Workshops on hope help cancer patients remain resilient, find strength

Reported September 03, 2007

TORONTO (CP) - For Victoria Campbell, hope is a "beacon in the darkness" in her long, intense battle with cancer that began five years ago.

The elementary school teacher was diagnosed with breast cancer in 2002, then colon cancer in 2005 - which metastasized to her liver. She has now just come through her third surgery for lung cancer.

"Hope is a critical aspect, I find, with living with cancer," says the Saskatchewan native who moved to Toronto a few years ago. "We want to live a quality life no matter how long we have to live."

"It's not the quantity, it's the quality," says Campbell, 56, who recently attended a workshop on hope at Wellspring, a national support group for people living with cancer.

She likens hope to a light.

"And light to me in healing is central," says Campbell. "Both the visual aspect of light entering into me and also the aspect of light and hope in terms of what is ahead for me - it is a beacon in the darkness."

Eva Thurlow of Wellspring in Toronto says the seminar entitled "What Is Hope" looks at the personal meaning of hope and how cancer patients and their caregivers can remain resilient in the midst of change and challenge.
 

Wellspring's programs are offered in conjunction with the Healing Journey Program, a support and coping skills regimen developed at the Ontario Cancer Institute/Princess Margaret Hospital in Toronto.

The hope workshops are led by Dr. Claire Edmonds, who manages the Healing Journey Program at Princess Margaret and Wellspring.

"Hope is about human dignity ... about carrying on even when circumstances are difficult," says Edmonds.

For many patients diagnosed with cancer, hope becomes flexible and "moves with us through our journey," she says.

Edmonds rhymes off the ways that hope emerges during illness and treatment.

"I hope there are treatments for this. I hope that the chemotherapy works. I hope that there are going to be medications to help me deal with nausea."

"I hope that I'm going to be well for the wedding. I hope that I'm just going to have eight months of chemo and then it will be gone."

If the cancer comes back, hope re-emerges.

"I hope I have time. I hope there are more treatments. When the treatments begin to run out, hope becomes I hope that the pain is manageable ... that I can have good days ... that I can spend time with my grandchild."

"If we are hopeless, in a profound state of hopelessness, we'd probably be a suicide," Edmonds adds. "There just is no reason to move on."

While there is no hard research on health outcomes related to hope, there is strong evidence of its benefits, says Denise Larsen, head of research at the Hope Foundation at the University of Alberta in Edmonton.

The foundation conducts research into how hope might be fostered in individuals facing difficult circumstances such as cancer and heart attacks.

"(Research) indicates that individuals with higher levels of hope actually appear to have neurochemistry that helps potentially to combat depression," Larsen says.

"There's some research that suggests that those people with higher hope may actually live longer with terminal cancer ... we know for a fact they live better."

"We understand now that hope is really about being able to envision a good future or a better future for oneself, and believing that that's possible."

There are several things that people can do to make hope happen, and this is where workshops, like those at Wellspring and the Hope Foundation, come in.

The Wellspring program has four steps, starting with basics like pain control, then moving on to mental states, social connections and spirituality.

The first step, says Edmonds, is "adequate nutrition, adequate sleep, adequate pain control ... It's hard to be hopeful when you're hungry, tired and in pain."

Level two concerns the mind and healthy thought management.

There are ways of saying things to yourself and others that support hope and ways of saying them that support depression and hopelessness, says Edmonds.

For example, "saying, I feel awful is different than saying I don't feel well today. (The latter) gives a spaciousness. I don't feel well today embodies hope. I could feel better tomorrow," she said.

Healthy thought management, says Edmonds, can be attained through meditation and keeping a journal.

Keeping a journal helps people to see what thoughts they are carrying with them and which ones they want to change, says Edmonds.

The third step is thinking about social connections.

"When we're stressed, we need people," says Edmonds.

"Hopefulness is actually somewhat contagious in a good way, just like hopelessness is. You can bring people down in a group and you can bring people up."

Lastly, for those who have a spiritual practice, it can connect them with places of peacefulness inside of themselves "so that they are not caught up in those anxious thoughts," says Edmonds. "They can sort of float a little bit."

Campbell found the workshop to be uplifting.

"By gathering and focusing on hope ... and having an opportunity to speak about it, I found it strengthened me," she says.

What gives hope to Campbell on a daily basis?

"When I awaken ... I'm just thankful that I have today, and hopeful that I'll have tomorrow in the same kind of way that I have today ... pain free."

Also, "focusing on what I have as opposed to what I have not" gives her hope, as do the practices that keep her in the light - a journal, meditation, imagery visualization.

"If I do those on a daily basis, I am filled with light and ... hope. If I don't ... my thoughts go the sadness that my life may not be as long as it would have been had this not developed."

"With cancer life becomes so precious. I'm so acutely aware of everything."

But sometimes, she said, her voice breaking, "you kind of wish it would just all go away."