R-3-15

Surviving the Fight: the Last Battle

“Riiiinnggg, Riiinng,” I could hear the sound of the phone from miles away as my mother

picked up the incoming call. It became silent, so much so that you could hear a pin drop.

Seconds later I heard a loud gasp followed by the sound of panic and shock in my mother’s

voice. I rushed downstairs curious to know what happened. She glared at me, knowing the words

about to be said would change my life forever. Tears rushed down my face as I heard her broken

voice say, “Gr-gr-grandpa passed away due to stage four cancer.”

A year later a similar call would take place, this one however having a much different

outcome. “Her cancer has stopped growing...she’s almost cancer free!” shouted my Dad as he

put down his phone. My face lit up as emotions of happiness and gratefulness filled my heart.

Who would have thought that after months of intense chemotherapy and doctors continuously

telling her she only had 3 months left to live, Diana Tucker would be celebrating life with a

whole new perspective. The brave and inspirational lady who survived her fight would later

become known as my ‘Grandma,’ one of the most kind hearted and deserving women I have ever

met.

I remember thinking to myself, all my life I had heard of other families having to go

through such a fight, but never did I actually think that cancer would be something that would

personally affect my family or friends. What these two stories share in common is the basis for

what cancer has done to so many people across this world. Every day families are faced with the

ups and downs of this disease, yet are able to fight and stay strong in hopes of beating the

monster that is cancer. This eventually led me to wonder what exactly caused the story of my

Grandpa to be so different from that of my ‘Grandma’. Curiosity stormed my brain as I tried to

grasp what really could cause one’s survival over another’s. This experience ultimately led me to

1
 R-3-15

ask the question: What are the different factors such as, time of diagnosis, chemotherapy, and

positive thinking, that affect/impact cancer survival?

Grandma’s story would be key to understanding how these three components of cancer

work together to impact the survival rate of a patient. As someone who experienced a remarkable

journey of survival, her opinion on the research question was vital in order to gain a better

awareness of the topic at hand. The glisten from the sun was shining lightly through the clouds

and into the windows of the tall gray building where Tucker worked. Bright red flowers and

winter decorations were scattered throughout the desk along with stacks of paper and reports for

her busy day of work. What would occur next would be a long discussion on the struggles and

impacts that these factors had on her journey which would serve as the basis for structuring the

research behind this paper.

Cancer is a disease that has taken the lives of so many individuals that it has become an

issue that captures everyone’s heart regardless of whether it has touched one personally or not.

Cancer occurs as a result of the uncontrolled spreading of abnormal cells which can ultimately

create tumors in the patient's body (“What is Cancer?”). Abnormal cells are created due to gene

mutations that happen in the body after birth. These mutations take place when there are errors in

the DNA of a cell, causing the cell to no longer act and perform its normal duties. As the mutated

cell grows and divides, it spreads its abnormal functions to the rest of the body causing

cancerous activities. These mutations can be caused by various sources such as genes being

passed down from generations, as well as radiation which can be transmitted from the

environment and atmosphere in addition to x-rays. Smoking, lack of exercise, cancer causing

chemicals, and obesity can also lead to mutations in genes (“Cancer”). Since there are millions of

cells in the human body, there are a number of different abnormalities that can occur within a

2
 R-3-15

cell. Because of this, there are many different forms of cancer that a patient can be diagnosed

with as well as different methods to treating the form of cancer. While doctors and scientists

have yet to find an exact cure, there are multiple components throughout one’s cancer battle that

can help lead to survival.

Whenever dealing with a life threatening disease, time of diagnosis is something that is

crucial for a chance of survival- so much so that getting detected early could lead to the

difference between life and death. According to Cancer Research UK, “More than 90% of

women diagnosed with breast cancer at the earliest stage survive their disease for at least 5 years

compared to around 15% for women diagnosed with the most advanced stage of disease” (“Why

Is Early Diagnosis Important?”). Being aware of the stage of cancer that the patient is diagnosed

with ahead of time gives the doctors and patients more options in regards to finding a suitable

path that will allow them to survive their disease. When someone is diagnosed with stage four

cancer, the abnormal cells have already spread far enough where treatment may not be as

successful in destroying the cancerous cells in the patient’s body (“Stages of Cancer”).

Therefore, the spreading of cells makes it imperative for early diagnosis to occur as it could help

a patient dramatically.

Yet, with every study also comes an outlier. In Tucker’s case, she was diagnosed with

Lung Cancer while she was in Stage IV, making it extremely hard to recover from. She explains

that time of diagnosis in her opinion is, “the largest impact on cancer survival – the earlier they

find the cancer, the sooner they can do something to stop it. Once it is past a certain size, there is

not much they can do except to try and extend your life as long as possible.” The importance of

early diagnosis was not only expressed by patients but by doctors as well. Doctor Tiffany Svahn,

an Oncologist at the Diablo Valley Oncology and Hematology Medical Group explains that, “In

3
 R-3-15

most cancers (not all), the time of diagnosis does have a significant impact on improved

outcomes and better survival.” Being able to accurately diagnose a patient earlier improves their

chance of survival significantly.

Time of Diagnosis as it pertains to survival rates also varies depending on what kind of

cancer the patient is dealing with. There are more than 100 types of cancer that people can be

diagnosed with making it harder to survive based on which one doctors are treating. According

to an article written by Cassandra Jardine in The Telegraph, the type of cancer along with early

diagnosis is key to improving survival as, “the chances of living for five years after diagnosis

with breast, bowel, prostate and blood cancers have all improved in recent years; but late

diagnosis combined with little research funding keeps lung cancer at the bottom.” Lung cancer,

despite efforts to improve research tactics, continues to be one of the hardest cancers to treat

even when being diagnosed early. As mentioned before, 90% of breast cancer patients will

survive at least 5 years due to early diagnosis whereas only 70% of lung cancer patients will

survive at least 1 year if diagnosed early (“Why is Early Diagnosis Important?”). This difference

is caused primarily due to the fact that lungs cannot be seen or felt making diagnosis solely based

on symptoms such as cough or pain. However, these symptoms oftentimes only appear at the

more advanced stages of lung cancer when it is too late to cure (Pennell 1). Due to this, many

factors go into survival despite being diagnosed early yet the prognosis timing can play a huge

role between life and death.

While cancer may not have a direct cure yet, chemotherapy is considered to be one of the

most prominent methods used to battle cancer around the world. Chemotherapy is the process of

destroying cancerous cells in order to reduce the spreading of these cells and prolong the

patient's life. Chemotherapy drugs contain mixtures of various steroids that are natural

4
 R-3-15

hormones/hormone like drugs that work together to attack the abnormal cells. These drugs also

contain alkylating agents which keeps the abnormal cells from reproducing as it destroys the

DNA inside it (“How Chemotherapy Drugs Work”). Chemotherapy works in many different

ways depending on the severity of the cancer. Sometimes chemotherapy can be delivered

through a shot, other times it can come in the form of a pill, and in most cases it is put into the

patient’s blood through the use of a catheter- or a thin plastic tube. It can also be delivered in

liquid form through intravenous therapy (I.V.) through a plastic bag directly into the patient’s

veins (Stephenson-Laws 1). Chemotherapy usually occurs within cycles with breaks in between

to allow the body to heal and build new cells to get the strength of the patient back to its original

form. A cycle can last one or two days but typically lasts anywhere from two to four weeks and a

course of chemotherapy usually consists of four to six cycles making each course last three

months or longer (“Questions about Chemotherapy”). Despite its complex process,

chemotherapy has been able to do remarkable things for the world of cancer. According to a

report done by the American Cancer Society, Doctor Kassandra Alcaraz explains that, “The

overall 5-year relative survival rate for female breast cancer patients has improved from 75%

between 1975 to 1977 to 90% for 2003 through 2009” and that this increase is due to many

improvements in the treatment of cancer such as chemotherapy, hormone therapy, and targeted

drugs. Thus, chemotherapy has in fact allowed for an improvement in helping cancer patients

survive their disease.

However, while chemotherapy has helped increase some survival rates, it is not the most

efficient way to treat the disease. When a cancer patient undergoes chemotherapy, there are a

number of side effects that can result from treatment, making it hard for the patient to endure

throughout the entire process. One of the main problems with chemotherapy is that in the process

5
 R-3-15

of destroying the cancerous cells, it can also destroy the good ones as well. Some of the main

cells destroyed by treatment include blood-forming cells in the bone marrow, hair follicles and

cells in the mouth, digestive tract, and reproductive system (“Chemotherapy Side Effects”). The

severity of the side effects as well as how long it takes for the body to recover from them all

depend on the person. In Tucker’s case, she explains that going through chemotherapy was

indeed hard for her and that, “In some cases chemotherapy helps – if the cancer is caught early

enough. However, chemo can really be extremely hard on your body at a time when you really

need something to calm your body. There definitely needs to be a better alternative and I believe

it will come – if it’s not already here.” What chemotherapy does to your body causes the patient

to become weak and irritable, as the normal cells are also being destroyed, making the battle

extremely overwhelming and difficult for them. Numerous studies back up this claim as it was

found that, “women receiving adjuvant chemotherapy for breast cancer have substantial

problems with fatigue, menopausal symptoms and cognitive changes” (Downie 1). Due to such

instances, measures are being taken to come up with a better way to treat cancer. Yet, doctors

and cancer specialists know that that is a long and hard process away as chemotherapy is the

closest researchers have gotten to a cure. Doctor Svahn explains that thousands of clinical trials

across all types of cancer show that treatment such as chemotherapy, surgery, radiation,

immunotherapy, hormonal therapy, and biologic or targeted treatments absolutely work in

helping the patient survive. In addition, Sangita Prasad, a breast cancer Radiologist at John Muir

Health, agrees with the effectiveness of chemotherapy stating that, “With the current technology

and research available, chemotherapy is the best fix for cancer as of now. However, hopefully as

technology advances, we can be on the verge of finding a better and more efficient way to cure

cancer while still inflicting as little pain and harm to the patient's body as possible.” Therefore,

6
 R-3-15

despite the immense downsides and side effects that come along with chemotherapy, it still

remains one of the best ways to help prolong a patient’s life.

Now, while physical treatments and factors such as chemotherapy and early diagnosis do

indeed play a big role in survival, there is also a plethora of mental factors that impact survival.

Positive thinking has been a key component in many survivor’s lives and is oftentimes seen as

the only way to get through such a hard battle. Positive thinking and its impact on science stems

from the concept of positive psychology created by Martin Seligman. Positive psychology

focuses on the strengths that enable humans to thrive and live better and meaningful lives as well

as cultivate what is best within themselves (“Positive Psychology Center”). This idea of positive

psychology has been applied to positive thinking in the hopes that it will help patients get

through their cancer in a less stressful way. In a research study conducted by Anna Casellas-

Grau, a researcher at the Catalan Institute of Oncology in Barcelona, Spain, explains her findings

saying:

Five groups of therapies were found: mindfulness-based approaches, expression of

positive emotions, spiritual interventions, hope therapy, and meaning-making
interventions. These specific interventions promote positive changes in breast cancer
participants, such as enhanced quality of life, well-being, hope, benefit finding, or
optimism. (Casellas-Grau 290)

According to Casellas-Grau, one of the main reasons why mindfulness based approaches worked

was that it helped reduce the stress of the patient as well as helped them gain more confidence.

The study also mentions that expression of positive emotions and interventions acted as a

catharsis for patients as they were able to express how they really felt as opposed to bottling up

their emotions. These positive practices resulted in the improvement of life quality with these

patients as the exercises allowed them to feel calmer and more confident in their own bodies.

Moreover, additional studies also show how positive thinking can also allow for less depressive

7
 R-3-15

symptoms and a better overall well being in cancer patients. In order to see the results of positive

interventions on patients, a study was conducted involving 4,266 individuals in which they

participated in interventions aimed at cultivating happiness and positive thinking such as group

therapy and teaching of positive affirmations. The results showed that, “positive psychology

interventions do indeed significantly enhance well-being (29%) and decrease depressive

symptoms (31%)” (Sin 254). By having such positive psychology tactics work to enhance these

patients lives illustrates that one's mental state does impact how they are feeling and how willing

they are to survive their fight as these interventions serve as a way to express their emotions.

Yet, despite such studies, there is no real evidence relating positive thinking to immediate

survival. In a study done in the Annals of Behavioral Medicine, it was proved that claims that

positive thinking interventions improve and enhance the prognosis of cancer patients by

strengthening the immune system are not actually accurate (Coyne 117). Because positive

thinking is not a medicine or a cure, it cannot truly lead to a patient’s survival of cancer.

Although evidence may not show positive thinking as a factor for survival, patients disagree. In

an interview done with The Ulman Cancer Fund for Young Adults, cancer survivor Erika Oertle

explains that what kept her going through her treatments was the positive support and

affirmations she received from her family and friends which translated to her having a much

more positive outlook on life (“National Cancer Survivor Day”). Tucker had a similar experience

claiming that she, “absolutely believes positive thinking played a role in survival – it may not

always cure the cancer but it will keep your spirits high and keep your stress level down...it has

helped in so many ways.” Doctor Svahn added to this idea of positive thinking affecting survival

by explaining that while she does not specifically believe that positive thinking improves

survival, she does in fact believe that positive thinking affects how well a patient feels during

8
 R-3-15

their treatments which can, as a result, improve their wellbeing. Therefore, while it may not

directly impact a patient's survival rate, it nevertheless plays an integral role in their journey.

While time of diagnosis, chemotherapy, and positive thinking can all impact cancer

survival, there are still multiple other factors that go into determining the outcome of a patient’s

battle. Oertle and Prasad both agreed that an informed and knowledgeable doctor is imperative.

Prasad explained that being with an amazing doctor can help a patient tremendously as it will

allow them to work with their doctor to find the best path for them in their journey as each

person’s cancer battle is very subjective. Oertle similarly agreed in her interview as she

explained that she had fired multiple doctors before she found the one that would truly be the

best fit for her on her journey (“National Cancer Survivor Day”). In addition to good doctors,

faith has also been a huge part in many survivors lives. When asked to explain how faith played

a role in her journey, Tucker responded by saying, “I don’t know why I’m still here while others

around me with the same stage of cancer have passed on before me but I know with everything

in me that there is a reason and a purpose for me. I have joy in my heart and faith that all is

well.” Consequently, one’s battle with cancer is based on a synthesis of components that can

help influence a patient overcoming their battle with the deadly disease.

In conclusion, after immense research, there are indeed multiple influences that can

impact cancer survival. Perhaps the most important being time of diagnosis as it is shown that

the earlier the cancer is detected, the sooner it would be to cure and help the patient recover.

Survival rates go up increasingly when early prognosis is made showing the severity of impact

that it can have on prolonging life. More so, chemotherapy also contributes in affecting cancer

survival rates as it remains to be the main treatment method used to cure cancer. Despite its

numerous side effects, it still helps destroy deadly cancerous cells and stops them from spreading

9
 R-3-15

which is imperative if the patient wants to survive. Lastly, while positive thinking may not play a

direct role in survival in does in fact improve the mental state and wellbeing of cancer patients

which can give them the strength to fight the tough battle that is cancer.

After spending much time interviewing and researching how there are many different

components that contribute to survival, it allowed me to get a better understanding of why the

story of my Grandpa and ‘Grandma’ were so different. If one thing could be taken away from

this project, it is that everyone’s cancer battle is subjective to their own experiences. There will

never be two of the same battles as each person goes through different problems and solutions

throughout their fight. That is the basis for what makes cancer survival stories so personal and

emotional. Writing my senior paper ultimately allowed me to realize this and come to terms that

there was not just one thing that made the two cancer stories in my life differ- rather it was the

synthesis of the factors mentioned that created those two outcomes to impact my life so heavily

creating an everlasting effect on my world.

10
 R-3-15

Works Cited

Alcaraz, Kassandra. “Cancer Survivorship Facts and Figures.” PsycEXTRA Dataset, 2014,

www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-

treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-

and-figures-2014-2015.pdf. Accessed 12 Mar. 2018.

“Cancer.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 9 Mar. 2018,

www.mayoclinic.org/diseases-conditions/cancer/symptoms-causes/syc-20370588.

Accessed 15 Apr. 2018.

Casellas‐Grau, Anna. “Positive Psychology Interventions in Breast Cancer. A Systematic

Review.” Psycho‐Oncology, 29 July 2013,

onlinelibrary.wiley.com/doi/10.1002/pon.3353/full. Accessed 12 Mar. 2018.

“Chemotherapy Side Effects.” American Cancer Society, www.cancer.org/treatment/treatments-

and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html.

Accessed 12 Mar. 2018.

Coyne, James C. “Positive Psychology in Cancer Care: Bad Science, Exaggerated Claims, and

Unproven Medicine | Annals of Behavioral Medicine | Oxford Academic.” OUP

Academic, Oxford University Press, 10 Feb. 2010,

academic.oup.com/abm/article/39/1/16/4569219. Accessed 12 Mar. 2018.

Downie, Fiona P. “Cognitive Function, Fatigue, and Menopausal Symptoms in Breast Cancer

Patients Receiving Adjuvant Chemotherapy: Evaluation with Patient Interview after

Formal Assessment.” Psycho‐Oncology, Wiley-Blackwell, 14 Feb. 2006,

onlinelibrary.wiley.com/doi/full/10.1002/pon.1035. Accessed 15 Apr. 2018.

“How Chemotherapy Drugs Work.” American Cancer Society,

11
 R-3-15

www.cancer.org/treatment/treatments-and-side-effects/treatment-

types/chemotherapy/how-chemotherapy-drugs-work.html. Accessed 15 Apr. 2018.

Jardine, Cassandra. “Lung Cancer: 'If Only I'd Seen My Doctor Sooner'.” The Telegraph,

Telegraph Media Group, 14 May 2012,

www.telegraph.co.uk/news/health/news/9260201/Lung-cancer-If-only-Id-seen-my-

doctor-sooner.html. Accessed 12 Mar. 2018.

“National Cancer Survivor Day.” The Ulman Cancer Fund for Young Adults, 1 June 2014,

ulmanfund.org/national-cancer-survivor-day-an-interview-with-erika-oertle/. Accessed

15 Apr. 2018.

Pennell, Nathan. “Why Lung Cancer Is the Deadliest.” U.S. News & World Report, U.S. News &

World Report, health.usnews.com/health-news/patient-advice/articles/2015/06/30/why-

lung-cancer-is-the-deadliest-cancer-and-why-it-doesnt-have-to-be. Accessed 15 Apr.

2018.

“Positive Psychology Center.” Positive Psychology Center, ppc.sas.upenn.edu/. Accessed 12

Mar. 2018.

Prasad, Sangita. “Personal Interview.” 17 Mar. 2018.

“Questions about Chemotherapy.” American Cancer Society,

www.cancer.org/treatment/treatments-and-side-effects/treatment-

types/chemotherapy/what-chemo-is-and-how-it-helps/questions-about-chemo.html.

Accessed 12 Mar. 2018.

Sin, Nancy L. “Enhancing Well‐Being and Alleviating Depressive Symptoms with Positive

Psychology Interventions: a Practice‐Friendly Meta‐Analysis.” Journal of Clinical

12
 R-3-15

Psychology, Wiley Subscription Services, Inc., A Wiley Company, 19 Mar. 2009,

onlinelibrary.wiley.com/doi/10.1002/jclp.20593/full. Accessed 12 Mar. 2018.

“Stages of Cancer.” Cancer Research UK, 12 Dec. 2017, www.cancerresearchuk.org/about-

/what-is-cancer/stages-of-cancer. Accessed 12 Mar. 2018.

Stephenson-Laws, Joy. “So What's in an IV Anyway?” Proactive Health Labs, Phlabs, 9 Oct.

2014, www.phlabs.com/so-whats-in-an-iv-anyway. Accessed 15 Apr. 2018.

Svahn, Tiffany. “Personal Interview.” 13 Mar. 2018.

Tucker, Diana. “Personal Interview.” 12 Feb. 2018.

“What Is Cancer?” National Cancer Institute, U.S. Departement of Health and Human Services,

www.cancer.gov/about-cancer/understanding/what-is-cancer. Accessed 11 Mar. 2018.

“Why Is Early Diagnosis Important?” Cancer Research UK, 23 Nov. 2017,

www.cancerresearchuk.org/about-cancer/cancer-symptoms/why-is-early-diagnosis-

important. Accessed 12 Mar. 2018.

13