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Cancer’s Unwritten Law

medical team By Anne Coscarelli, Ph.D. (Simms/Mann Center Director)

There is an unwritten law (Coscarelli’s Law) about cancer and its treatment that goes like this: “For every physical effect, there is an equal reactive psychological effect.” It seems so obvious when you say it out loud but is so hard to realize when you are in the midst of a cancer diagnosis, diagnostic work-ups and treatment regimens. So I often find myself explaining this unwritten law and its details to patients, family members and the physicians that treat them. From the moment the word “cancer” is uttered, life changes, not because in that instant the world actually deconstructs, but because it psychologically changes you and how you think and feel about life at all levels. It also changes how your family and/or a close network of friends think and feel.

Think for a moment about the myriad of physical situations that a person diagnosed with cancer begins to experience. Almost every test requires cognitive energy for scheduling appointments, dealing with insurance companies and inevitably some type of discomfort from needle sticks, dyes injected, hard cold tables, unusual or uncomfortable positions, and placement in rooms in the center of a cylindrical tube that goes rat-a-tat-tat at various deafening levels. There are more visits to more doctors, requiring more time and attention being directed to health issues instead of other activities such as work, family and social networking. When treatments begin there are inevitably more pills to swallow, IV’s to be started, blood tests to be taken, surgeries to have and side effects to be endured. It is not simply the pain and physical discomfort of these with which patients must grapple, it is the psychological impact as the mind processes each of these events and the ripple effect that they have across the fabric of a person’s life. While one event seems manageable, the sheer number of discomforts, physical changes, and daily appointments add up and can snowball into something that, at times, seems overwhelming. I’m not even outlining the deeper existential issues of life, death and meaning yet!

How one responds psychologically to these events is highly individual. What may seem like a non-event to one person can be monumental to another. Each individual’s personal history, experience preceding the diagnosis as well as the details about the individual’s treatment and cancer makes each person’s experience a very personal journey. That being said, we have documented a number of the most frequently expressed reactions and feelings. It is not unusual for patients—and we must also add family members—to react with anxiety, depression, and sadness. The uncertainty of situations, the waiting for information, the twists and turns that the diagnosis and treatment can lead people through varies by individual and, as a result, the cancer journey is uniquely personal. Despite this, there are documented experiences that fit within what we can call a “frame of normalcy. ”

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