Cancer

As we discussed in the first part of this two-part series, cancer is not a single entity. Various cancers have general similarities in that they develop from normal cells which mutate to make them grow in an uncontrolled, unnatural fashion, yet each type of cancer behaves in its specific, unique way.

Some cancers are aggressive, and some are much slower growing. Some tend to be localized and are quite slow to spread to other parts of the body, whereas others are likely to show up in locations far from where they began.

It is not possible to make blanket statements about cancers, but in this section, I will discuss some general things about prevention and treatment, then I’ll finish with some thoughts about us as Christians relating to someone who is dealing with cancer.

Lifestyle Changes to Prevent Cancers

Many of the things that increase the risk of cancer are things that (hopefully) we, as Christian people, are already avoiding.

Tobacco is one such thing. Tobacco, when smoked, increases the risk of lung cancer. It also increases the risk of head cancer, neck cancers, esophageal cancer, stomach cancer, and cancers of the liver and bladder.

Alcohol is another substance that raises the risk of cancer. Liver, voice box, and esophagus cancers are all related to alcohol consumption. Some people claim to drink alcohol for “health benefits,” but there is no safe level of alcohol consumption. Even people who drink moderately have an increased risk of death related to their alcohol usage.ⁱ

Another thing that should be limited is exposure to ultraviolet radiation. We know that UV radiation increases the risk of skin cancers, so wearing clothing that protects, such as hats and long-sleeved garments, and using sunblock can reduce this risk.

On the positive side of things, healthy eating habits, such as consuming lots of fruits and vegetables and avoiding highly processed foods, will reduce the risk of colon cancer.ⁱⁱ Fiber seems to be a key here and higher levels of dietary fiber are helpful. Additionally, fruits and vegetables are rich in antioxidants, vitamins, and minerals and are supportive of a healthy immune system. It is recommended to eat at least two servings of fruit and five servings of vegetables per day.

It is interesting that while people who eat healthy diets have a decreased risk of cancer, there is little evidence that there are specific vitamins that will prevent cancer. That is, there is little benefit if you eat a very unhealthy diet and then take vitamins in an effort to compensate for your unwise choices.

Prior to doing a controlled test it is always hard to know whether or not a certain supplement will help. Vitamin E is an antioxidant and so it was thought to be helpful in the prevention of cancer. However, it turns out that studies have not shown this to be true. Actually, in high doses, it seems to increase the risk of certain cancers and heart disease.ⁱⁱⁱ

Rather than trying to find the right supplements, it is more important to make certain that we are eating healthy diets.

Chemotherapy

Now, let us move to a brief discussion about different types of treatment for cancer. Chemotherapy is probably what most people think of first. It was first used in the 1940s when doctors used a derivative of nitrogen mustard to treat lymphoma.

Since that time, hundreds of different medications have been developed as chemotherapy, designed to attack the cancer cells. It is hard to generalize about chemotherapy because there are so many different medications designed to treat different cancers and because they have different side effects.

Due to the fact that they attack cells that are rapidly multiplying, many of these drugs tend to make a person’s hair fall out since hair cells are of the rapidly multiplying type. Nausea, vomiting, and blood count alterations (low white cell counts) are other common side effects.

If a cancer has spread from its initial location, chances are good that it will require more than just one type of medication in order to achieve remission.

Even if a cancer hasn’t spread, surgeons will often recommend doing some chemotherapy ahead of surgery to shrink the tumor and to make surgical removal easier.

While chemotherapy sounds scary, it actually works quite well for certain types of cancers, such as blood cancers (like leukemias), lymphoma, and breast cancer.

These days, cancer doctors test the biopsied cancer cells for genetic markers. As a family doctor, I see these reports but, since I am not a specialist in this field, I find them somewhat confusing. The important thing to remember is that these markers help to predict what the best drugs are to use on a specific type of cancer.

Surgery

For many years, surgery was the cornerstone of cancer treatment. Cancers that have not spread can be removed entirely, allowing a person to move forward without any further treatment.

Often, by the time that a person’s cancer is discovered, it is too late to completely remove it. Surgery can still be helpful. For one thing, it gives a sample of the cancer for testing to help identify the best treatment. More than that, even if a cancer has spread, there are times that a tumor needs to be removed, simply because of the organs that it is putting pressure on.

I have heard some people claim that it is dangerous for a cancer to be exposed to oxygen. They believe that cancer cells spread faster after the tissues are opened up and exposed to the air during surgery. There is no documented evidence to support this idea. Many people do seem to get sicker after having an exploratory surgery when their cancer is being diagnosed. But the issue isn’t really the air getting into the cancer cells, rather the cancer was most certainly at the point of beginning to exhibit serious symptoms, and the surgery simply brought things to a head. Also, any surgery will be stressful for any person’s body, which will only increase the wearing down of a person’s already taxed strength and vitality—their ability to stay on top of a debilitating illness.

Typically, when a tumor is removed, nearby lymph glands will be sampled to see if they contain cancer cells. This presence, or absence, of cells helps with the “staging” of the cancer (such as “stage 3” or “stage 4”) and will provide insight for further treatment to prevent a chance of recurrence.

Immunotherapy

One of the newest treatments of cancer is called immunotherapy. These are medications that rev up a patient’s immune system to clear their body of cancer cells.

This sounds great and you would think the side effects should be minimal. Unfortunately, it doesn’t always work according to plan. Some cancers don’t respond to these sorts of treatments. And as far as side effects go, these medications can result in autoimmune diseases. When a medication is prescribed that makes the immune system extra active (or over-active), sometimes it begins to attack the patient’s own organs. While some of these side effects get better with the cessation of treatment, not all of them go away.

As an example, I had a patient who took immunotherapy for melanoma that had spread to his lymph glands. He was cured of the cancer, but the immunotherapy damaged his saliva glands enough that he has ongoing issues with a dry mouth. At this point, it seems unlikely that he will regain that moisture in his mouth.

Future Treatments

There will probably be more treatments in the future, targeting specific types of cancers. Something that is currently under investigation are vaccines that would target specific types of cancers. Currently none of these are available except in clinical trials.

Choosing Wisely

Oncologists (cancer specialists) do not know the future. They talk in terms of percentages. One protocol has an 86 percent chance of achieving a two-year remission from cancer, another only 56 percent. The same thing is true for side effects. While a doctor can tell you that 26 percent of patients get nauseated with a treatment, that doesn’t tell you if you will be one of that 26 percent and whether that nausea will be controllable with anti-nausea medication.

In deciding what course of treatment to choose, you will find no Bible passage to indicate one direction or another. Having a good oncologist who will explain things carefully—both the chance of success and risk of side effects—is key. There are times that you may need to change to a different cancer doctor, simply because the one you have does not take the time that you need to feel comfortable with your treatment.

If any of you lack wisdom, let him ask of God, that giveth to all men liberally, and upbraideth not; and it shall be given him –James 1:5. We need wisdom in many areas of our lives, but certainly choosing how to navigate medical decisions is one of those areas. It is a wonderful thing that God has promised to give us the wisdom that we need—if we just ask.

Prayer—both personal prayer and by your church community—is very important. Prayers can be for healing. It can also be for caring, Christian, medical caregivers, and for wisdom in choosing the best treatments.

Sometimes God cures through doctors and medications. Sometimes, He heals in spite of them. Sometimes He decides it is time for us to go home to be with Him, thereby providing us with a new body that is not sick and broken.

Bless the LORD, O my soul, and forget not all his benefits: Who forgiveth all thine iniquities; who healeth all thy diseases –Psalm 103:2-3. With all of the medical technology available to us, it is easy to forget that healing comes from God. All the chemotherapy in the world will not avail if God does not work an act of healing. At the same time, there are many times that God works in miraculous ways to heal despite the dire predictions made by the medical professionals or other well-meaning individuals.

Often the best that a patient can do is to choose (according to their best judgment) the best treatment course (based on success rate and side effects) and then see how things go. If the side effects are too severe or the treatment doesn’t seem to be working, there is always the option to change.

Ultimately, when healing comes, regardless of how it comes, it is God that provides that healing. Let us never forget that.

Cancer Takes Energy

Relating to someone with cancer is not much different from relating to a person with any other chronic illness. There are differences though.

Both having cancer and receiving treatment for the cancer takes a lot of energy out of a person. While it is important not to ignore someone who has cancer, it is just as important to remember that they do not have endless energy supplies. A ten- or fifteen-minute visit may be all that they can handle. It is best to let them decide the length of visits that they have energy for.

Hesitate to Give Advice

Your “cousin” may have had cancer and may have gotten better after taking a particular supplement or visiting a particular clinic. Sharing that information with a person who is dealing with cancer is just one more piece of information for them to process out of a “thousand” others they may have received. It seems as though someone with cancer is often bombarded with advice and recommendations from well-meaning friends and family.

It is hard to figure out what the best thing is to do when a person is already low on energy. Sometimes, cancer patients simply have prayed that God would bless their choices and then have left the outcome in His hands.

If the cancer patient asks for your input, you can give it, but if not, it is probably best to hold off on the temptation to give unsought advice.

Listen

There is never a situation where listening isn’t beneficial. It is through listening that we allow others to unburden themselves from fears and frustrations. Listening can help the person to put their thoughts into words. More than that, we may hear ways in which we can help.

Maybe it is someone telling you the (too long) story of how their doctor missed their cancer. Or perhaps, it is them telling you about their fears regarding either their cancer or their treatments.

Pray

…The effectual fervent prayer of a righteous man availeth much –James 5:16. This verse comes in the midst of James talking about anointing with oil, confession of sins, and physical healing.

We can certainly pray for, and with, someone who is dealing with cancer. Listening helps us to know how best we can pray for them. It lets us know what their particular struggle is on a given day and how we can best lift them up to the throne.

The passage in James makes it clear that healing does not come from the oil that is poured over someone, but rather from God’s work in their life. The prayer, the faith, and the obedient action is more important than the anointing oil, although all demonstrate a dependence on a God who is always faithful.

Do Small Chores

If a brother or sister be naked, and destitute of daily food, And one of you say unto them, Depart in peace, be ye warmed and filled; notwithstanding ye give them not those things which are needful to the body; what doth it profit? –James 2:15-16.

If it is not enough to pray for someone who is dealing with a serious illness, it is certainly not enough to tell them, “God bless you.”

Figuring out what things someone with cancer needs help with may not be easy, but often even little tasks are difficult for them. It could be that they need transportation to a chemotherapy appointment. Maybe they need help with making a meal, with childcare, or with cleaning their house. Helping in whatever ways we can makes a huge difference for those who are dealing with the fatigue and stress of cancer.

More than that, the important thing is that we make the effort to demonstrate our love to those in our church body who are suffering. Paul told the Corinthians that when …one member suffer[s], all the members suffer with it… –1 Corinthians 12:26. Whenever there is a need, the rest of the local church body has an obligation and should have a deep desire to help in whatever way they can.

Be Willing to Keep Your Distance

Chemotherapy can cause a cancer patient to have an extremely weak immune system. A normal white cell count is between 4,000 and 10,000. but during cancer treatments I have seen patient’s white cell count drop down to 200. In this scenario, if they catch any type of infection, they will be unable to fight off that infection and will end up in the hospital.

It is important to understand that someone in this condition who chooses to keep their distance is not necessarily trying to avoid fellowship. Rather, they are trying to avoid an unneeded hospital stay for what cancer doctors call a “neutropenic fever” (a febrile illness with a really low white cell count).

In these sorts of situations, phone calls or even text messages go a long way toward helping a brother or sister feel that they are not alone, even when they cannot physically be around other people.

Conclusion

I wish I could give a complete run down of every type of cancer out there and the best treatment for each one. That would be beyond my capability and further, it would be outdated within six months’ time.

What I can say is that prayer is key. Prayer for the Holy Spirit’s leading (see John 16:13), for energy for each day, for healing, and for God’s will to be done. Most of all, we need to pray that God would be glorified in and through us. (See 1 Peter 4:11) There have been so many people who were able to speak to their nurses and doctors about their Lord, even as they dealt with side effects and cancer symptoms.

It is easy to read all the instructions about giving up worrying that is found in Scripture and think that it should be easy to cast our cares on Him (see 1 Peter 5:7). However, it is much harder to put into practice. We may feel one day as though we have conquered fear and wake up the next morning with every bit as much anxiety as we ever had.

It is in this that we desperately need a church community. We are not alone, but we will feel alone unless we have brothers and sisters around us who help us as they are able and who pray for us in our valleys and rejoice with us in our times of victory.

It is only then, that we can come to the place that the Apostle Paul did when he said, For to me to live is Christ, and to die is gain –Philippians 1:21. Of course, he was talking about a possible execution, but his resignation to God’s will was total. I pray that we too might reach that place, even as we deal with something as difficult as cancer.