“Hope is the thing with feathers that perches in the soul, and sings the tune without the words, and never stops at all.”
- Emily Dickinson
Hope is confidence in the future.
One of the greatest challenges the cancer
community faces is finding the balance between the ‘reality’ of the illness and
hope. For some, any hope is extinguished from the moment they are given a
cancer diagnosis. For some, a diagnosis represents an imminent battle, which
can fuel a fire of zealous hope. For still others, hope waxes and wanes based
on current circumstances. Has there been a recent optimistic test result? Or is
there a new symptom?
However the concept of hope is elusive
while we live in a research-rich, science- and data-driven world. We know the
poor morbidity and mortality statistics for some cancers all too well, however
there are always exceptions to the rule. There are patients who are started on
palliative therapy who then go on to become long-term survivors.
Some people place their hope in everything
outside or around them – treatment measures, scan results, blood counts, etc.
However this external focus can be precarious when things go wrong.
Others place their hope within themselves –
whether that be their inner strength, their faith, or their belief in the way
the world works on a more spiritual level.
When discussing caregiver interactions with
patients diagnosed with metastatic cancer, the vast majority wanted their
doctors to be realistic yet also individualise their approach working with
them. The other factors that gave the patients more hope were: doctors offering
most up-to-date treatments, doctors knowing the patient’s cancer really well,
doctors reassuring the patients about good pain control, telling them all the
treatment options, and using humour. There were 6 styles used to convey hope:
realism, emotionally supportive and responsive, facilitating coping with dying,
providing information, emphasising therapeutic options, and sharing personal
information. In all of these, the clinician’s aim needs to be fostering
“Hope is… at one and the same time both an
anticipation of something positive and a positive acceptance of the
Perhaps we should instead view ‘hope’ as a
reflexive response to uncertainty, a means of self-preservation through
adversity. A way of life. A choice to take each moment, live it wholly, without
focusing on the next. For there is no such thing as false hope, there is just
hope. And sometimes that just means getting on with it, enjoying good quality
of life even when life expectancy is uncertain.
“We may need to grieve [one hope] to allow
another to bloom.” – Thiel and Harris