Zen for Daily Living: A skillful path for cancer

A few years ago, I had a rapidly growing lump under my left arm. Having worked for over 20 years in oncology, palliative care and hospice, my rapidly growing tumor was a cause of fear and alarm. My parents had cancer four times between the two of them so I’ve known for years that I have a genetic risk for cancer. As soon as I noticed the growth under my arm, I immediately made an appointment with a trusted family physician.

At my appointment, as my physician examined my potentially cancerous tumor he remarked with sadness, “Only the good die young.” I’m not sure what he meant by that, but I didn’t find it comforting.

There are over 200 kinds of cancer, and the experience of what it’s like to have cancer can be radically different for every individual. What tends to be true for the vast majority of cancer patients and cancer caregivers is that cancer is hard.

It’s hard to describe the strange new world that is a cancer diagnosis. Often, at first, people are in a state of shock. It can be hard to acknowledge, even on a purely rational, factual level, that you have cancer. It’s hard for the brain to process this seminal, new reality. A cancer diagnosis is often the first time many people are forced to confront their mortality directly in a realistic fashion, and it can be shocking.

Many cancer patients have told me that it takes a few months to work through the numbness and shock of a cancer diagnosis before they can begin to process their emotions and start adjusting to the breadth of changes that cancer brings.

One thing people are often surprised by is how complicated cancer is. Patients and families are faced with a bewildering amount of treatment options with far-ranging consequences and often with little time to consider the ramifications of their choices.

In his book "Being Mortal: Medicine and What Matters in the End," Dr. Atul Gawande describes what it was like when his own father was diagnosed with cancer. Gawande is both a surgeon and a professor at Harvard Medical School, and his parents were also both physicians. A family of doctors would seem like the ideal family to care for a loved one with cancer. However, Gawande explains that despite the fact that all three of them were physicians, none of them understood their treatment options because they weren’t specifically oncologists. In other words, modern medicine has grown so complicated that being a medical doctor isn’t always sufficient training to fully decipher and process cancer-related treatment options. If a family of doctors doesn’t understand what their oncologist is saying to them, how much does the average patient actually understand about their cancer treatment?

Cancer is also expensive. Ask any newly diagnosed cancer patient what one of their biggest fears is and they’ll usually reply that they worry about medical expenses. Former professional athlete Lance Armstrong described how cancer could have bankrupted him if his insurance was cancelled, which almost happened to him, and he is a multimillionaire. It’s not hard to imagine what cancer treatment can do to the finances of most people. What type of toll does it take on one’s mental health to internally debate cancer treatment or bankruptcy? The leading cause of bankruptcy in the United States is medical bills. Medical bills leading to bankruptcy is particularly a problem in Texas, which has the highest rate of uninsured patients in the country.

I remember when my mom had cancer. Sometimes she would lie in bed in so much pain and discomfort that shivering and quietly weeping was all she could do. My mom cried when her hair started falling out in clumps, a common side effect of chemotherapy. Being a caregiver can be equally hard. When a loved one is diagnosed with a chronic or incurable illness, caregivers can sometimes have shorter life expectancies than the patient. For both patients and family members, the psychological challenges that cancer presents are often the toughest. Many cancer patients and caregivers have compromised immune systems, and the COVID-19 pandemic has been especially hard for the oncology community.

That’s why I’m so grateful for the Flatwater Foundation (flatwaterfoundation.org). The Flatwater Foundation provides mental health services via licensed providers (psychologists, social workers, licensed professional counselors, etc.) for cancer patients and their family members that would not otherwise have access to mental health support. The Flatwater Foundation was founded by Mark Garza after he struggled to find affordable mental health support for his family when his father was diagnosed with a Stage IV cancer.

The Flatwater Foundation provides mental health services for cancer patients and their family caregivers in Central Texas; they connect individuals with professional therapists to help provide support and find the strength to take on a cancer diagnosis. Since its inception in 2010, the Flatwater Foundation has raised over $7.5 million and paid for over 54,000 hours of therapy for those who would otherwise not have the means to pay for mental health care.

There are a lot of stressful things happening in our society. But something I think we can all support is providing quality mental health support to cancer patients and their family members who could not otherwise afford it, especially when so many people are struggling to find access to care.

More good news, if you want to do something to help make a concrete difference in your community, there’s a great opportunity coming up. On Monday, Sept. 12, the Flatwater Foundation will have its annual fundraising event: Tyler's Dam That Cancer. Participants riding stand-up paddleboards complete a 21-mile course from Lake Austin’s Mansfield Dam to the Tom Miller Dam. This year, 230 paddlers have committed to the event, seeking to raise $1.2 million to benefit the foundation’s mission of providing mental health therapy in the form of counseling sessions to Central Texans impacted by cancer. So far, this annual event has raised over $5 million for families touched by a cancer diagnosis.

I’ve seen the trauma that a cancer diagnosis can inflict. And I’ve also seen the hope, determination, growth and grace of cancer patients and caregivers, which amazes me on a daily basis. If you’re interested in attending and supporting Tyler's Dam That Cancer, please visit tylersdtc.com.

There are hard things in the world, and there is also joy and transformation. The Historical Buddha said the community is the most important part of the spiritual path. I can’t think of a more skillful community and vision than the Flatwater Foundation, and this Buddhist monk offers the Flatwater Foundation my sincere bow of gratitude.

Dr. David Zuniga is a clinical psychologist in private practice in Austin, and he is also a vice bishop in one of the oldest lineages of Korean Zen; his website is a free, interdisciplinary source of support: drdavidzuniga.com.

This article originally appeared on Austin American-Statesman: Zen for Daily Living: A skillful path for cancer