel guilty about the dark moments, or to try to force positivity, is neither natural nor healthy. Trying to reach the bar of ‘always positive’ is one that every human will fail.

The toxic effect of this narrative

Here’s the effect I think it has. It adds a deeply unhelpful inner voice!

Receiving a cancer diagnosis, the ripples of its effect on your world, undergoing treatment, navigating the physical, practical and financial consequences, re-building your life and identity, etc. is really bloody hard – for the patient, and their loved ones.

There are days when you’ll be angry, sad, feel hopeless, overwhelmed, morose, exhausted, and lots of other dark negative feelings. The ‘you must be positive to survive this’ narrative is an added pressure in these moments.

I found myself thinking that if I even allowed myself to follow the thought journeys of my various unwanted outcomes that I might be willing it to happen. I thought about how my death might affect my daughter, and a little voice told me not even to think it because I might wish it into being.

Here’s the thing… every cancer patient (particularly one facing the sort of survival statistics I’m facing) thinks this stuff. To layer on an extra dose of ‘you’ve got to be positive’ guilt and fear in these moments is the opposite of helpful.

We need to make it ok for patients to have, and properly process, these feelings without loading extra guilt and fear.

The lasting legacy on the memory of lost loved ones…

Had I been in the 90% of pancreatic cancer patients that are not lucky enough to be diagnosed whilst they’re operable, or if I’m not lucky enough to be in the 25% of patients in my position that do not get a recurrence (that is then considered terminal), what would this say about me? That I wasn’t positive enough?

The idea that, in the event of my death, my daughter will be exposed to a pervasive media and societal obsession with positive mental attitude and overcoming cancer, tells me that there will be a little voice placed in her head that mummy didn’t love her enough to live.

Out of respect for those that don’t survive (and for my particular condition, that’s 99%), we have to know that they loved their families, they wanted to live, they gave it their best, their choice was to live, but their fate was to die.

Because the disease, not their attitude, is a killer.

Positivity is still a good thing

Now, don’t get me wrong, I am a big fan of positivity. Turning anger into positive action is a good thing. Finding techniques that soothe your mind and allow you not to dwell on fear is a good thing. Choosing to find fun and laugher in your life is a good thing. All of these things make life better, for you and everyone around you. Positivity is, for the most part, a very good thing — and I’m all for it.

But, it doesn’t cure cancer!