Finding Hope on the Journey Through Cancer

Rick Boulay, MD
Rick Boulay, MD
August 7, 2014
· Rick Boulay, MD

Dr. Rick Boulay is the Director of Gynecologic Oncology at Lehigh Valley Hospital in Allentown, Pennsylvania, and the founder of The Catherine Boulay Foundation. As a cancer surgeon and the husband, son, and grandson of cancer survivors, he writes, speaks, and connects with others to share the wisdom of cancer survivorship.

Hope.

The magnetic attraction drawing us toward a Seven-Eleven to drop a couple bucks on a small card with a series of six numbers. The spark within us, ignited by passion, now flaming brilliantly focusing all effort and intention on achieving a given purpose. The driving force propelling us through our deepest fears and adversities. Hope runs the gamut from passive to active, mundane to life-altering, concrete to ethereal.   

But to the cancer survivor, hope is so much more than a lofty subject of the intellectual curiosity of thoughtful poets, philosophers, and religious scholars. Hope is a way of life. Hope is a choice that once made, once grasped, once clung to, provides the security in knowing that after a restful night’s sleep, you will wake with the contentment of so many blessings, worldly or otherwise.

But where do we find hope? Where does it live? And how do we access it when we need it most? At the time of our greatest vulnerability—the time when cancer knocks at our door—there is, of course, no single concrete answer. But in my experience as an oncologist and caregiver, hope exists in one of two places: externally or internally.

Hope as an external focus

At the time of initial diagnosis and in early treatment, the cancer survivor may find hope within the myriad of therapeutic options or even from the strong relationship bonds forged with the care team. I’ll often hear comments like: “This chemotherapy and surgery is my only hope for a cure,” or “You are the only one who has ever offered me any hope.” The people with an external focus tend to use outside measures as validation of their hopefulness: “My scan looks great!” or “My blood work is completely normal.” When all is going well, the external focus of hope is very reassuring. But in the chaotic times, when treatments fail or disease recurs, this group is often left cold. Alone and vulnerable, their hope strategy has failed them.

Hope as an internal focus

For others, hope exists within themselves. It stems from a trusting relationship with the divine and an acceptance that all things work together for good. From these cancer survivors I will hear comments like: “Sure, treat me with whatever you need to, but the overall plan rests with His will,” or “If it is my time, it’s my time.” There is no measure to validate this hope.

Interestingly, I often have to negotiate follow-up blood work and scans with this group as they see no need because they believe “God will provide.” Some will get follow-up testing to appease me and have no desire to know the result. This is a group that responds in deeply divergent ways when tested at times of cancer recurrence. They either become even more deeply hopeful, clearly able to see their position in the universe, or they become despondent, hopeless, faithless, and depressed.

My advice to my patients is to develop a little bit of both philosophies: an internal focus resulting from a deeper spirituality to help answer life’s more complex questions and carry you through the most challenging times and an external focus to manage the short-term issues of acute cancer treatment. For a further discussion of hope, please watch this short video excerpt of a live event called Being Alive: Songs and Lessons of the Journey Through Cancer that I wrote, moderated, and performed.

What gives you hope? Share your thoughts in the comments section below or on Twitter.