against the odds
by Lynn Eaton
Fifteen months ago, 77-year-old Una Seccull was told she had two weeks to live. She had been diagnosed with a malignant cancer, affecting her spine, and was in terrible pain.
© C4
Now, after a year in hospital and spending time in two nursing homes, she is back home again.
'I never ever thought I would be back home again,' she says. When they diagnosed her cancer, the first thing they told her was to get her son, who lives in Wolverhampton, to come down to stay with her on the Isle of Wight.
She talks positively about the care she is receiving at home from the nurses and from her carer and, within minutes, is joking about the lovely rubberised chair they have installed for her in her bath. As she goes into details of how it is inflated initially, then deflated as she sits on it and the bath fills up with water, you can't help laughing with her.
be positive
Positive attitudes to ill health and dying can not only make living with pain and illness a lot easier, according to the experts, but can also extend your life, as has happened with Mrs Seccull.
Her doctor, Ian Johnson, a consultant in palliative medicine who works at the Isle of Wight hospice, is continually amazed by people's ability to overcome all odds – through sheer will power.
'It's fairly well known that people who adopt a fighting attitude tend to do better than those who don't,' he says. 'Attitude of mind is all important. A lot of what we do here at the hospice is to try to encourage people.'
And he also cautions against telling people with a terminal illness exactly how long they are likely to live.
'The worst thing you can say is you have got six months because it is likely to become a self fulfilling prophecy. When that time comes, people go really down hill because that is when they are expecting to die.'
power of faith
He recalls how, when Mrs Seccull was in hospital, she was almost totally paralysed. 'Many months ago she was expected not to live. But she has a strong faith and had many people praying for her. If people have some sort of belief system – not necessarily Christianity, it may be a belief in a healer or a specific diet, like juices – this is part of them having a fighting attitude.
Certainly she is a strong believer in God, as a member of the Christian Science church. 'I put my life in God's hands,' she says. 'If anything untoward happens I say, all right, let God deal with it. He never lets me down. Each day I get stronger.'
Faith or no faith, she is an up-beat woman: 'There is only one way to do it, she says. 'You can't moan to everybody about it.
'My advice to others is, don't panic. Don't let go. Just fight it all the way, with God's help you will get through.'
carrying on for the family
Susan believes it is her two children, rather than any religious belief, that have helped her to carry on as long as she has. She has struggled to cope with severe Crohn's disease, which affects her intestine, leaving it ulcerated and giving her pain she describes like knives sticking inside her.
'It's mainly my family and the kids that keep me going,' she says. 'I'm not classed as being ill by them. It is just a case of not letting the illness beat me. I try to keep busy and not to sit brooding. 'It is just a case of living your life. You just have to carry on.'
Dr Steven Greer, consultant psychiatrist at St Raphael Hospice, in Cheam, Surrey, is convinced just having a positive atttitude – although not necessarily a religious faith – can make all the difference.
He carried out ground-breaking research, first published in 1979 in The Lancet and subsequently followed up in 1990, to show that women with breast cancer survived longer if they had a positive approach to their illness.
fighting spirit
The 'fighting spirit', as he calls it, would show itself in the way the patient was actively involved in decisions about their care, or in the fact they felt they had to live for their family or for some significant life event.
He also offers patients and their partners a six-session course of cognitive behavioural therapy to teach them ways of adopting a more positive approach to the illness. He describes it as adjuvant therapy – something in addition to their mainstream treatment, rather than an 'alternative' therapy. (See also the feature on cognitive behavioural therapy in the mind section.)
'The key is to teach them to get back to their ordinary normal lives, to maintain daily activity so they can push it to the back of their minds – so that they are thinking about what they are going to do that day, about their holiday or what new school the children should go to. We find that we can alter their attitude.'
He says these skills can be learnt. 'You can change attitudes from a hopeless, helpless attitude towards a positive one.'
How people are told about their diagnosis can also affect the way they feel about their illness, he believes. 'It is important wherever possible for the patient to be able to ask as many questions as they want to.' He says they should also be told to write down any queries afterwards and bring them along next time they come for a consultation.
Just why such an attitude makes a difference, he doesn't know. 'We haven't been able to explain it physiologically as we haven't been able to do the research. But the feel good factor certainly improves the body's immune system.
They do also know from other research that a negative attitude can potentially hasten death.
'If someone has turned their face to the wall and says "I am going to die", that has been shown to decrease the immune system,' he says. 'What hasn't been shown is whether those changes are strong enough to explain why one person lives longer than another.'
So is the answer, then, to develop a strong religious faith?
'It happens in non-religious people as well, providing they have got a strong meaning or purpose in life,' says Dr Greer. 'It is really more about the positive attitude they adopt. What doesn't work is to suddenly take up a faith when you find out you are going to die.'
help and info
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organisations
Hospice Information
34-44 Britannia Street
London WC1X 9JG
Helpline: 0870 903 3 903 (Mon-Fri 9am-5pm)
Website: www.hospiceinformation.info
Provides information on hospices and palliative care services for both professionals and the public. Website features details of local hospices and palliative care services, and has a range of links.
IndependentAge
6 Avonmore Road
London W14 8RL
Tel: 020 7605 4200
Website: www.independentage.org.uk
National charity whose main aim is to help older people on low incomes to live independently with dignity and peace of mind by providing: regular extra income, grants for emergencies, equipment to aid independence, the support and friendship of volunteers, nursing and residential care and help with fees.
National Council for Palliative Care
The Fitzpatrick Building
188-194 York Way
London N7 9AS
Tel: 020 7697 1520
Email: enquiries@ncpc.org.uk
Website: www.ncpc.org.uk
The umbrella and representative body for palliative care in England, Wales and Northern Ireland.
St Raphael's Hospice
London Road
North Cheam
Sutton SM3 9DX
Hospice Care tel: 020 8335 4575
E-mail: enquiries@straphaels.org.uk
Website: www.straphaelshospice.org.uk
Offers hospice care to those in the community of Merton and Sutton facing life-threatening illness. The service is completely free of charge, and provides high quality medical and nursing skills, as well as support of family and friends.
websites
Coping with Advanced Cancer
www.cancerbacup.org.uk/info/advanced.htm
Part of the CancerBACUP booklet series, this online booklet has been written to help people who have been told their cancer has spread or come back, and their relatives and friends. It outlines common concerns and problems and advises on how to cope with them.
Helping Yourself Live When You Are Dying
www.hospicenet.org/html/help_yourself.html
Brief article aimed at those with a terminal illness who are faced with the challenge of knowing they are dying and yet wanting to live.
The Lancet
www.thelancet.com
Look up the study, the 'Influence of Psychological Response on Survival in Breast Cancer: A population-based cohort study' by M Watson, JS Haviland, S Greer, J Davidson, JM Bliss in The Lancet, vol 354, issue 9187, page 1331.
reading
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Beyond dying: the mystery of eternity by Ted Harrison (Lion Publishing, 2002) |
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Dying, Grieving, Faith and Family by George Bowman (Roundhouse Publishing, 1998) |
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Palliative Care and Communication by Anne-Mei The (Open University Press, 2002) |
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Recovery from Cancer: The Remarkable Story of One Woman's Struggle with Cancer and What She Did to Beat the Odds by Elaine Nussbaum (Square One Publishing, 2003) |
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(July 2002, resources updated January 2005)
