How Seasonal Depression and Low Testosterone Can Cause Suicidal Episodes in Testicular Cancer Survivors

I’m unfortunately writing this PSA out of personal experience. As much as I might have hoped to just have a clean getaway from the 2010’s after all my family and I had been through in this decade, they weren’t done with me yet. Yes, I had a suicidal episode of all things over the Christmas holiday of 2019. What a wonderful way to end 2019 and the entire decade, right? It wasn’t all palm trees and sunshine.

[Note: This is one of those blogs where literally everything ties together. Mental health, physical health and wellness, proper diet and eating right, getting enough exercise, taking proper care of yourself, and then what can happen when you do none of the above and allow for the possibility that your body (and mind) gets into a very serious tailspin. It took me an extra day just to add links to all of the related blogs and add a few photos. Take your time, definitely check out all of the linked and related blogs, and get in touch if you want to talk about anything. Although not present on social media much, I’m always in the background for the testicular cancer and broader AYA cancer communities, and am just a click away. - Steve]

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Related Blog: TESTOSTERONE CHALLENGES AFTER TESTICULAR CANCER

For testicular cancer survivors adjusting to their new lives after treatments, many doctors like to think that the other testicle will “pick up the slack” as far as our testosterone levels go, but it’s not nearly that simple, and this has merely been an assumption by many doctors that hasn’t been backed up by any formal data. Hormonal peaks and valleys are common, which I’ve most certainly experienced over the years, along with a general ‘irregularity’. The best way to describe how a man can feel when having a testosterone level dropout, is like Superman without his powers — weak, lethargic, depressed, afraid, directionless, and completely lacking any confidence about anything. Very manly, right? With a single testicle, we’re not like a twin-engined aircraft that can still fly almost as normal with a single engine out. As I wrote in my above blog, for the most part I don’t have any ongoing symptoms of low-testosterone, and my body managed to figure things out after a few years. I’ve decided to forego any testosterone replacement therapy (TRT) so long as I’ve remained asymptomatic, but I’m not always asymptomatic, and the bottom fell out on me over the holidays.

The end of the year, and in particular right around the winter solstice — the shortest day of the year — has always been a problematic time for me. It was on one of the first winter solstices that I experienced after my cancer fight, that I noticed just how out of it I felt, almost as though my body wanted to shut down and hibernate. I was experiencing extreme fatigue and felt very depressed, had zero libido, and noticed around the same time that I didn’t even need to shave along with the loss of some body hair. All of this was a dead giveaway for low-testosterone, which a subsequent visit with an endocrinologist confirmed. I’ve managed to minimize these seasonal hormonal troughs so long as I’ve kept myself in pretty good shape and hit the gym regularly, while also maintaining a reasonable diet.

So of course, I hadn’t been doing any of this lately. A brutal work travel schedule the entire last third of 2019 obliterated any fitness routine I might have attempted, exacerbated my chronic fatigue issues, and my diet regressed as well. In hindsight, it’s almost entirely predictable that something like this was bound to happen, because I’d been doing absolutely nothing that I should have been. And there I was.

A Suicidal Episode at Disney World Due to Seasonal Depression And a Hormonal Dropout

We trekked all the way down to Orlando from our D.C. area home base for a week at Disney World over the holidays. With 5 human beings and a dog and all of the expense and logistical complications that come with flying a family of that size anywhere, we decided to drive in our land yacht all the way down. This saved us a few thousand dollars in airfare and car rentals, which is a big part of why we bought it. We split up the drive over two days, but it’s still a long friggin drive, and I was seriously fatigued from my work schedule in the preceding few months. I couldn’t catch even a single friggin break, because right on cue our alarm system acted up the night before we were leaving, which disrupted my sleep and made things even worse. Our first day at Disney World was Monday, December 23rd 2019, the exact date of the winter solstice, and almost like clockwork I couldn’t have been more out of it.

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Here I was at the “happiest place on earth”, and I didn’t want to be there at all. Heavy feelings of depression hit me out of nowhere, I wanted out but felt trapped, and that’s when the suicidal thoughts hit me. None of it made any sense to me. Why on Earth was I having such godawful thoughts over Christmas, with my family, in the warmth of Florida, and out of the cold, miserable, and swampy sh*t hole of D.C. while at Disney World of all places? I was afraid and confused and definitely feeling very lost.  

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Do I look suicidal here? Fooled you! Not literally right in this very moment, but around this time is when it was hitting.

Related Blog: PROTECT YOUR ENERGY FROM THE CRINGE AND JUST DO YOU

I think I must have felt it coming somehow, because I decided to go totally ‘dark’ once again. I logged out of all social media accounts, never looked at the news, and didn’t even put up any Merry Christmas or Happy New Year greetings on social for family or friends. When you’re having really awful thoughts like these, do you really need to be reading about all of the twisted sh*t going on in the world, or seeing yet another friend blowing a gasket over the latest thing they’re outraged about in the news, which probably isn’t even true? I just focused on staying in the moment with my family, put all external worries and concerns out of my mind, and luckily whatever spell this was faded by the middle of Christmas Day.

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It saddens me that I have a bit of experience with suicidal episodes, but it can most certainly come with the territory of being a cancer survivor, and really speaks volumes about just how badly hormones being out of whack can mess with your head. The first time I’d ever been suicidal in my life was just short of two years after my cancer diagnosis, when PTSD was ravaging me from the inside out and burning my mind to the ground. It was the same feelings of feeling trapped with no way out, and just wanting to end it all as a means of escaping the pain that you can feel from PTSD. I was terrified of my body and couldn’t bear to live another moment in it, but how do you escape your own body? Well… 

Don’t do it.

National Suicide Prevention Lifeline: 1-800-273-8255 

Call the above number any time in the U.S. Reach out for help. Call a friend. You can even try the GRTY Health Chatbot. You can CONTACT ME and I’m happy to talk people through these situations, but I can’t guarantee I’ll be immediately available. Things will get better. Everybody is entitled to a “bad day”, especially as cancer survivors. The next one will be better, I promise. Believe in yourself, don’t give up, and keep getting back up. You will find ways to make it through whatever’s been haunting you, just as I and many others have.

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At Disney, I took a deep breathe, told myself that this wasn’t what I wanted and had no idea where these thoughts were coming from, and just fully immersed myself in the moment, enjoying each and every second with my family at Disney. I didn’t give myself time to think or my mind the ability to wander, and that’s what turning off you phone, social media, the news, and all of those other distractions is all about. When you’re immersed in these external things, you’re not in your moment; you’re in someone else’s, and potentially someone else’s pain and misery, which there’s been no shortage of on the Internet! Stay in the moment — your moment. How “clean” is your social media feed? How clean is the news? Everybody’s experiences are likely to be a bit different, but I personally can’t go on social media or read the news without wanting to throw up. This is why when I’m feeling vulnerable or have dark thoughts going through my mind, I just switch all of this garbage off. At Disney where you pay by the minute, running around like crazy and hitting 20,000 steps per day probably did a lot to jerk my body out of whatever hormonal slump I was in, and I perked right back up.

Different Causes Require Different Responses

Of course, nobody wants to keep feeling this way. It can be tough to decipher where deeply depressive states or suicidal thoughts are coming from. I’ve been in depressive states because young adult cancer is a terrible life situation to have to deal with and adapt to, having nothing to do with hormones at all. Cancer sucks and there is no easy cancer, period. PTSD after cancer definitely caused some suicidal thoughts, but I’ve also had them from other seemingly impossible and completely unfair situations that life has thrown at us as well. The 2010’s were a rough decade for my family in far more ways than just cancer. It can be tough to know what to do, as each cause requires a different response.

Related Blog: PTSD After Cancer

There’s plenty of reasons to be justifiably upset, depressed, or distressed as cancer survivors, which could possibly lead to suicidal thoughts. Life doesn’t tend to let up after cancer either, and the rest of the world doesn’t care that we had cancer, either. The point is, don’t discount or forget about hormones and their potential to wreak havoc on our minds when they’re out of whack. Plenty of my other blogs might help you to work through many of the other sources of pain and distress after cancer, but keep testosterone levels on your radar screens, especially if something seemingly comes out of nowhere and you’re not even sure why you’re feeling the way you are.

Much of my off-and-on depression over the years has been situational based from serially bad and traumatic situations that my family and I have been forced to bear going far beyond just cancer, and not because of chemical imbalances, hormones, or other things. But testosterone dropouts like these from cancer can still rear their ugly head even 9 years out, if I’ve been doing a terrible job of taking care of myself, as had been the case over the last few months of 2019.

What I’m Doing Now

I can blame a grueling work schedule all I want, being 50% travel and hardly being home, and then having to work two full-time jobs at my full time job, too. None of that helped, but did I ever hit the hotel gym while on business travel? I did exactly one time, the entire year. Did I maintain healthy eating habits, or did I allow myself to completely fall off the bus on that too? Did I make an effort to get back into the gym when I was home? Not really. I just kinda gave up for awhile and hoped for the best, and ended up with the worst. No, my work schedule wasn’t forgiving at all, but I also wasn’t doing jack shit for myself, and paid a terrible price.

The moral of my story is that if I had even been attempting to do what I know I need to do to take care of myself, this most certainly wouldn’t have happened. I need to do a much better and more consistent job of taking proper care of myself, and can’t allow anything to get in the way of that. I’m doing the same things now that I’ve known I’ve needed to do all along, which is to get my ass into the gym at least a few times per week, clean up my diet and lay off of all of the caffeine and ‘boba’ and other garbage, and make sure I’m getting enough rest, and I already feel a zillion times better. It’s one thing to just expect to feel a bit of seasonal depression, a semi-predictable hormonal dropout, and feeling totally wasted for a few days, but it’s something entirely different when it devolves into suicidal thoughts to go along with it.

Related Blog: HAVE I MENTIONED HOW IMPORTANT REGULAR EXERCISE IS FOR CANCER SURVIVORS?

Read the above blog published almost exactly a year ago where I said the same goddamned thing. Too bad I didn’t listen to myself! Maybe this suicidal episode is the wake-up call and motivation that I need to finally start taking consistently good care of myself, and to stop making excuses.

Rescued By Disney World Again

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Disney was, of course, fantastic. The new Star Wars Galaxy’s Edge attraction at Hollywood Studios which had literally just opened two weeks before was amazing, and the new rides were mind blowing and unlike anything you’ve ever been on before. We all had a great time even if I was shaken up a bit, and now I can say with authority that Disney has rescued me from some truly awful things not once but twice. 

Related Blogs: Overcoming Post-Cancer Depression

The first time I went to Disney World with my family in April of 2013, I was just a few months out of the first time I had been suicidal due to heavy PTSD for over a month. While my suicidal thoughts have never been anything more than brief moments, it’s enough to leave a mark on you, and the depression can linger. Here I was just over two years out from my cancer diagnosis thinking I should have been through it all, only to realize that I was merely at the start of a far greater challenge adapting mentally. I also felt like if something was going to happen to me, it was going to happen sooner rather than later, and that I just needed to truly live every moment that I had. Most testicular cancer recurrences occur within two years from the end of treatments for non-seminoma patients (5 years for pure seminoma), and towards the end of this window is definitely a very nerve-wracking time.

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That week at Disney back in 2013 was truly magical in that I didn’t think of cancer even once, never had a single depressive thought, and just cherished every magical moment with my family. Here I was feeling so lost and directionless, but Disney taught me exactly what I needed to do. Just live and enjoy every moment of your life, and never let a second of it go to waste.

Related Blog: The Best Way to Survive Cancer, Is to LIVE!

And then here I was again nearly 9 years out from my cancer diagnosis, in the midst of something awful once again due to a perfect storm of internal and external factors, combined with the winter solstice and a testosterone level dropout. Disney World and in particular the new Star Wars Galaxy’s Edge attraction was so amazing that I literally didn’t have time to be depressed or anything else, but instead found myself in awe. And then the fast pace of Disney (paying by the minute!!) snapped my body out of whatever physiological or hormonal slump it was in. 

The depressive and suicidal thoughts vanished at Disney, just like the money in our wallets! 

Magic!!! (LOL!)  

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Cancer Can Affect People For Their Entire Lives

The last thing I want to point out is just how illustrative this episode has been of the fact that AYA (adolescent and young adult) cancers can affect people for their entire lives. If you thought that because I’m 9 years out from my cancer diagnosis that everything is okay, that I’ve been through everything, that it’s all in the distant past, and that everything is fine and good, you’d be wrong. I’d like to think that too, but my young adult cancer experience as a whole is still something that I have to manage, as a whole. 

I have to keep myself physically active and exercise regularly, especially in these winter months in order to keep myself ‘perked up’ hormonally. Although it’s a fraction of what it used to be, I still have chronic fatigue issues. I can push it for awhile and far more than I could in the early years, but there’s still a line that once crossed, my body will basically shut down and I can’t really do anything for a day or two. I still have to watch what I eat and eat a well-balanced diet, to help maximize my potential and the energy that my body does have available. I still have neuropathy related pain and shooting nerve pain just about every day. And I can’t have toxic people in my life at all, and my tolerance for BS is basically zero, which is something that many, many cancer survivors will tell you.

If you understand how hard I’ve had to work and fight just to overcome depression, all of the anxiety issues I’ve faced, the PTSD, and the suicidal episodes, then you’d understand why other people causing issues in any way are just a non-starter. It’s an all hands on deck ordeal just to keep my own mind afloat and on an even keel at times, hence not having any tolerance for other people that might rock my boat with their bullshit, whether they realize it or not.

As I write this, there’s someone in my life who’s just had some pathological need to bring up the fact that my childhood best friend commit suicide every time I see them, among other things. The more they brought him up, the more I tried to suppress these painful memories until one time I wasn’t able to do so, and spent the next six months re-grieving this loss, re-experiencing all of the pain, and just being depressed again at the childhood best friend that I lost very early in life. They were finally called out for this behavior and were disinvited from visiting us for the past year for more reasons than that, and not only were they completely unapologetic, but were offended and called me ungrateful and more.

With a history of mental health issues from cancer and a few suicidal episodes myself, do you think this sort of behavior is something that I really need in my life? I should neither have to explain any of this, nor should I have to provide an answer to the above question, and yet I’m having to do so. I haven’t given up on this person yet because of how much I care about them, but I’m close. Some people are just truly unbelievable.

Related Blog: Steve Pake's Top 10 Guide to Surviving a Young Adult Cancer (In particular, read the section on removing toxic elements from your life.)

you have To Cure The Whole Patient 

Related Blog: CANCER IS NOT JUST ROGUE CELLS - AND NOT JUST INSIDE THE PATIENT

As I wrote in the above blog, “curing cancer” is about a lot more than just eradicating some rogue cells from someone’s body. Cancer becomes as much a disease of our minds in the way it can haunt us, as it is of our bodies. If you want to cure a patient of cancer, that means curing the entire patient and not just removing the rogue cells. Although this episode was merely from a hormonal dropout (and a bit of seasonal depression) and not from some broader core psychological issue, it’s enough to show me that this “disease” is still present, and something that I need to keep managing much better than I had been. I’ve failed plenty of times as a cancer survivor, in understanding what I’d even been through, in managing my body, in managing my mind, and in managing the people around me. It’s important to learn from your mistakes, and so I hope sharing this bit of darkness from my life as a teaching moment can continue to help others that have faced the same.

I hope to never find myself here again in my life, and I hope you don’t either. 

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Onwards and upwards for 2020!

Steve

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Two things before you go. If you’re struggling with any of this and want to talk, please do get in touch. I’m happy to talk with anyone about any of this to help people find their way through the dark times, but if you’re actively contemplating or attempting, please call 1-800-273-TALK (8255) right now, as I can’t guarantee that I’ll be immediately available.

You’re also more than welcomed to check out all of our fun photos from Disney World below, and we also swung by Kennedy Space Center as well, which was amazing albeit slightly rained out. Despite all of my and our struggles, the point of sharing fun photos of our adventures of the year is to illustrate lives well-lived, and that we’re not just sitting around and sulking and feeling sorry for ourselves. I’m sorry, but fuck that. Life is meant to be lived and enjoyed, despite whatever hardships you might face.

Keep on keeping on!

Cancer Blogs

Home - StevePake.com

Cancer Survivors Are Grieving Too

My good friend, Hanssie, writes about the very painful divorce that she went through on her website. I've always enjoyed reading her thoughts, as she writes about her divorce in almost the same exact ways that I've written about my cancer experience. It's comforting in a way to know just how similarly we can experience and process traumatic events in our lives. I've really found myself in some of my friend's writing despite such different situations, and being at opposite ends of the country from one another, and never having actually met in person yet at that point, and being different genders. What does that tell you? It doesn't really matter what traumatic life experiences we've had, as we're all human inside, process things in all of the same very human ways, and that we're never alone. To struggle is human.

One day I was reading my friend's website, and my jaw hit the floor when I read a post about grief. It was the first time I'd ever seen a "grief chart." I had no idea there even was such a thing, but I could easily identify myself at every single step of this big curve as a cancer survivor. I had been writing and sharing in my cancer journey for a few years at this point, and it had never occurred to me even once that this entire process and all that I was going through, was all really one massive grief curve.

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Mind blown.

It's pretty obvious and intuitive that when you experience something such as a divorce, that you're grieving the loss of your marriage, and someone you had loved. Similarly, if you've lost someone that you love to cancer, or a disease or some tragedy, no one needs question if a grieving process is taking place or not. Duh. When it comes to cancer survivors though, it's completely counterintuitive, and nobody really seems to understand, that cancer survivors are grieving too.

Everybody seems to think that cancer survivors are just supposed to be happy. Our doctors are ecstatic when they can actually cure someone, because plenty of cancers aren't curable. They think we're just supposed to go on with our lives and be over the moon, because we beat cancer. Our families and friends tend to think the same. Yes, they'd been through a little something, but emerged victorious and ought to be feeling like a million bucks. I'm telling you, it ain't like that. So what are we grieving?

Cancer Survivors Are Grieving The Loss of Their Lives As They Once Knew It

Nobody gets married thinking they're going to get divorced, and so a divorcee is grieving the loss of their marriage, the loss of someone they had loved, and are now facing the entirely new challenges of single life, and single parenting or co-parenting, all of which had been previously unimaginable. I know a few mothers, fathers, and wives who have lost someone that they've loved to cancer, and are now facing the challenges of a life that they couldn't possibly have imagined either, while missing their loved one every single day. All of these are naturally understood, but cancer survivors are grieving in much the same way. We too are grieving a "loss" - a loss of our lives as we once knew them - and are facing new lives as cancer survivors that we couldn't possibly have imagined, either. 

Related: Cancer Survivorship - The Fight After the Fight and All of its Firsts

We were invincible and nothing could possibly happen to us, until something did, and now we know just how vulnerable we all are. We were in the best shape of our lives, and then cancer beat us down to nothing, and we have to start all over again. We thought we had control over everything, only to realize we don't, and now we feel so powerless. We were worry free, but now every cough brings the worry that our cancer has returned, and that there won't be a cure the next time. We're overwhelmed and afraid. It's all too much to handle, and we fall into depressions for weeks or even months at a time, when previously we had always been upbeat about everything. We find ourselves sitting in a corner one day, in tears and scared out of our minds, because our eleventieth follow-up scan is the next day, and we're petrified that "this is the one" where they're going to find something. We worry that our cancers have returned, that we've just lived our last good day (again), and that we're not going to be so "lucky" this time. We feel so alone as all of our friends are continuing on with their lives like business as usual, while we're perpetually fearing death and stuck dealing with all of this crap.

This is not the life we had expected for ourselves, facing cancer and all of this misery - and much like the divorcee, we couldn't possibly have imagined the lives we're having to live now if we had tried. The divorcee, the widower or someone that's lost someone, and the cancer survivor, all have something in common - the loss of their lives as they once knew it, and the completely unforeseen challenges of an entirely new life that they couldn't possibly have foreseen nor imagined. We all grieve. It's all the same process of loss and loss adjustment, just about different things.

How Do Cancer Survivors Grieve?

Going Down

I know some people in their 60's who have recently been diagnosed with various cancers, and many of them are in shock and disbelief, thinking they're too young for this. How do you think I felt at 33? That's right, nobody ever thinks they're going to get cancer, even those right at the median age for the diagnosis of many cancers. When I was diagnosed with cancer, I felt everything on the left half of that grief curve all at once. I was in shock, I was in denial, I was angry, and I cried for days. I was terrified out of my mind and thought for sure that I was going to die, and was in complete disbelief about everything. How could this be happening to me? I'm only 33! What about my children? We had just brought them into the world, and here I was on my way out already? Searchings, Disorganization, and Panic. I had just been laid off from my previous job in the months before I was diagnosed with cancer, so I can tell you a few things about loneliness and isolation, too. That was like being kicked when you were down.

Everybody is a little different, but during my cancer fight I went entirely numb. I shut down emotionally and just put a brave face on for my family and my children. If daddy looked like he was going to kick this cancer's ass, my family wouldn't worry as much. I didn't want them to. My children were so young and didn't know anything about cancer, but they understood that daddy's back went out once in awhile. We just told them that daddy had spiders and ladybugs in his back, and had to get some really nasty medicine for a few months to kill them all, and then I'd feel better. We eventually told them that I had cancer, and that I write this website to help other people find their way through this really rotten grief curve that nobody seems to think cancer survivors should be experiencing. Maybe they will after this.

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The actual grieving process can easily look much more like the one on the right than the left. This is not necessarily a linear process at all, but you get the idea.

Rock Bottom

After cancer, I was back to life, got a new job and was back to work, back to kicking ass again, and I was energized and motivated. I loved my new job, loved my new colleagues, and loved having money in the bank again. Know what was awesome? Just having money to go out to lunch with friends, which was a helluva lot better than sweating every penny because I was out of work for six months due to a layoff and fighting cancer at the same time. We're one of the few people that actually kept a six month buffer of living expenses in the bank, because I had been worried about losing my previous job. That did happen, but who would have ever thought we'd need every bit of that to fight cancer, too.

For my first year and a half after cancer, I thought I was doing great, but still didn't have even the slightest clue what had hit me, nor what I had been through, but it all started catching up to me. Monthly scans were starting to get the better of me, and when my body acted up I worried, but nothing makes cancer more real than when friends you had made started dying of theirs. It's almost like my subconscious mind really did want to believe that my cancer was just a really rotten case of the flu, but watching friends die suddenly made it all real. This is cancer, not the flu. People die of this, and families are torn apart by this, and watching this happen to people I cared about is when the emotional floodgates finally opened on me.

I nearly lost my mind. In fact, I did lose my mind for awhile. I always had this rock solid confidence about me, but now I didn't know up from down, and spent every waking moment of 2013, two years after my cancer diagnosis, trying to stay one step ahead of PTSD. I fell into a terrible depression, I withdrew from friends, and I withdrew from my colleagues, and to this day have never really re-engaged fully. I know why, but that's a story for another day, having to do with complex trauma issues. About the only people I could be around at all were my wife and my two children, and my world became very small for a while. I thought I had everything figured out, but here I was adrift like a kite in a thunderstorm, two years after my cancer fight.

"Re-Entry Troubles" to the max.

Finding My Way Up

Related: Steve Pake's Top 10 Guide To Surviving a Young Adult Cancer

It took me a year, but eventually I figured life out and wrote the above essay, not for others but for myself. When one finally emerges from a long struggle, there's this moment of clarity where you have an intimate understanding of all that went right and why, and all that went wrong and why, and how you got through it all. This is the very first essay about cancer that I ever wrote, and I wrote it for myself because I wanted to remember, and because I never wanted to hurt like this again in my life. God forbid if that day ever came, I wanted to be able to read my own writing, so that I'd know what to do if I had forgotten. I just couldn't hurt like that again. Ever.

This essay to this day has been shared and read thousands of times on social media, and within hours of its publishing I had a few offers to join various cancer non-profit organizations. From that point forward, it just became a mission for me in my life to do everything in my power to help others through not just their cancer fights, but these challenging survivorship years after. I joined the Testicular Cancer Awareness Foundation and started blogging for them, because it just felt like the right place for me to be, and I got all of the right vibes and energy from the family that founded it. I made a lot of new friends in the non-profit arena, and there's so many similar people on similar missions that just like me, have grieved loss in their lives, and wanted to do good for others.

New relationships and new strengths, and all of the right people that I needed in my life.

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I wasn't out of the woods yet, but I finally knew how to take care of myself, and how I needed to live my life after cancer. I enjoyed the hell out of every day the best way I knew how, I ran like the wind because it gave all of the anxiety I had freewheeling inside of me a healthy way to exit, and I bled into my keyboard to give all of that dark energy inside of me a healthy way out, too.

New patterns and hope.

My wife would often see me at my computer in tears, and asked me why I wrote if it hurt so much. The answer was not that I was hurting because I writing, but rather that I was writing because I was hurting inside, and my writing gave that pain a healthy way out of me, just as my running gave my anxiety issues a healthy way out of me as well. The PTSD that I experienced two years after my cancer diagnosis came far closer to killing me than the actual cancer ever did. That was so painful to experience that it took me another three years to even start opening up about it, but I felt so much better after I did. My writing has helped me release so much pain, and it's helped so many others find their way through their own.

The Top of The Curve

You know that you've done something really amazing and worthwhile when you have someone tell you that your writing has saved their lives, because they were so lost and afraid after cancer that they were ready to end it all, just like I was. They had found my writing and another person suffering like they were, and just knowing that they weren't alone, weren't truly crazy, and that other people deal with this shit too, was enough to keep them going. That's just amazing.

What if I told you that I've been told such things more than a few times now?

Mind blown.

I'll tell you that recently becoming a Director at the Testicular Cancer Awareness Foundation, and having launched an entirely new from the ground up TCAF Ambassadors program that I've created and am really proud of is all fine and good. Having won an award for my writing, and being able to say that I'm an award-winning cancer blogger is a pretty cool thing to be able to say too, but all of this pales in comparison to those moments like the above. When someone reaches out to me to let me know just what a difference I've made, and that they might not be here today if it wasn't for what I've been working so hard at over the years, that's what matters, that's what counts, and that's why I do what I do, bleeding all over my keyboard for the past few years.

I still have some days here and there when I feel like something's once again gone or going terribly wrong in my body, and knowing that I've done some good in the world with my time here helps me to still feel at peace.

Affirmation, Helping Others, and Full Loss Adjustment.

I'm finally there. It only took me the better part of five years, and I've never had to work harder nor for longer at anything than I have at this, but I'm there.  

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I look back on this long grieving process of cancer survivorship, and tear up at some of these dark times I've experienced. It's not right, and it's not fair, but that's just how life is sometimes. No matter where you are on this grief curve after cancer, I'm here to tell you that you're going to make it, even if your body isn't. Our bodies are fallible, but souls are immortal. I'm all-in on believing that even if you don't, because it's the only way I could stop being afraid of cancer, and I refused to live my life in fear anymore. Otherwise, I wouldn't have gotten to where I am today. I'd be perpetually stuck somewhere back on that grief curve around re-entry troubles and depression, and I just refused to accept that that's how things were going to be. No f****** way! 

You just head straight past Go, and onto New Relationships, New Strengths, and New Patterns (including thinking patterns and beliefs!), because that's the only way you're going to get past where you are. You have to evolve. My motto is this. So long as you're not hurting yourself or anybody else, it's all fair game. 

Now tell me again that we're just supposed to be happy after cancer. The next time you run into someone who thinks this, send them my way. I don't think my friend is fully over her divorce yet, just as I don't believe that deep inside I'm fully over having had cancer yet, either. I don't think my friends that have lost husbands or sons to cancer will ever fully be "over it" either, but we grieve and we evolve slowly but surely, and maybe one day, we can eventually reach that plateau of full acceptance and loss adjustment.

Related post: Longing To Feel What I Know I'll Never Feel Again After Cancer

There's still some days like the above when I once again find myself grieving about all of this, but I accept it now. Cancer survivors are hurting inside, just like a divorcee hurts, or someone that has lost someone hurts. We hurt about very different things, but it's all the same human process inside. There's nothing wrong with you. Cancer survivors are grieving too.

StevePake.com

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How I Finally Found Peace After Cancer

My six year cancerversary is February 14th, 2017. This is an essay looking back on these six years of young adult cancer survivorship. If cancer were to take me now, if today were my last day, and if this were my last sunrise, how would I feel right now? 

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If Cancer Were To Take Me Now... I've Enjoyed the Love of a Beautiful Woman for Over 20 Years Now. 

My wife is everything to me. She's my best friend, my lover, my soulmate, mother to my two beautiful children, and so much more. She's the one that's always made all that's been so wrong so right. We've supported each other through our very worst times together, but also shared in so many of our very best. After all that we've been through together, there's still only one person I'd want to be stranded on a deserted island with. Her. I'm so lucky. Not everyone is blessed with a love like this. I'm turning 40 this year. To have had such an amazing and beautiful woman along on this ride for over half of that journey has been the greatest gift a man could know. If cancer were to take me now, to my wife, thank you. Thank you for being so perfect, for providing me with such unconditional love, and for finding your way into my life so early. I pray we'll have so much more time to enjoy this love that we share in this lifetime, but if cancer were to take me now, I'm so grateful to have enjoyed our love for as long as we have. I love you. Thank you. 

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If Cancer Were To Take Me Now... My Children Know Their Father. 

When I was diagnosed with cancer at the age of 33, my children were just turning 2 and 4 years old. Ask me what my biggest fear was. It wasn't dying of cancer or of a life not lived, but of leaving this world early with these two amazing young souls never having a chance to truly know their father. We've filled these years after cancer with so much quality time, and fun trips and adventures everywhere. A lifetime of happy memories has been created in just a few short years. They're still so young and have so much growing up to do, but at nearly 8 and 10 now, I've had the chance to see them grow so much. I've had a chance to know them and to have had an impact in their lives, to let them know how much I love them and believe in them, and to help them find their way in our crazy world. I pray we'll have many years of love and adventures in the future together, but if cancer were to take me now, I've been so grateful for these years, and the opportunity for my children and I to have known and loved each other. It's meant so much to me. 

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Just a small and by no means complete collection of truly beautiful souls in this world that we have come to know and really appreciate in large ways and small.

If Cancer Were To Take Me Now... I've Enjoyed Some Truly Wonderful Friendships. 

Through my cancer fight and so many challenging years as a cancer survivor, my friends have meant the world to me. Whatever I've needed in a friend, the world has seemingly provided at the moment I was in greatest need. The love that I feel for my friends, and those that have truly been there for me through such dark times, knows no boundaries. It's such a deep love and appreciation that transcends the limits of our language to describe, and my ability to express. Let's just say that if I were to depart this world a bit early, if cancer were to take me now, that these friends of mine will have an angel watching over them up in the heavens. And when it's their time to make this transition, they'll soon see a familiar face welcoming them, and guiding them on their way up.

My friends have restored my faith and renewed my hope when I had completely lost it, and have represented the very best that humanity has to offer. I couldn't have made it through all that I have without these beautiful souls. If cancer were to take me now, I'm so thankful for our friendships, and for the differences we've been able to make in each others lives. Passage of time and the varying trajectories of our lives might take us to different places in our physical world, but the bonds of these friendships are for a lifetime, and will never be forgotten. I will love you all until the very end, and until we meet again. Namaste!  

If Cancer Were To Take Me Now... I Know That I've Evolved. 

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I'm not the same person that I was before cancer or after. I'm a far more spiritual, connected, and compassionate individual than I used to be, or ever could have been. I've evolved more in these past six years of cancer survivorship than many might evolve in an entire lifetime. Such a huge transformation at a relatively young age has been incredibly painful at times, but now I have the privilege of living the considerable numbers of years I could have left in my life as a far better and far more evolved version of myself, and for that I'm very thankful. I'm neither afraid nor haunted anymore thanks to this evolution, and I'm free to live my life fearlessly. I'm finally at peace with all that I've been through, and have learned to be grateful for this journey. I pray that I'll have many more years, but if cancer were to take me now, I know that I'll be leaving this world as a far better soul than when I arrived, and for that I'm very thankful.

If Cancer Were To Take Me Now... I Know That I've Made a Difference in the World. 

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It's funny how having cancer as a young adult can warp and accelerate such linear concepts as time, and stages of life. We can feel this rush to truly live our lives, to accomplish things, and to make a difference for others and leave a legacy, all at the same time! I was lost for awhile, and didn't know what I was supposed to do, or how I was supposed to live my life after cancer. How do you accomplish things in every stage of life all at the same time? I was so frustrated, and took to writing just trying to sort everything out. At first, my writing was just a private coping mechanism for me, but it transformed into a powerful tool to help uplift and empower hundreds of thousands of others across the world, helping them find their way through their own life journeys and struggles as well.

It's through my writing that I found a purpose and the direction that I needed. I was meant to write, and so I've written, over a hundred thousands words so far. Being named a top cancer blog out of hundreds of entries by a huge cancer website helped me feel as though a life purpose had been fulfilled, and I've been so grateful for that. I have so much more I've yet to write, but if cancer were to take me now, I'll feel complete knowing that I put my inner talents and life experiences to good use in this world, that I've made a difference for so many people, and that I'll have left this world a better place than when I found it. Nothing is more honorable.

The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.
Ralph Waldo Emerson

A special thanks to those that have believed in me, and that have given me the opportunity to share my writing on platforms with such a broad reach. Namaste! 

If Cancer Were To Take Me Now... I Know That I've LIVED.  

It took me a few years to really understand what Mark Twain meant in this quote, but I get it now.

The fear of death follows from the fear of life.
A man who lives fully is prepared to die at any time."
-Mark Twain

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I was too afraid to ever really start living my life before cancer, and was afraid of not having one to live at all after. My second biggest fear after not being around for my children, was of a life not lived. My cancer diagnosis rocked our world. We started living our lives fully and completely after cancer, and have never looked back. You don't need permission from anyone to get out there and live your lives. The only person holding you back is you. We've gone to some amazing places, and have done some amazing things. We've had the time of our lives so many times over, and have created so many wonderful memories as a family, and with friends. 

As I look back on six years of cancer survivorship, I'm so glad that no matter how lost, depressed, or afraid I'd felt at times, that I never stopped pushing forward, and never stopped living my life. I've lived more each year since cancer than I had in all 33 years of my life before cancer combined. That's a whole lot of LIVING in a few short years. I've not wasted a day, and I know that I've lived each and every one of them since cancer. I pray I'll have many more years on this grand adventure, but if this is it for me, if I get bad news tomorrow and learn that cancer is going to take me now, I won't be afraid, and will have no regrets. I know in my heart and soul that I've lived my life fully and completely and the best I know how, that I haven't missed a thing, and that I'll be thankful for every joyous day that I've been blessed with. I'm not afraid anymore, because I've known that the best way to survive cancer is to LIVE, and lived I have. 

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This is not a collection of our adventures over these past six years. All of these photos are from just ONE year, 2016, and we've made every single year since cancer just like this one. This is how life is meant to be LIVED! What are you waiting for? You don't need anyone's permission!

How Did I Finally Get Here After Six Years?

How did I finally get to where I am? How do I sleep so peacefully at night, and how do I live my life without fear or worry after cancer? Make no mistake, there were plenty of days where I was so distraught that I could never even get out of bed that day, nor leave that proverbial corner. But dammit I pressed on!

I never gave up, and I never stopped believing in myself, even when nobody else did. When I had fears, I confronted them. When my own attitudes and beliefs were just getting in the way and no longer serving me, I was smart enough to realize that and let them go. I always kept an open heart and mind, and adopted new ones so that I could move forward again. Our attitudes and beliefs are self-fulfilling prophecies, including towards ourselves. You'll find exactly what you look for, so look for something wonderful. Some people had really hurt and disappointed me in this journey. I let them go too, so that I could find better souls in this world to have along on my journey with me. I found so much fulfillment with these new friends, and learned that you never need to fear closing doors, because better ones will always open for you. I learned to forgive those that had hurt me, not because I felt all were deserving, but for me, so that I could again feel love and peace in my soul, rather than continuing to have it dragged down with so much hatred. I loved my wife, and I enjoyed my family and my friends endlessly. I stayed true to myself and went with what my heart told me. When people had made such a difference for me, I told them so, and let them know how much I loved and appreciated them. I lived my life fully and completely, and found a purpose through which I've been able to make a difference for so many others. I always strived to become a better person, and refused to ever allow myself to turn ugly. Sometimes it took everything I had to not become destructive to myself or others. You don't have to be the same person that you were yesterday. You can evolve. You can become a better version of yourself, but you have to want it to happen, and you have to work hard for it. It was so hard to have felt so wounded in life, and it was twice as hard to evolve, but twice as rewarding when I finally succeeded.

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TL;DR - Just Grab Life By The Balls! ;-)

As I approach 40, I realize now more than ever that we're only here for a very short time. It's okay to be afraid, and it's okay to have a meltdown. Just don't stay there for very long. There's no time for that. Our lives are made up of two dates and a dash, and no amount of stressing or worrying can ever tell you when that second date will be. Just make the most of the dash. No matter how afraid I was, I never stopped living my life. The best way to survive cancer is to LIVE! Get out there and live your lives fully no matter what's hanging in the background. I've been blessed with all of these years since cancer, but I wouldn't be where I am today had I not been truly living my life. Read Twain's famous quote again. Read it over and over, and repeat it to yourself every day to let it sink in.

The fear of death follows from the fear of life.
A man who lives fully is prepared to die at any time."

I pray I'll have many more days, but if today is my last day, and if cancer were to take me now, I know that I've lived my life fully and without regret, and that I'll be at peace and ready. This is the ultimate peace that one can feel after cancer, and it again transcends the limits of our language and my ability to express to even begin to describe how wonderful this feels, after so many years of inner struggle.

Mission Completion. Hallelujah, I'm finally there! The next chapter begins now.

God bless,

StevePake.com

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If you're lost and looking for some inspiration, you can never go wrong with TobyMac's #SpeakLife. I'm spiritual but not very religious, but you don't have to be Christian to appreciate and enjoy either his message or his music. I write about many of these and more in the Daily Inspiration section of my website!

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Nickelback's "If Today Was Your Last Day" is a song that's really spoken to me as a young adult cancer survivor, and has been a favorite of mine for many years now. This is exactly how my life has felt like to live, and I can relate to almost every line of the song. Lyrics here.

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How To Overcome Your Fears After Cancer (Or COVID)

[April 3, 2020 Update: It’s been surreal to once again be experiencing so many of the same fears and feelings that I did as a cancer survivor in the midst of the COVID19 pandemic, and then having to engage the same exact coping mechanisms that I had developed so long ago. You can replace the word cancer in this blog with “COVID-19”, and it’s really about the same thing. Just stay 6 feet away from your friends. :) ]

Experiencing fear on a regular basis comes with the territory of being a cancer survivor. It's a very normal and even healthy part of cancer survivorship, but something that needs to be managed, so here are six tips on how to help cope with and overcome it.

1. It's Okay To Be Afraid

It doesn't matter what type of cancer you're diagnosed with, what your age or prognosis is, nor even if you have a "good cancer". The fact is, when it's your ass and life that's on the line, and you're the one left wondering if you're going to live or die, a cancer diagnosis is just plain terrifying. It's okay to be afraid, it's okay to not have the answers that we need, and don't let anyone tell you otherwise. 

2. Fear Might Come When You Least Expect It

Fear isn't just something that we face at the time of cancer diagnosis and treatment. It's normal to experience fear in the years after while "S.O.S" (Stranded On Surveillance), and can hit you at the most unexpected times, and in the most bizarre ways. Like when standing in line at Starbucks one day, almost a year after my cancer fight had ended. I had been feeling good for a change, and had finally managed to forget about cancer for awhile, only for two people behind me to start talking about how a friend had been diagnosed with cancer, and how awful that was. My heart sank into my stomach, and it all came back.

I'll never forget the day that I was out for a run, when a paralyzing wave of fear swept over me that was so intense that I collapsed onto the curb in tears. I couldn't even believe what I was afraid of. I was terrified at the prospect of having to get the retroperitoneal lymph node dissection (RPLND) surgery done for testicular cancer, except that I'd already had this surgery done 18 months ago! I had always wondered why I hadn't so much as batted an eye going into that brutal and highly invasive surgery. Sometimes our fears are repressed in order to get through challenging situations. 

I sat on that curb in tears for about 15-20 minutes, letting it all out about a surgery I'd already had long ago. I was so embarrassed and ashamed. I didn't understand why I was feeling this now, but it felt so good to release whatever this was. I was never afraid of that surgery again, and the recurring nightmares I'd been having about it stopped for good. I quickly realized that I had so many more repressed fears bottled up inside of me like this, and that they just needed to come out. My emotions had simply switched off while fighting cancer, and now they were finally coming out, years later. 

3. Find Healthy and Productive Outlets

Running over lunch became my daily ritual. It was an hour just for me, away from the office and away from my family, where I could privately work my way through all of my inner pain, without distraction. There's nothing worse than having fight-or-flight type anxiety freewheeling inside of you with nowhere to go. Running, specifically outdoors, with the wind on your face and scenery passing you by, was just so satisfying in a very primal way, and gave this dark energy the perfect place to go. No matter how badly I'd been feeling before, I always felt so much better physically and mentally after a run. Running didn't just work wonders for my body, it worked wonders for my mind as well. 

I also took up writing, per the encouragement of a friend. I didn't always understand what I was feeling or why, and plenty of times my thoughts or fears made absolutely no sense. Writing about them, in the form of a private journal at first, helped me to make sense of my inner hurricane of thoughts. Slowly but surely I managed to unravel what was truly behind a lot of these inner fears and insecurities, who and what I really was inside and what I needed, and began to find ways to heal. Plenty of quality time with family and friends along with an active lifestyle became a necessity for life in general, but running and writing became my two primary outlets for processing all of my inner fears and pain.

4. Be Your Own Best Friend and Advocate

It's important to be your own best friend and advocate. Don't make the mistake that I did, where for years I was closer to my own worst enemy, beating myself up for being afraid of a "good cancer," with a good prognosis. Stop this. It's okay to be afraid. Our fears come from the deepest and most true part of ourselves. Never deny what you feel, and don't deny your true self. Clean up your inner dialog and be your own best friend and advocate. 

When you're overcome with fear and find yourself sitting in a corner in tears, would your best friend beat you up for this? No. My own best friends have told me that they couldn't possibly imagine what I've been through, and have been mortified knowing even half of what my cancer experience has entailed. They're not the ones mourning the loss of friends that didn't make it, sweating out scans and dealing with scanxiety, nor are they dealing with so many physical and mental challenges such as bodies that don't work like they once did, and depression or even posttraumatic stress. Cancer survivors need strong support to make it through all that we do, and that has to start from within. Cut yourself some slack, and kill off that negative internal dialog. Love and accept yourself and all that you feel unconditionally, and be your own best friend and advocate for yourself in handling your fears. 

5. Find People That Can Support You*

When fears about cancer are already pushing you beyond the limit, you're going to notice more than ever how other people in your lives affect you. Make sure that you have the best people for you in your life, that can help bring a sense of calm, and positive energy into your world. Part of being your own best friend and advocate, is allowing yourself to find those people, and removing others that just aren't working for you. Especially as young adults, cancer can be such a lonely and isolating experience, because so few peers at our age will have experienced anything like what we have. Community support can be vital, and today I enjoy a wonderful mix of both regular and cancer community friends that I couldn't be without. They all add so much to my life, and help me to feel complete.

*But with respect to the COVID19 pandemic, just make sure you keep your friends at least 6 feet away, unless you’ve been co-isolating together. :)

6. A Little Faith Can Go A Long Ways

Slowly but surely, I found my way through my years after cancer. I found the outlets that I needed, I continued to run and write as my outlets, and led a busy and active lifestyle surrounded by family and friends that always managed to put a smile on my face. But I couldn't stop being afraid. My fears about cancer always managed to find ways to come back and haunt me, and with it, periods of depression that could last weeks or even months, and periodic episodes of posttraumatic stress that would put me back in that corner again, huddled up in tears.

Ultimately, it was neither an attitude, a routine, nor lifestyle, that helped me to finally overcome my fears. It was faith. When I talk about faith, I mean that in the broadest possible sense to encompass anything and everything that faith can be. I don't go to church, and I'm still not a part of an organized religion, all things that I had shunned in the past and continue to shun today. What I finally developed was an independent set of spiritual beliefs that worked just for me. I gave myself something to believe in about what we are, and where we go after our physical lives end, all based on things that I've experienced and believe in myself. There's no right or wrong answer when it comes to something like faith. Developing faith is just as individual of a journey as surviving cancer is. For me, after years of struggle, finally allowing myself a system of beliefs took the wind out of the sails of my fears of death and dying of cancer, and today I'm living my life without fear for the first time. I'm free. 

A little faith can indeed go a long ways.

StevePake.com

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Top 5 Lessons Learned in 5 Years of Cancer Survivorship

In November of 2015, I was invited by the Cancer Knowledge Network to write a guest post. CKN is part of Current Oncology, Canada's leading oncology journal, which is read by thousands of oncology professionals and patients. It was a great honor to be invited to write for such a publication and to reach a new audience. This was also a huge opportunity to help spread the knowledge of my experiences, especially to oncology professionals, responsible for the care of many thousands of patients. What better thing could I share with such an audience than an updated list of my list of top lessons learned in five years of cancer survivorship? 

Top 5 Lessons Learned in 5 Years of Cancer Survivorship

After treatments for our cancers conclude, every single one of us wants so desperately to believe that our bodies have been rid of our cancers forever, and that our fights are over. We want to believe that we'll be able to put what we've been through behind us, and that our lives will return to normal, if not a new normal. That's exactly what I believed in July of 2011 after a five-month long fight against testicular cancer, but I was in for a rude awakening. My body was free from cancer, but my life wasn't. There was so much I'd yet to experience, and so many important lessons that I'd learn along the way.

1. THE END OF YOUR FIGHT IS ONLY THE BEGINNING OF YOUR JOURNEY

The biggest and most shocking realization I’ve had is that the majority of my struggles all came after my cancer fight had ended, and that fighting cancer was the easy part! After my cancer fight, I had yet to experience excruciating nerve pain and muscle weakness issues that developed, all due to chemotherapy-induced peripheral neuropathy. I'd yet to experience anxiety about every little ache and pain, worrying that my cancer had returned, nor hormonal ups and downs that caused huge swings in my mood and energy levels. I'd yet to experience recurrence scares where I feared that I had just lived my last good day. I had no idea how to handle the depression and post-traumatic stress that followed all of this. I had beaten cancer, but became so overwhelmed with all of the unforeseen and seemingly endless challenges in the aftermath, that I contemplated suicide as a means to an end.  The trials of life after cancer had pushed me that far. 

2. NEVER STOP BELIEVING IN YOURSELF

Your attitude is everything, and is a self-fulfilling prophecy. No matter what it is that you're facing, if you believe in yourself with all of your heart and soul that you'll find a way to cope, to heal, or to overcome, you'll find that way no matter how extraordinary. If you don't believe in yourself, not only will you not find what you need, but you'll prolong your own suffering and pain. Never give up, never stop believing in yourself, and keep your heart and your mind open. Surround yourself with positive and uplifting people that believe in you too, who can help to carry you during the times you might stumble. 

3. THE POWER OF THE RIGHT PEOPLE AND FRIENDSHIPS

Time and time again, it's not been pills, but the power of the right people, the right friendships, and the right souls in my life that had made critical differences for me through periods of distress. Through the power of the right people in my life, I've found the encouragement that I’ve needed, spiritual guidance, and those that could help me laugh, forget, and have a great time. Never be afraid to keep opening new doors, and bringing new people into your life. You never know when the next person you meet could change your life for the better. Some amazing souls out there have been all the medication I've ever needed, and I'm so blessed that they've become a part of my life. 

4. NEVER STOP LIVING AND ENJOYING LIFE

I've been that person, huddled up in a corner in tears, and suffering from post-traumatic stress after cancer. I was afraid of everything and everybody, and just wanted to hide from life and the world, but I refused to give in. Don't let cancer keep you down. Your survivorship years are the time to get out there and truly enjoy life. Everything is sequential. Never stop believing in yourself, and never stop opening new doors. Find things that you enjoy doing, people that you enjoy doing them with, and have the time of your life. Make plans both big and small, and do the things that you've always wanted to do. I've learned that each day is a gift and never let one go to waste, and have never enjoyed life more than I have after cancer. The best way to survive cancer is to LIVE! 

5. LOVE YOURSELF UNCONDITIONALLY

Above all, love yourself unconditionally. But what does that mean? Loving yourself unconditionally means accepting all that you feel. It means allowing yourself to sit in that secluded corner to cry, without feeling ashamed. Loving yourself means pushing hurtful people and things out of your life, without feeling guilty about doing so. Most of all, loving yourself means simply being yourself, without feeling the need to apologize to anyone for being who and what you are. Ridding myself of this internal mechanism for self-loathing, and learning the importance of self-love and acceptance, has been my gateway drug towards healing from within, reducing stress, reducing anxiety and depression, and finding what was truly meant for me in my life. Our perceived faults are not flaws. We're all perfect just the way we are, and were made the way we are for a reason. Embrace yourself, and love yourself unconditionally.

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These past five years of life after cancer have put me through more than I could have possibly imagined. Both cancer survivors and care providers should never underestimate the potential challenges of life after cancer. Even reading about such possibilities while going through treatments never registered, because it simply wasn't believable to me at the time. What could possibly be worse than what I was already going through? Believe it. Cancer survivors everywhere should be encouraged to find and stay closely connected to sources of support throughout these years. It is my hope that through the sharing of my story, care providers will have greater recognition of these patient challenges after cancer, that survivors will become more attuned to the very real challenges that we can face, and not be afraid to seek the support that they need.

StevePake.com

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There Is No Easy Cancer

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This is what I looked like after 5 months of hell fighting cancer and getting the massive RPLND surgery. I was all bald and bloated and disgusting feeling, having gained 30 pounds from the crazy ways in which the chemotherapy had affected my body. I had never been in more physical pain, nor more uncomfortable in my entire life, but believe it or not, this was the easy part of fighting cancer.

On at least two occasions when I've mentioned my cancer story to new friends or acquaintances that hadn't known, I've received comments that were just short of dismissive that testicular cancer is an "easy cancer", alluding to the high cure rate. I'll be honest in saying that I haven't been offended by such comments, because I know that short of having been there in some way themselves, it's simply impossible for people to truly know what a cancer diagnosis feels like, nor all that one entails.

Regardless of the type of cancer and early or late stage, the fact is, cancer turns your life upside down. Especially as young adults, we have so much of our lives left to live, and we wonder if we'll ever be able to live our hopes and dreams at all. Cancer forever casts a dark cloud over us, and it's a difficult adjustment to make when we're supposed to be brimming with optimism about our futures. There was nothing easy about the five months of toxic treatments and brutal surgeries that I had to endure, to get through my Stage II cancer. There was also nothing easy about the excruciating nerve pain and chronic muscle fatigue and weakness issues that developed, all due to the toxicity of treatments. I also suffered a loss of my fertility from a surgery that helped to cure me, which wasn't easy either. Fighting cancer left my body permanently scarred in dozens of ways.

The real scars however, were those within. It's tough to go from thinking that you have your entire life in front of you, to wondering if you're still going to be a free person, or have a life to live at all if your next round of monthly scans don't come back clear. We want to be free, and we want to know that our bodies are rid of our cancers forever, but you never really know. The uncertainty can eat you alive inside, and mental health issues such as depression are common. The anxiety about cancer tends to worsen in the years after fighting, because we live our lives constantly watching over our shoulders. We worry about every little pain in our bodies, because once you've had cancer, every such pain could mean the possibility that our cancers are back.

I became so spooked that my cancer had returned at one point, that it opened the floodgates to all of the terrible emotions that I had kept locked away when I was fighting cancer. I began suffering from post-traumatic stress, which puts the feeling of panic inside of you as though your house were on fire, except you have nowhere to go, and no avenue of escape. My body had betrayed me in the most terrible of ways, cheating on me with death at such a young age. I was terrified of living in my own skin and body. I wanted to run away from it all, but how do you run away from your own body? You can't escape it, or could you?

I was hurting so badly inside, that I contemplated suicide as a means of escape. My wife needed me. My children needed me. My family and friends needed me. I didn't do it, but I had to find a way to end this pain, and doing that wasn't easy either.

It took the support of the cancer community, some wonderful friends and mentors whom I will love for the rest of my life, the unconditional love of my wife who has never left my side, my family, and my two totally awesome children to help pull me through such a terrible ordeal. Not one single aspect of what I've been through could ever be considered easy. Everything has been hard, and I've had to reinvent myself and my life three times over since my cancer fight ended, all from an "easy" earlier stage "good risk" cancer with a 95% cure rate. A high cure rate is wonderful, but finding my way through these past five years after cancer have been the hardest five years of my life.

There is no easy cancer.

StevePake.com

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10 Important Lessons on Life, Love, and Forgiveness After Cancer

An essay on the deep interpersonal and spiritual struggles after cancer.

From painful physical after effects of our treatments and various struggles with our bodies, to the emotional ups and downs during the long periods of surveillance after our cancer fights, most cancer survivors are no strangers to all sorts of pain. There's a type of pain that's not often talked about however, and that's the pain we experience when the nature of our relationships with people in our lives change, as either a direct or indirect result of our cancer experience. This is the story of my deep interpersonal and spiritual struggles after cancer, of trying to make sense of the world again, of trying to get to the bottom of who I really was and what I needed in this world, and all of the bumps and roadblocks along the way.

My friend Karen Sewell, whose husband Sean Martella died of testicular cancer the year before my own diagnosis, wrote of how lonely and isolating cancer and illness can be. As soon as you announce that you have cancer, some friends might simply disappear from your life, never to be heard from again. Most mean well, but some might have a tendency to say and do the wrong things. Others shy away simply because they know how delicate the situation is and don’t want to do any harm, except that not saying a word about cancer to someone fighting it can be dismissive and hurtful by itself. Those that are fortunate enough to have never faced a major trial in life, most likely won't be able to relate at all. Everything about life is still a sure thing to them. Cancer, especially as a young adult, can be such an awkward and isolating experience. 

My wife and I had already been feeling somewhat isolated even before cancer. I had envisioned this stage of our lives as being filled with our brothers and sisters, big fun family get-togethers on holidays, our children getting to play with their cousins, and my wife and I getting to play aunt and uncle to various nieces and nephews that we'd undoubtedly have. Instead we felt nothing but a vacuum here. What a strange life experience it's been for both of us to have siblings that have had absolutely no interest in being a part of our lives at all, to the point that it’s like we're both only children. We're the only ones that are married, the only ones to have children, and we took on the challenge of starting a family without any of the peer level support that one commonly gets from brothers and sisters. Then cancer entered our lives, and we had to face that without that peer level support as well. Brothers and sisters are such a huge source of support for many facing cancers and other life-threatening illnesses, and to be without that really hurt. My wife and I have both felt feelings of abandonment towards our families, and I couldn’t bear to feel alone like this anymore after cancer.

I’ve been blessed with some wonderful friends, but too many of them were spread too far away. Even those that have been close by just tended to be on different life rhythms than us, which made it hard to connect. A few years prior to cancer entering our lives, I had encouraged my wife to join some women's professional groups to find people she could relate to better in the absence of brothers and sisters, and now I needed to do the same. I needed people closer to me, and began seeking new or closer friends that could become like brothers and sisters, but which people? Who could possibly understand what I was going through, and who could know me like a brother or sister could? It was a herding instinct coming to the surface. I had terrible feelings of insecurity after cancer, and felt so vulnerable.  I needed my ‘herd’ to surround and protect me, people that could help look after my family if I wasn’t going to make it, but felt like I didn’t really have one, which made the feelings of insecurity even worse. I had mentally reserved those inner-circle slots for people that just weren't ever going to exist in our lives. How do you suddenly develop family-like friendships at this stage of life in such a bizarre situation? It felt like it would be impossible, but it was what I realized I needed. I learned some very important lessons along the way. 

1. Good Friends are Hard to Find

Someone I had met the year after my cancer fight seemed to be the perfect person for me to know. There was a click and a connection that you don't commonly feel towards most people, there were so many common interests, and we were at similar stages in our lives. I felt like I already knew this person in a way, not unlike a brother or sister, or perhaps from a previous life. A wonderful friendship soon developed, or at least I thought one had, and there were some pretty fun times. I genuinely enjoyed this person and their presence in my life, and the camaraderie that we shared. I thought for sure this was a person that could fill one of these voids, only for them betray my friendship and my trust in such a terrible way that they were told not to ever speak to me again. I was so hurt, confused, and disappointed.

I was in the midst of a very dark time. A friend of mine had just died of his cancer, and other friends had relapsed and were back in the fight for their lives again. I had a lot of strange things going on with my body, and had all but convinced myself that my own cancer had returned. I was so distressed about life that I had cried myself to sleep on numerous nights, fearing that I was next, and that I was going to die. I needed every single friend, and source of love and support that I had, only to be feeling the loss of one in such a terrible way instead. I'd had a friend or two betray my trust like this long in the past, but of all the times for something like this to happen again. It was just plain rotten.  And it wasn't merely a single friend that was lost either, but effectively an entire circle of friends that I no longer felt comfortable leaning on for any sort of support, and that I felt the need to distance myself from. I genuinely feared for my life and couldn't afford to be hurt anymore, and started pulling the plug on everything and everybody in my life except those I trusted the most. I was so afraid, and felt so alone. Cancer can indeed be so lonely and isolating at times.

2. Expect the Unexpected

When friends fail you, it's natural and even instinctual to turn to your own blood and family for support, but here I found surprises as well. My parents love for me knows no limits. They're both wonderful and dedicated people who have been a constant source of support for my wife and I through these difficult times. There's nothing that they wouldn't do for us, but that was also part of the problem. When things were really bad, the more they tried to help me, the more they just ended up hurting me in the end. I had to send my own parents away for a time too, and then I was completely heartbroken.

The only thing my parents have ever been guilty of is loving me a little too much, and trying a bit too hard, when they just didn't have the right God-given tools for the job to connect with me in the way that I needed. I love my parents with all of my heart, even if it’s difficult for me to show. It's such a cruel trick of nature that even your own family might not know how to connect with you on that soulful level needed in order to support you. It wasn’t just new brothers and sisters that I needed to find, but a second set of parents as well. I needed help from those that just knew what I was going through, and that had the tools needed to nurture me and guide me through such distressing times after cancer as these, either through experience or God-given ability.

3. We All Carry Pain

“If we all threw our problems in a pile and saw everyone else's,
we'd grab ours back.” - Regina Brett

What I've learned the most from these failed friendships and relationships in my personal life, is that there's no shortage of people who carry pain around with them. From others carrying the burden of their own cancers or other diseases and disorders, either as fighters or caregivers, to those who have lost loved ones, things are just getting started. There are those suffering from failed or loveless marriages, divorces, abuse, and other relationship woes. There’s abandonment, job and career woes, poverty, addictions, victims of crime and rape, family and parenting woes, and the list just goes on and on. Loss of fertility is common with young adult cancer survivors, and for many, there’s the pain of knowing you might not ever be able to have a family of your own.

If someone doesn't carry any pain with them or they're not struggling with anything in life, it just means that they're fortunate enough to have not faced a major trial in life yet. Or perhaps they are, but you just don't know about it, or they're better at hiding things than most. You never know what lurks within. Life will test all of us sooner or later, and periods of struggle or suffering in life are inevitable. You’re never alone in your pain.

4. "Be Kind, Everyone is Fighting a Battle You Know Nothing About"

I pretend to know and understand nothing of the pain that others carry with them. The only shoes that I walk in are my own, but I know what it's like to have a battle waging inside of you that no one knows a thing about, and I know what it feels like to be on the losing end of that battle. Cancer never really leaves us. It can continue to haunt us and affect us even long after it's gone, and filled me with so many doubts. Cancer isn’t just a disease of the body - it can be a disease of our minds as well.

“My body is battered so badly from cancer once and I’m only in my 30’s. What if I have to face cancer again? Will my body even be able to handle it? Will I have any quality of life left at all? Will I ever live a life without pain? Will I ever live a day where I’m not struggling so badly with fatigue again? My cancer is just going to come back. I’m just going to die anyways. Why plan for a future if I’m not even going to have one? My children will grow up without me. I will not live to see the day my daughter gets married, and won’t get to walk her down the aisle at her wedding. I will never get to hold a grandchild. I’m going to window my wife, and she’ll never find happiness in this life again without me. She’ll suffer, and my children will suffer, and there’s nothing I can do about it. My cancer is going to come back, I’m going to be one of the ones, it won’t be curable, and I’m just going to die. Enjoy this moment now. It will be the last time.”

These are the thoughts that had plagued my inner dialog for awhile. They had flooded me, and pushed me to the brink. I couldn't enjoy the simplest of sweet moments with my family without such dark thoughts coming into my head. They were demons that had invaded my mind, savaging me at every opportunity. These thoughts took hold, I had no control anymore, and didn't know how to make them stop. I couldn’t bear to be hurt like this anymore, and for one very brief moment that I'll never forget, I contemplated suicide. That would make them stop. 

“Cancer as a disease of my mind came far closer to killing me
than it ever did as a disease of my body.”

God bless my wife, my soulmate in this world, for sticking by my side. Even she was at her wits' end, but she never gave up on me, and she got inside of my mind in a way that only a soulmate could do. With the power of her love, she got my demons on the run when I lacked the ability to fight them anymore, pledging to never stop loving me, and that she would go to ends of the earth for me if that's what it took. Her love cured me. 

No one else has known about this until now, because I've never spoken about it to anyone. I don't think my wife even knows, because I didn’t want her to worry anymore than she already was, and because that moment of contemplation came and went quickly and didn’t linger. I knew it wasn’t the answer, and that it would be a terribly selfish thing to do. I knew just how much my family needed me back, and my wife was able to get me there. She saved my life not just from cancer as a physical disease, but from cancer the mental disease as well. I’m forever indebted and in love. It’s never been more clear to me how our purposes in life are linked to one another. I’m so blessed.

I've learned to never truly judge anyone, because you never know what sort of pain they're dealing with on the inside, what their paths through life have been like and the challenges they’ve faced, nor what their own internal dialogs have been telling them. Not a soul in this world has known just how dark my own internal dialog became. Someone may have been terribly hurtful towards you at the end of one chapter, but you have no idea what was going on in their lives for all of the previous chapters. Be kind to others always, and leave the judging to God. Protect and isolate yourself from those that are behaving in hurtful or potentially destructive ways. Remove them from your lives if you must, but know that they probably need love and someone to believe in them more than anything, and not your condemnation.

5. All You Can Do Is Your Best

“Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day. You shall begin it serenely and with too high a spirit to be encumbered with your old nonsense.” - Ralph Waldo Emerson

All you can ever do is your best, even if the best you can do on a given day is to just survive and be present. I have nothing to hide and nothing to be ashamed of, because I know in my heart that I've always done my best every single day, no matter how badly I'd been hurting. I know that I haven't always been the best father, the best husband, the best son, or the best friend when my mind has been trapped in the darkest of places. I know there are people that I've disappointed and hurt, and for all of that, I'm sorry. My intentions have always been pure and honorable. There’s no one that I’ve ever wanted to hurt, despite it just having become impossible to avoid in some cases. Life occasionally presents us with impossible situations, and sometimes there’s just no way to win. I’ve accepted my failures and shortcomings as part of me, I know in my heart that I did the best that I could do, and that's all we can ever do.

6. We’re All The Same Inside

We're all unique and beautiful in our own ways, but it doesn’t matter if we’re younger or older, richer or poorer, black or white, or left or right. One of the most comforting and unifying things I’ve come to realize as a young adult cancer survivor from interacting with hundreds of fellow young adult survivors all over the globe, is that we’re all the same inside. We all want someone to love, and to be loved in return. We take great pride in our children and their accomplishments and love watching them grow. We have our unique dreams and ambitions, and yearn to make the world a bit better place than when we arrived. When faced with something such as cancer, we feel our lives turned upside down. We’re all so afraid, and feel betrayed by our bodies when everything suddenly becomes so uncertain. We want so desperately to know that we’ll have a future, and that we’ll be able to go on living, loving, and being present in life with all those we love and care about, and still trying to make our dreams a reality. It hurts so much to lose that perceived certainty in life. 

All of this transcends race, religion, class, and caste. I’ve never felt more at peace than the times I’ve shared such terrifying thoughts with other cancer survivors, whether across town or across the globe. Here I was thinking I was all alone and that nobody else could possibly understand, only to realize that everyone did, and that they had felt the same exact things too. You’re never alone. We’re all so unique and diverse, yet so much the same, and all in this world and this life together.  

7. Love and Forgive

“When each of us is able to look into the eyes of even our worst enemies and see our own eyes looking back, then we’ll see true transformation of the human race.” - Anita Moorjani

When I think of the people that have hurt me today, I no longer see people who were trying to hurt me. I see myself. I see people who have been hurting inside that have been lost, troubled, and confused. I see people that have perhaps been on the losing end of inner battles they’ve been facing in their own lives. I see people who were just trying to find what they needed in life, but sometimes making mistakes, and occasionally terrible ones. We act out towards others when we can no longer bear the pain that we’ve been experiencing, just as I’ve acted out when I could no longer bear my own. And perhaps, sometimes, we cause each other pain without even knowing it. 

With all that I’ve learned and have come to realize, and all the soul-searching that I’ve done through this journey of mine, how can I go on hating people for hurting me, when I know they’re really the same as me inside? It’s like I’m hating myself, and maybe that’s what I’ve really been doing. 

I want the people who have hurt me to know that they’ve been forgiven.

Life is far too short to want to waste even a minute of your life hating someone if you could just forgive and love them instead. It’s a conscious choice that we have on how we’re going to feel about people. My choice now is to love. Those that have hurt and disappointed me are beautiful beings of the universe just like me, but facing different challenges in life, and hurting in different ways. They have my empathy, my understanding, and my love and forgiveness.

8. “Sometimes all you need is a Second Chance, because time wasn’t ready for the first one.”

Everyone deserves a second chance, even yourself. A few months ago, I ran into someone that I had previously considered a friend. As soon as they caught sight of me, they turned themselves around and went straight back where they came from. They thought I hadn’t seen them. What happened between this person and I was very sad and unfortunate, and I was sorry to still see such a reaction after so long. I’ve long since healed and moved on from the damage this person had caused, and such experiences today only serve as reminders of a painful past, when I’d rather just remember the love and the good times.

I’m sorry that it’s taken me so long to get to the point of being able to offer others forgiveness and second chances, but that’s just how long it’s taken me to heal from my own pain, and to win my own inner battles. And then some people just haven’t done themselves any favors, either. You can’t forgive the mistakes of others until you can forgive yourself for your own. You can’t offer others second chances until you're willing to grant yourself one. And you can’t truly love others, despite the pain they may have caused you, until you can truly love yourself. 

It’s long past the time to bury the hatchet with some, and I’m no longer going to barricade people from our lives as I have. It just seems so pointless now, knowing that we’re all the same inside. Forgiveness and second chances don’t suddenly right past wrongs, nor do they mean I don’t still feel disappointment towards some. It means that time can help heal wounds too, that the pain has slowly been forgotten, and that the good times and laughter are still remembered. The time is ripe for old friendships and relationships to resume. So long as hearts are all in the right places, doors can be reopened with a smile, even if it's only to say a more proper goodbye, or to leave things better than they’ve been. I’ve made peace with the past and know that I’ve always done my best, and am looking forward to a brighter future.

9. Love Yourself Unconditionally, and Be 100% Genuinely You

"My cancer taught me the importance of loving and valuing myself unconditionally for who I am - a perfect child of the Universe, who is worthy and deserving of love, without needing to prove myself, better myself, or change myself in any way."

"If you believe that 'like attracts like', then the absolute best way to attract what's best for you is to love yourself to the point where you are filled with love. You will then attract to your life everything that confirms this belief about yourself." - Anita Moorjani 

Perhaps one of the reasons that I struggled to fill the various voids in my life that cancer had revealed is because I hadn’t been fully genuinely “me” with anyone besides my wife yet, and even long before cancer. Like attracts like, so stop being afraid to be yourself. If all you allow yourself to be is "not quite you", then the best you'll ever find will be "not quite for you."

Cancer survivorship is the time to strip away all of the societal expectations and social conditioning that have never really fit you, and to allow the true you to shine through. Don’t let anything hold you back, don't make any excuses, and don’t be afraid to break the mold. Be genuine, be true to yourself, and be the person that you were always meant to be. Do the things that you enjoy doing, and who and what you need will find you without any effort. If you haven't found people to fill your life that can love and appreciate you for all that you are, exactly as you are, you haven't found the right people yet. Keep looking! You deserve nothing less than the love of full acceptance.

10. Don't Be Afraid to Keep Opening New Doors

It's all too easy to want to shut out the world when you've been so hurt and have felt so alone. Withdrawing to only those that you feel most secure around is natural, but don't allow yourself to become completely isolated, and don't be afraid to keep opening new doors when you’re still feeling voids. Keep the faith, and don't be afraid to take a leap of one either! Had I not had the courage to keep opening new doors after having been so hurt, I'd have missed out on the most wonderful of friendships that came soon after these tough times. The only way to find what you need is to keep opening new doors!

God winks. It’s almost as though I was being watched over from the heavens during my most distressed times, it was seen how hurt I had been despite the best of intentions, and was rewarded with the blessings of exactly the right people that I needed at exactly the right time. My heart has melted time and time again from those that came into my life after such dark times, and all of the ways in which they've been able to enrich my life, and help me find that sense of peace and security that I’ve needed. Don’t be afraid to keep letting new people in. Eventually you’ll find what you need, and the friendships gained will be so much sweeter when you do. 

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I’ve wondered for so long why fears about cancer would keep finding ways to come back and haunt me, only to realize it wasn’t cancer. It was me! I never really forgave myself for anything. Not for the hell I had put my wife and my family through, the times I had let others down as I struggled, nor did I ever truly forgive those who had disappointed me. My ongoing fears about cancer weren’t really about cancer, but rather of being disappointed, or disappointing others!

It’s tough to have had cancer and be a Scorpio. We might appear calm and easygoing on the outside, but have such powerful thoughts and emotions on the inside. We're intense individuals, have such high standards for ourselves, and expect perfection from everyone around us. We’re so unforgiving when things go wrong, even towards ourselves, yet dealing with cancer and cancer survivorship, with all of its churn and turmoil, is the time when it’s just inevitable that things are going to go to hell in a hand basket. I've really needed to forgive myself, but had only paid a deeper forgiveness on this level lip service before. That doesn't cut it. You have to go all-in, to unconditionally love and accept yourself with all of your heart and for all that you are. It’s only when you love yourself unconditionally for all that you are, that you’re able to love and accept all of others as well. Then forgiveness comes easy, and seems so natural. Our perceived faults are not flaws. They’re part of what makes us what we are. We’re all magnificent, beautiful beings of the universe, and all we ever need to be is ourselves. Being anything else is betraying yourself.

There’s no one known to me in this world that I have anything but love for. I’ve released the pain and animosity that I've held onto for so long towards both myself and others. I hope and pray that those that have felt animosity towards me are able to release their pain as well, in their own time and their own ways. I don’t want anyone to be hurting on my account when it’s so much better to just love. It's a great release to feel this sort of love towards all again, and a huge burden to have lifted. This has been such a long journey not just of a cancer fight, but of learning so much about life itself, the nature of the inner struggles that we face, the extent to which we can hurt, and of what it truly means to be human. Unconditional self-love and forgiveness has always been the way forward. I just needed to see it and feel it for myself for the very first time to believe it. True love knows know limitations, and has no boundaries. It has to start from within, and from there it can spread to everyone else.

Omnia Vincit Amor. Love conquers all.

StevePake.com

Special Acknowledgements: Many of the thoughts in this essay had been floating around in my mind for the better part of two years, but I just couldn’t manage to get them together and see the big picture. About a year ago, a very thoughtful friend shared author Anita Moorjani’s TEDx talk, and I was struck by just how closely I related to her experiences as a cancer survivor, and as one who had a near death experience! It wasn’t her NDE that I related to, never having had one myself, but rather the spiritual death and reawakening that she experienced through her cancer journey. The ways in which she described some things in her TEDx talk were so similar to how I had thought and written of things on my own, and I was absolutely flabbergasted to have such a similar view! I finally read her incredible book over the summer, “Dying to Be Me”, and like magic, everything just clicked and came together. It’s been transformative and has taken me to another level, and I regret not having read it as soon as she popped up on my radar. I’ve never conversed with Anita personally, but have vowed to see her at one of her events, and hope to meet her in person one day. This is a great book for many, and especially if you’re struggling at the spiritual level as I have, it’s a must read. 

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Top 4 Lessons Learned in Four Years of Cancer Survivorship

On Saturday, February 14th, 2015, Valentine's Day of all the days, I'll mark four years as a cancer survivor. It was around 4am on this day four years ago that the intermittent aching and tenderness in my right testicle that I had noticed off and on for the past few months, had progressed to steady pain that was bad enough that I couldn't even sleep anymore. It was only at that point that I finally did a full and proper testicular self-examination, where I noticed a rock solid hard mass at the upper rear portion of my right testicle, right where it was so easily missed before. I'm glad I caught it when I did, but had the opportunity to catch it earlier and missed it. Monthly testicular self-exams, done properly, are so important!

In that heartbeat skipping moment, only a week from my little baby boy's 2nd birthday at the time, my life changed forever and it's never been the same since.  I've learned much about how to truly "survive" cancer in these past few years, and I think just a little about life too, and wanted to mark this occasion by passing along my top four lessons learned in four years of cancer survivorship.

1. The End of Your Fight is only the Beginning of Your Journey.

As terrifying and as difficult as being diagnosed with and fighting cancer was, the years after my cancer fight ended up being even more difficult. When you're diagnosed with cancer, you become a fighter and always have a lengthy to-do list of appointments to keep you occupied. You go in for consultations to make a plan for your cancer, and then for surgeries, for chemotherapy, radiation treatments, and scans and blood tests, or whatever it is that you need to do to fight the cancer and win. But afterwards, when your body is acting strangely and you don't know why, what then? If you're dealing with scanxiety, a recurrence scare, or depression or post-traumatic stress, what do you do? Even health experts today don't have the answer to that! The answer is that we all have to find our own answers. That "new normal" after cancer that everybody talks about took years for me to find and settle into. It didn't happen overnight, and also took a whole lot of trial and error (read "failure"), and love, support, nurturing, and guidance from a lot of wonderful friends to finally make it happen.  

2. Never Stop Believing in Yourself

No matter what you're facing, and whether it's during your cancer fight or beyond, you have to believe in yourself. Don't ever stop believing in you, and you also need to surround yourself with people who believe in you too. Not once did I ever give up on myself, but there were times when I just had nothing left to give, and needed every bit of the love and support that surrounded me to help lift me up again. Even in the darkest throes of depression and post-traumatic stress over a year after my cancer fight, and finding myself huddled up in quiet corners for days on end, I never stopped believing. I knew that I had to find a new attitude, new outlets, and new friends who knew how to support me either through experience, or through natural ability. I needed an entirely new approach to life and a new philosophy by which to live, and had to completely abandon my old one. And find that approach I did, because I never stopped believing in myself, nor did those who loved and cared about me. Not ever. The power is within you to make the changes you need in your life to not just survive in the aftermath of cancer, but to thrive! Never stop believing in YOU!

3. The Power of the Right People and Friendships

I grew up very independent minded and never placed enough value on friendships, but cancer changed all of that. Time and time again, the power of connecting with the right people and having the right friendships is what's made the biggest difference for me throughout this cancer journey of mine. Whatever I've needed, I've managed to find through the power of friendships, whether it's been cancer mentoring, spiritual guidance, someone to laugh with, someone to cry with, someone that could help me sort through my very worst fears and sources of pain, and so much more. Some of the people that have managed to make the most profound difference in my life, I'd only met under the most coincidental of circumstances, and whose presence in my life I only have God to thank for. When I could only feel darkness and despair, these friends helped me to see light and hope. And when I was terrified of being alone, these friends filled my day with joy and laughter. The true power of a friendship is the right person, the right soul in your life, who can connect with you in a way that you need, and enrich your life in a way that it hadn't been. And the power of faith and God, is when your paths manage to cross at the time you're in the most need. These friends have become like family to me, and I love them all dearly as such. I couldn't have made it through all that I have without them. My friends mean the world to me.

4. Never Stop Living and Enjoying Life

I had made it through my entire cancer fight, and a year and a half on surveillance with another six months to go, when I finally lost it and came completely off the tracks. A friend had just died, and it seemed like other cancer warrior brothers of mine were having recurrences left and right. I felt like I might be next, and that if something was going to happen to me, it would happen sooner rather than later. For six agonizing weeks, my post-traumatic stress had exploded so badly that I could barely even leave my house to go to work, but I refused to allow cancer and my fears to rule me as they had been. I forced myself to get out, to go places, to do things, and to spend time with my family, and with friends that I trusted and felt safe around. I made it a priority to live the best possible life that I could, because if my time was really coming, I wanted to enjoy each and every day that I had left. The reality is that we never know when our last good day is going to be. We should be appreciating every day that we have as it is, as each is truly a gift. No matter how afraid you are, force yourself to get out there, and never stop living, loving, laughing, or chasing your dreams. Live Life, Make It Happen.

Valentine's Day is a perfect opportunity to check your nuts! Know the signs of testicular cancer as well, and just get it done my friends! Happy V-Day! 

StevePake.com

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Cancer Survivorship - The Fight after the Fight and All of its Firsts

I thought I was all done with cancer here. I was really just getting started.

After our fights with cancer are over, we all want so badly to believe that everything is behind us and that life is going to get back to normal. Those first weeks and months after our cancer fights are such a precious time. It’s our first taste of freedom after having been wrongfully held hostage by cancer for so long. I had my life back, but as time and the months went on I realized that it wasn’t my old life that I had back, but rather an entirely new one.  Cancer survivorship brings with it an entirely new set of life circumstances and a whole lot of firsts, many of which I was completely unprepared to handle or to deal with at all. 

For the first time in my life after my cancer fight, I was genuinely afraid. Gone was that false sense of security that we all tend to have about our lives and our health, especially as young and invincible adults, replaced with incredible feelings of insecurity. My cancer fight had stripped me bare of all of this false security, and I felt naked, afraid, and vulnerable. It’s not something you dwell on during the actual cancer fight because you’re so focused just trying to survive and get through each day. It tends to hit you later after your cancer fight, it never really goes away, and it's terrifying that you never really feel safe like you always had before.

For the first time in my life, I also had to deal with some pretty serious secondary health issues. As a result of chemotherapy and a complication from a surgery, one of my kidneys nearly failed. On one hand I was happy just to be alive and took it in stride as the price of the cure, but on the other hand I was frustrated and disheartened, and in a lot of pain for quite a long time. The one and only body I’ll ever have had just taken the beating of its life at only 33, and I began to worry about what life might be like as I aged, and what my quality of life would be like if I faced another health crisis.  I worried that my body wouldn’t be able to handle it, and this just added to the existing feelings of vulnerability and insecurity.

For the first time in my life, I learned what an emotional roller coaster was in the form of cancer surveillance checkups. Suddenly we go from living a normal life and dreaming and working towards wherever we want to be in 5, 10, or 20 years, to just trying to get through our next set of scans a month or two down the road. The thorn in the side of every cancer survivor is that we never really know if we're "cured" or not. The passage of time without any new evidence of disease is the only way we know, and it's a terrible thing to have hanging over your head for so long, and it’s a huge shift in our mentalities especially as young adults.

For the first time in my life, I developed hormonal issues in the form of low testosterone. This resulted in spells of fatigue, depression, mood swings, and low or even zero libido among other things, which could last for as little as a few days or as much as a few weeks. We’re already dealing with insecurities and anxieties about this whole new world that we’ve been thrust into, only to have hormonal issues playing head games with us too! It just piles on, and it’s so cruel and unfair. It was totally not me and a truly awful feeling to be a moody, depressive, lethargic, and asexual lump. It was disconcerting to my wife as well, who had been used to always getting a certain amount of attention from her husband. When that attention suddenly trailed off, she felt self-conscious and wondered if I still loved her, or if I didn’t find her attractive anymore? It was nothing but the hormones talking, or rather not talking!

For the first time in my life, I had a body that would no longer do whatever I asked it to do, whenever I asked. I didn’t get my old body back, but rather a new post-cancer body that needed a whole lot more rest than it ever did, and that no longer had anywhere close to the stamina that it did before. My body had developed permanent symptoms of peripheral neuropathy as a result of my chemotherapy. To this day I cannot really feel my left foot, have limited feeling in my other foot and both hands, and have had to learn to deal with almost constant feelings of muscle fatigue and weakness to varying degrees. Imagine waking up each day and never feeling like you've got anything more than a half tank for the whole day, no matter how well rested you are. It was an entirely new body that I had, with an entirely new set of limitations that I head to learn to respect and stay within, or else suffer the consequences in the form of terrible and nearly disabling fatigue spells.  

For the first time in my life, I truly felt loss. I had gained numerous cancer warrior brothers during my fight against testicular cancer, but not all of us were fortunate enough to win our battles. I mourned the loss of each of these friends as if they really were family and brothers. And when one friend passed who left behind his wife and four children, I learned what survivor’s guilt was all about. Why him and not me when I only have two children and he has four? I was so sad, devastated, and felt so guilty that I cried everyday for two weeks.

For the first time in my life, I began to very deeply resent the fact that my wife and I are basically only children, and became extremely jealous of the many people I knew who enjoyed close relationships with their siblings. It was the herding instinct coming to the surface, and the feeling of safety in numbers. I wanted to believe that if for whatever reason I wasn’t going to make it, that our brothers and sisters would be there for my wife and my children, and provide that peer level support and continuance to my family. Instead I felt nothing but a vacuum, which added yet more layers of insecurity on top of numerous other layers of insecurity. 

For the first time in my life, I learned that a cancer recurrence scare can be even more terrifying than your initial cancer diagnosis, because all of your naivety and innocence about the brutality of fighting cancer is gone. When you experience a recurrence scare, you're fully aware of the pure hell and world of terror that you could be in for all over again. You know that you've already exhausted the best treatment options and will be on to second and third best options, each with decreasing effectiveness and chances of a cure. When I’ve had recurrence scares, I’ve been so afraid that I’ve cried myself to sleep, only to have terrible nightmares and anxiety that just woke me up again. I was so convinced that my cancer had come back at one point that my death instincts kicked in again. It’s the feeling that this is it, and of needing to tie up loose ends and to say goodbye to people that you love and care about. It was enough to feel these terrible instincts once after my initial diagnosis, but deeply traumatizing to feel them for a second time after a recurrence scare over a year after my cancer fight had ended.

For the first time in my life, I experienced acute extreme anxiety so bad that I’d commonly find myself huddled up in a corner and in tears. I fell into a very deep depression and experienced post-­traumatic stress. My terror from the past and worries about the future all combined into one terrifying present, to the point that my mind lost the ability to distinguish real from imagined. Everything and everyone around me felt like a threat that I needed to protect myself from, and my world became very small for a while. I was so spooked and afraid, so tired of my reality of living in constant fear of cancer, and was terrified of living in my own body from which I knew there was no escape. I had had it. I was so done with all of this and just wanted out, but knew that I had to press on. I had beaten the cancer that had taken me hostage, only to have my own mind and its out of control fears and emotions take me hostage during survivorship. I had to learn how to regain control of my mind, and how to master and control all of my fears and emotions, rather than allowing them to control me as they had been. I was ill and hurting so badly inside, but my family needed me. My wife needed her husband, and my children needed their daddy back.

And for the first time in my life, I finally realized just how different life really was after cancer, and how different my needs were as a person. It wasn't just a new life or a new normal after all, but rather a whole new world that I was living in. The terrible anxiety, depression, and post-traumatic stress that I experienced for months over a year into my cancer survivorship was both the very worst thing that happened to me, but also one of the best. It was only then that I realized the need for a complete reset and reboot of my life, and only then that I allowed myself full license to do whatever I needed to do to help myself feel whole, writing people and things out of my life that had been hurting me or just weren't what I needed, and bringing those that were closer.

We do go back to our established adult and young adult worlds after cancer, but we’re also born into this entirely new and terrifying world of cancer survivorship where we’re only just children, and that we’ve only just begun to live in. The way we suddenly lose so much support from all of our doctors and nurses and other medical professionals after we’re declared cancer free, simply because we don’t have anymore appointments to go to, is not unlike abandoning a child in a way! We return to all of the pressures and challenges of our existing lives, but now with all of these new challenges of cancer survivorship, and without the experience and wisdom that age provides to always know how to overcome. We end up having so much growing up to do all over again, but without the benefit of a real childhood in which to learn and explore more freely. 

I was declared all clear in July of 2011, but it took me until December of 2013, two and a half years later, to finally feel matured, confident, and secure in both of my worlds. For everything that I’ve faced during my cancer survivorship, there’s always been a way to improve, reduce, minimize, or overcome. There's always been another approach to try, or a new philosophy or way to look at things, and today I enjoy excellent quality of life physically, mentally, and perhaps most importantly spiritually. I know my new body both inside and out, have full control of my mind and all of its emotions and fears, and have finally felt at peace with everything for the past year. This is never something that I or anyone could do alone. It requires a strong village of support for both cancer survivors and caregivers. There are plenty of times throughout all of this, long after my cancer fight had been over, where I've needed a lot of hand-holding, nurturing, and especially the guidance of other cancer survivors or caregivers who had already been there and done that, and could help me find my way. Be those people for us. Be the ones that reach out both to both survivors and caregivers. Be that blessing to us and and check in on us and keep asking how we’re doing. We're only just children again in these first few years as cancer survivors, trying to find our way in a whole new world, and still need every bit of your love and support.

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The Best Way to Survive Cancer, Is to LIVE!

If there's one thing I've learned over the years as a cancer survivor, and just one thing I could say or one piece of advice I could give to cancer survivors everywhere who might be struggling in these challenging new lives as I had been, it's that the best way to survive cancer is to live the best possible life that you can.

I've been through some pretty dark periods during my cancer survivorship - and have written a bit previously about depression and indirectly about the PTSD that I experienced during the first half of 2013. It’s only natural if you’re experiencing either to become withdrawn, and especially if you’re experiencing post-traumatic stress your world becomes very small. Your mind’s protective instincts kick into overdrive and grip down on you hard, and the lines between real, perceived, and imagined threats become blurred such that everything and everyone around you becomes a potential threat to protect yourself from. When you’re having such terrifying and depressive thoughts, caregivers and loved ones will all tell you not to think about such things, but they don’t understand. When you’re in such a state you don’t have full control over your thoughts and emotions, and might not even have any control at all. The bad thoughts just find you, and you might not be able to consciously stop them. You must push back against this and get help if necessary. I've read the stories of fellow cancer survivors having been trapped in such states for years, and even know a few myself. People who have had pre-existing issues with anxiety and/or depression prior to cancer are especially prone to this, and I know just how easily this could happen. It’s no way to live, and if anything such dark periods are especially the time to double down and to truly “attack life”, as I know a friend of mine would say.

As I first started trying to pull myself out of this very dark period that I had experienced, it was important for me to spend and enjoy as much time with my family as possible. We had done some pretty cool things the previous year as a family just during the tail end of the year alone. We went to Disneyland over Thanksgiving of 2012, and in October just my wife and I managed to score some alone time without our kids and went on a private getaway to St Lucia to celebrate our anniversary. It was our first real getaway together since my cancer fight, and it was an incredible time. We knew what worked from 2012, and doubled down in 2013. We followed up our Disneyland trip with a trip to Disney World in the spring of 2013, and went to Chicago and on an awesome road trip across the Midwest in the summer, ending at the Minnesota State Fair in Minneapolis. We hit the beach more times than I could count, almost every weekend we had fun places to go and things to do locally, and my wife and I managed another private getaway again that October. I took care of myself, I did little things just for me each day, I rid my life of toxic influences to help clear my mind, and I kept a full and busy schedule.

As wonderful as my wife and family have been for me, supporting someone like me through such a painful and confusing time is far too big of a job for one person alone to handle. We have a family to take care of and a household to run, but the support I needed would have been an all-consuming effort for one person alone. As I’ve written previously, it takes an entire village to keep a cancer survivor feeling whole, especially when dealing with a lot of metal health fallout. During this time more than ever before in my life, it was important for me to find and develop friendships with people that “got me”, that I could stay engaged with, and most importantly that I felt safe around while sorting out post-traumatic stress. In February of 2013 I had plans to go to a basketball game with a long-time friend, but nearly cancelled at the last minute because my mind had been in all the wrong places that day. I forced myself to go though, and had a wonderful time. It was a few hours where my mind had plenty of things to concentrate on and stay engaged with besides cancer related demons, and it was a breathe of fresh air. A month or so later another friend invited me out to go hiking. It’s something I’d always wanted to try but just hadn't made the time, and it was another wonderful few hours with a trusted friend. I greatly enjoyed the outdoors, the wonderful change of scenery and the fresh air, and it was great exercise that forces you to focus outward on the trail and your surroundings, rather than what might be going through your mind. Around this same period of time I had just managed to meet a family at their daughter’s birthday party, which I almost didn't go to also for the same reasons. Bad thoughts had been plaguing me again that day and I just didn't want to be around people, but I forced myself to go. We quickly became friends when we realized that we lived right down the street from each other, and that there were so many common threads and interests between us. On outings together with our families, whether we were going hiking, to a museum on a day trip, or just out to dinner, I realized that there was a such a nice mix of personalities that I was able to stay engaged with these friends for an entire day, and not have a single cancer related thought even once. It was all such a relief and a huge mental breath of fresh air.

There was so much more going on here than just spending as much time with family and friends as possible. I was definitely having a great time and enjoying life, but by keeping me focused and engaged, all of my friends were collectively helping to rescue me from my own painful and terrifying thoughts that I didn't yet know how to control. By keeping my mind focused and engaged with them and whatever we happened to be doing, they aided in my healing process by throttling and slowing the rate of all of the painful thoughts I was experiencing to the point that I could process them one by one as they came. I had been drowning and was sinking, but friends helped slow this down the point that I could keep my head above water. It also lessened the strain on my wife, and gave her a breather. She needed her husband back, our kids needed their daddy back, and I needed to be able to stand on my own two feet. I’m truly grateful for and feel so much gratitude towards those that were there for me in my time of need. 

By the end of the summer of 2013 around this time last year, everything finally clicked, and the answer all along was so obvious. The more engaged with life and living I was, and the more engaged I kept myself with friends, the less time I had to worry about things that might not ever happen, and the better off I was going to be. That’s not to say that I didn't still think about cancer because I did, and it’s not to say that I wasn't afraid because I was. After having kept so many bad feelings repressed and locked away inside of me for so long, I finally allowed myself to feel and express these terrible feelings. It was a great release to finally let them out, and like a huge weight had been lifted off of my shoulders, but I didn't stop living while doing so.

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The Best Way to Survive Cancer Is to LIVE: When you find your magic formula, lather rinse and repeat! Another fantastic summer for 2014 is now in the books. Top row, left to right: a Summer Kickoff Color Party that I threw with friends, our first trip to the beach over Memorial Day weekend, and a trip to Shenandoah National Park for the Blackberry Festival with friends. Center, our trip to Seattle and Mount Rainier National Park, which was spectacular. Bottom: One last beach trip with another in between, the County Fair, and the Maryland Renaissance Festival.

Towards the end of the year I finally managed to process and release all of the repressed fears and memories that had been haunting me, and I learned how to better control these things as they came such that they wouldn't ever gain the upper hand on me as they had been during the beginning of the year. I got the breathing room that I needed from the end of my two-year period of active surveillance, and stopped worrying so much about my cancer coming back. And I consciously chose that I was no longer going to worry myself to death about all of the things I had been worrying about before. Because we've had cancer once, we’re automatically at an elevated risk level for so many other types of cancer. Because our bodies had to endure the harsh and toxic treatments to beat said cancers, we’re automatically at an elevated risk level for secondary health problems later in life relating to said treatments. And because we commonly develop permanent side effects from said treatments that affect us today, there’s always the chance that they could get worse over time and we might not have the quality of life that we had expected as we age, especially if we’re faced with another health crisis. What if we experience a late relapse? I struggle in various ways today, what about tomorrow? What if we do develop another cancer? Will our bodies be able to handle it? What if something else happens? What if we don’t make it? How would our families go on? The list of worries never ends! 

I quite literally had worried myself to death, from a mental health standpoint.  

The harsh reality for everyone is that there’s never been any sort of guarantee on our health or longevity, and especially as cancer survivors there’s always going to be some sort of a dark cloud or question mark floating above our heads. There’s no sense in worrying about that which you have no control over, advice I had given myself long in the past but seemingly had forgotten. Take the best care of yourself that you can, both to minimize whatever risk factors you face and to maximize the potential of your body, and then simply live and enjoy your life today and every day as best you can. It’s a huge undertaking to be able to let go of your old ways and to completely change your attitude and approach to life, but once I finally managed to free my mind from all of these worries to fully focus on enjoying and maximizing the potential of each day instead, my healing process completed itself. I became a free man mentally and emotionally for the first time in years, and I've never been enjoying life more than I am today. Worry not about tomorrow, live and enjoy your life the best you can today.

The Best Way to Survive Cancer, Is to LIVE.

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Steve Pake's Top 10 Guide to Surviving a Young Adult Cancer

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To mark the end of Testicular Cancer Awareness Month this month, and as a late way to honor Young Adult Cancer Awareness Week which was also in April, I'm pleased to be able to share with you all a young adult cancer survival guide that I've written.  

Especially for Young Adults aged 15-39 and faced with a cancer diagnosis, there are so many unique challenges that we face compared to other age ranges. It’s not just our lives that we fear for at a time when we’re supposed to be invincible, but the fear of so many of our hopes and dreams that we’ve had for our lives slipping away right before us. As young adults, we’ve come so far and worked so hard in life, and are finally on the verge of being able to live if not already enjoying so many of these dreams. But in one fell swoop, a cancer diagnosis threatens to destroy and take all of that away from us. It’s so unfair, and we feel so crushed and cheated having to set all that we’ve worked so hard and made so many sacrifices for aside, just for a chance to even live at all. A cancer diagnosis is truly the ultimate betrayal. It’s our own bodies cheating on us with death at a time when we were counting on it the most, and all of the confidence and security we had about life vanishes in an instant. It’s beyond devastating, and it hurts so bad to be betrayed by our own bodies in such a terrible way at a key time in our lives.

Being struck with a cancer diagnosis and fight is challenging enough as it is. But if in mid-2011, right out of my brutal 5-month long fight against testicular cancer, someone with a crystal ball had told me that the mental and emotional challenges I would face in the coming years as a cancer survivor would exceed the physical challenges I had just faced fighting the cancer itself, I’d have given them some pretty funny looks, told them that they were crazy, and shaken my head with looks of disbelief and confusion and walked away. Because what could possibly be worse than the hell that I had just been through, right? Right? But today I know just how true such a statement would have been, because it’s exactly what happened to me, and it’s exactly how I feel today long after. I still can’t believe it myself, but I know it’s true. I had heard some stories, and I had even read Lance Armstrong’s book before my treatments started, but didn’t think any of the challenges of survivorship would apply to me. I was naieve and so very wrong, and know painfully now that the challenges of cancer survivorship should never be underestimated.

My cancer ordeal and the new challenges that I faced in life as a cancer survivor forced me to go through a personal evolution of self, and brought about the need to fundamentally change and restructure my approach to life and way of living in order to accommodate this new reality of mine. For the first time in my life I was truly scared, was afraid of living in my own skin, and was ill-prepared to deal with the anxiety and emotional rollercoaster that is “scanxiety”, as we go for follow-up appointments month after month, praying that our cancer doesn’t come back. I know what it feels like to have finally gotten your life back, only to fear losing it all over again from a terrifying recurrence scare that I experienced. I know what it feels like to have lost all hope, and feeling like you’re next, just waiting for the moment for more bad news to come, and that you’re going to be taken from the family that you love so much again. I know what a very deep depression feels like because I’ve been there. And I wish I didn’t know a thing about PTSD, which is single-handedly the worst thing I’ve ever experienced in my life, but I know all about that too. Rest assured that the real thing is far worse than any portrayal that you’ve seen in the movies. Your mind simply loses track of what’s real and what isn’t, and so many of your fears from the past find their way to the present, with little ability to distinguish between the two. And it potentially doesn’t stop… for weeks. It’s been over 3 years since my cancer diagnosis and over 6 months since any PTSD episodes, but the whole of this experience from diagnosis through today has hurt me so badly and deeply inside that I can still evoke tears on the spot, as I recall such painful episodes in my life as I write this.

My cancer survivorship experience spurned a personal evolution that finally began, way too late at the beginning of 2013, nearly two years after my initial cancer diagnosis. I knew that my entire approach to life needed to change, and that I was going to have to shake things up. Everything and everyone in my life was given scrutiny, including the person staring right back at me in the mirror. I was tired of cancer hurting me and my family, and set off to do whatever it would take to beat these terrible demons off for good, and for me to feel whole again. It took a full year to complete this evolution and it involved a lot more pain and trial and error, because I didn't know or understand what my needs were anymore. I needed to find out and re-discover my new self, whatever that may be. Towards the end of 2013 I was at last able to declare victory, and since the beginning of 2014 I’ve finally developed the emotional strength to begin looking back on all of this. After 4 months of reflection and more than a few tears and bottles of wine, I’m proud to finally be able to share with the world today my recipe for success. All of my secrets, my biggest lessons learned, everything that’s kept me going, and what’s really worked for me over the past few years as a young adult cancer survivor who has struggled to find my way in this new life of mine. 

1. Remove All Toxic Elements from Your Life

First and foremost, remove all toxic elements from your life. Fears, uncertainty, and doubts about cancer managed to fill every corner and crevice of my mind to the point that it broke me as a person.  When you’re so overwhelmed with negative thoughts, you literally become crowded out and can lose the ability to feel anything good at all, such as the love and laughter of your family. I slowly learned how to deal with and overcome all of this through the steps in this guide, but it came at a price. Having to focus inward so strongly has left the new me with neither the energy, nor the patience, to deal with much in the way of external toxicities. The news and its daily death count, who’s killing whom in the various wars that always seem to be raging around the planet, and the nasty blood-boiling political debates of the day have all needed to be switched off.  Trust me, you don’t need it and can get by just fine without it. And if Rome really is burning, you’ll manage to hear about it through word of mouth or at the office water cooler anyway. No need to be bombarded with such news 24/7. Focus on the good in your life and the world, and stay away from dark places and sources of negative energy.

2. Remove Toxic People from your Life

Similarly, if you’ve had people in your life that have repeatedly crossed lines with you, that have gone treading where they shouldn’t, or have rubbed you the wrong way one too many times, it’s high time to let them go too. Cancer is going to be playing enough head-games with you as it is, so the last thing you need in your life are actual people that are doing this to you too. True friends don’t do this. Let them go. God will not only bring much better people into your life when you do, but will reward you two-fold if you can forgive those that have hurt you, especially in such difficult times. I regret the few times that I’ve had to push people out of my life in these past few years as a cancer survivor, but it’s hard to imagine life without having met those that God brought into my life afterwards. These people have added so much to my life, helped to fill voids that I didn’t even realize existed, and I love, cherish, and appreciate these people so much. Make sure that your heart is in the right place, cut ties as gently as you can, and forgive those that have wronged you when you’re able and move on. Have faith that God will take care of you.

3. Find People that you Feel Safe Around and that Help you Feel Good

As someone who has suffered from post-traumatic stress disorder from my cancer, I’ve had to completely restructure my social life and social circles all based around how “safe” I feel around people. To this day, I still struggle to even begin to explain what exactly it is about some people in their ability to help me feel better, safer, more protected, or more understood in my life. Perhaps it’s some sort of deeper connection or understanding, or a common thread between souls, but these people are out there, and these are the ones you should try to develop closer ties and deeper friendships with, and spend more of your time with. These people are the gifts that God will bring to you, if you can manage to do the above and remove from your life those that have been toxic to you. Even if you’ve been hurt and are afraid to reach out, trust what your instincts are telling you about some people. The new or deeper friendships that I’ve developed with “safe-zone” people in my post-PTSD world have meant the world to me, helped me to heal, and helped me to feel safe and whole in my own skin again. Don't waste your time with people that bring out feelings of uneasiness in you and make you feel unsafe. They're no good for you.

4. Stay Engaged with Life and Enjoy Each Day

A history of cancer in our lives takes so much away from us. It changes our reality forever with an entirely new set of life circumstances. Memories of the brutality of our treatments haunt us, all while the future becomes so uncertain and terrifying. We worry if our cancer might come back, or if we’ll even have a future at all. All we really have left is the day and the moment before us, and nobody can take that away from us. Carpe Diem! Learn to live in the moment, and to enjoy and cherish each one that comes. Don’t let a day pass where you haven’t done something for yourself, anything that you know will put a smile on your face to give you some enjoyment in life.  Take the long way home because you like the drive better, go out to lunch with friends, or sneak out of work early to go for a run or for some private time with your significant other before your kids come home from school. After you’ve fully enjoyed today, make plans for tomorrow, and fill your calendar with fun things to do for the days, weekends, and months ahead. Keep your calendar full, and your mind engaged on enjoying the days and the life that you have before you, right here and now. Enjoy today first. Worry about tomorrow when it comes.

5. Take Back Control, Don’t Be Afraid to Do Your Own Thing

Among the many things that we lose as cancer fighters and survivors is the sense of control that we thought we had over our lives. It’s a helpless feeling as we shuttle from one doctor and one treatment to another just fighting to live, which is another traumatic life experience all by itself. Both at the time of our diagnosis, and during survivorship if we have a scare or fear our cancer might be back, it's not just our lives that we're fearing for once again, but that sinking feeling of being taken prisoner and our lives once again being held hostage by cancer, and the fear of losing all of the freedom and control that we had over our lives. It's a truly helpless and humiliating feeling to suddenly feel dependent on so many others at a time when we're supposed to be fully independent, and realizing just how little control we have. During survivorship, it’s all too easy to be caught up in the plans and schedules of others. Don’t be afraid to break with the group and make your own plans, or to do your own thing, in your own time, and on your own terms. It’s a very healthy exercise that will help you to gain a sense of getting some of that perceived control and independence back. Especially if you’re struggling emotionally or are trying to stay one step ahead of depression or PTSD as I have, every bit of control you can gain over your external environment is important. There are times when I couldn't even ride in a car with someone else, because I just felt like I needed to have that extra bit of control in my life, to drive my own car, at my own speed, and to have the ability to come and go at a time of my choosing and no one else's. When I've been hurting so terribly inside dealing with the after effects of post-traumatic stress, little things like this helped me to gain back some sense of control, and slowly my world was able to expand again. Enjoy your friends and the plans of others, but don’t be afraid to do your own thing and live life on your own terms as often as you need. 

6. Find Healthy and Productive Outlets for your Stress and Anxiety

Cancer truly is about the worst kind of betrayal you can face in life, which is why it’s not just a suggestion but a requirement that you find healthy and productive outlets for the stress that you’re likely to experience as a cancer survivor. Writing in my private journal has been a great way to vent away painful feelings, or to help understand confusing emotions. I’ve unlocked a lot of secrets about what makes me tick through writing in my journal, which in turn has helped me to understand what I need in my life and how to take care of myself better. When I’ve been anxious or afraid, executing my exercise routine has been a great way to bleed that energy off. I commonly run a 5K over lunch, which also serves as my private “me” time where I’m free to just meditate, or try to sort out whatever is on my mind. When I’ve been angry I’ve gone to the local shooting range with paper cancer targets in hand, and it’s strangely satisfying rapidly unloading a pistol or better yet a shotgun into those stupid cancerous cells. When I’ve been too afraid to be alone and my wife has been tied up with work or other things, I’ve made plans to spend time with some of those friends that I’ve felt very safe around, and it’s always been a great time. I never used to drink, but I’ve become a bit of a wine connoisseur, and can tell people a bit about different types of wines. I’ve never been on anti-depressants as it just wasn’t the right choice for me, but a nice glass of wine as needed has always helped to calm my nerves, ease my pain, and help take the edge off of things for me. And hobbies are a truly wonderful thing, along with the friends that come with them. I have photography buddies, car buddies, shooting buddies, among others. There’s always a circle of friends out there that I can engage with on my hobbies, and this has always helped to keep my mind out of the dark places.

7. Accept your Limitations, and Listen to what your Post-Cancer Body is Telling You

Your body is never going to be the same again after fighting cancer. Chemotherapy regimens are extremely toxic and can leave lasting damage, and highly invasive surgeries have their own risks that can permanently alter the landscape of your body as well, even when performed by the world’s best surgeons. Cancer itself means that a part of our bodies went terribly wrong and likely had to be removed in part if not in full. There’s excess capacity and redundancy built into our bodies in many cases, and we can go on living, but it absolutely doesn’t mean that our bodies will go back to normal. There’s likely to be some if not a lot of dysfunction as our bodies struggle to adjust, and our hormones and other levels fluctuate around, not to mention the chronic pain issues that so many of us experience too. What happens when a twin-engine aircraft loses an engine? Are pilots trained to keep flying it and get it on the ground safely? Yes. Is it business as usual? Heck no! Cancer means that our bodies just lost something permanently, and you’re going to have to learn how to keep yourself airborne without that, for the rest of your life. 

It took me a pretty long time to let go of the fact that I didn’t have the body that I once did. I pushed myself trying to do the things that I could do before and thought that I still ought to be able to do, but just kept failing. I became more and more frustrated with myself, my body kept breaking down, and my mood sank. I had been crashing and burning hard. Once I let go of my expectations for my old body, started listening to what my new post-cancer body was telling me, and the more I learned to respect what its new needs were, the better my life became. You’re never going to be able to learn what your new post-cancer body can and can’t do until you fully let go of what it was capable of before. It’s going to take some time, and it might even take years as it has with me, but once you fully know your body again and what exactly it needs and when, you’ll feel empowered and your quality of life will improve. I’ve let go of my frustration and disappointment at what my body can’t do and the various dysfunction that I have to deal with, and have just learned to become appreciative of what it can. I can't reach the altitudes that I used to and have to be extra careful in crosswinds these days, but I’m in the air and know how to keep myself there now, and dammit I’m proud of that!

8. Don’t Try to Forget – Stay Engaged with the Cancer Community

It’s all too common advice from friends, family, and even medical professionals to tell you to “just try to forget this and move on”. They’re all crazy. It’s tough enough to forget a supposed friend who stabbed you in the back, and it’s also tough to forget a failed romantic relationship or marriage especially if there was cheating. So how on earth can we be expected to “just forget” the ultimate betrayal or our own bodies? Maybe someday you’ll be able to make peace with and forgive your body, and hopefully this guide will help you a bit, but you’ll never be able to forget that you had cancer. It’s been far too painful for me to forget, because reminders of this terror inevitably find their way to me, which then brought this terrible history back in a sudden and uncontrolled way. The most helpful advice I’ve ever received during my cancer survivorship was from my dearest mentor, who suggested the completely counter-intuitive approach of NOT forgetting. Rather, embrace it. Do some good with it. 

My mentor had been writing articles for an association magazine for her own cancer, which she asked me to proof read and which I found to be inspiring. Numerous cancer survivor friends of mine participate in LIVESTRONG events across the country, which had also inspired me. And there are plenty of support groups and organizations that you can join to help others through their own battles. Staying engaged with the cancer community and outreach groups is also a way of holding onto that warrior instinct that you had when you were fighting your own cancer, and gives you additional strength when you're feeling weak. And when your own cancer demons really come knocking hard, it's your friends in the cancer community that will know and understand what you're feeling the best. It's good to surround yourself with people like these. We all help to support each other in the cancer community, and even those that have done so much to inspire and support others need support themselves at times.

There’s not a day that goes by when I’m not thinking about cancer at some point, my experiences and what I’ve learned through my cancer journey, trying to help someone else going through their own cancer fight, or the ways in which I could help others in the world facing cancer with my own knowledge. Becoming a Young Adult Cancer Survivor is the last thing I ever thought would happen to me. But it’s the life that I’ve been given, and just as my mentor has, I’ve not just accepted it but embraced it as best I know how. I don’t want to think about cancer everyday, but it’s the very best way forward for me. Staying engaged with the cancer community is a way to give back to this community and other people in need, and a way to do some good with this terrible knowledge that I possess.  

9. Love and Support your Supporters and Caregivers

As hard as it is to be the one fighting cancer and then having to heal both physically and mentally, don’t underestimate just how much pain it causes those that love you to be along for this terrible ride in the passenger seat. Fighting cancer is a deeply traumatizing experience not just for the person fighting, but for anybody emotionally involved in their lives. It tears them apart inside too. Cancer survivorship is a time of healing for all involved parties. Take time out of your lives for your loved ones. Go on some nice trips and getaways together and really enjoy each other. Let no moment go to waste. You all know how short and precious life can be. Live it up! If not now, when? You’ll never forget what you’ve been through, but the new wonderful memories you’ll make together with those closest to you, will go a long way towards helping you heal. 

I’m especially grateful to my wife, my family, closest friends, my cancer mentors, and spiritual guides and confidantes for their active support, and have let them know just what a difference they’ve made. I wouldn’t have made it to where I am today without their love, support, and friendships. And there are some that have just been exactly the right people, the right souls in my life, at exactly the right time, without even being aware of the difference they had been making in my life. Just the presence of their persona was able to have such an effect on me. It’s a very powerful feeling to know that you’ve helped to make such a wonderful difference in the life of another, especially just by being yourself. Share the gift of this knowledge with these people and let them know. I guarantee you that they’ll be honored and filled with joy.

10. It's Okay for Young Adults to Cry Too

The bottom line is that all of this just plain hurts. It's okay to cry, and don't let anybody tell you different. I've been so distressed and spooked, haunted, afraid for my life, afraid for my family, and so tired of being afraid of so much during these past few years as a cancer survivor, that I cried everyday for an entire month at one point. It's the body's way of relieving extreme stress, anxiety, and tension. It's beyond terrible to hold so much pain inside of you as I had been. I was completely wrecked inside and needed to release it all in whatever way I could, with whatever outlet I had. Most people probably don't know or understand what it's like to carry so much pain that you could cry everyday for a month, sometimes numerous times per day. The potential for emotional distress and mental-health issues for Young Adult cancer survivors is right up there with parents that have lost children, losing a significant other, or soldiers returning from war suffering from PTSD. I wish I could say this has been a lot easier, and I hope to never feel pain like this ever again in my life, but it really can be this bad. But you must release this pain. When you're at your lowest and darkest point, you can't begin to resume life as a more fully functional human being again until you do so. This 6-foot 3-inch large-framed bruiser of a guy that many have thought surely must have played [American] football or whom must have been in Army Special Forces is telling you that it's okay to curl up on the couch and cry it out. It's okay. Go for it. Just let it fly, and you'll feel better after you do.  

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Despite all of the challenges that I’ve faced in my life as a result of cancer, I know that I’m also truly blessed in so many ways. Many young adult cancer survivors find dating and relationships to be so awkward. How and when do you tell a love interest about your cancer history, and will they be accepting of that or not? Cancer becomes yet another layer for potential rejection in something that’s already difficult. What a blessing it’s been then, to have the true love of a soulmate by my side all these years. My wife and I will celebrate our 10 year wedding anniversary this year, and will have been together for 18 years total. I’m married to an angel, and my wife is truly God’s greatest gift to me in so many ways. I wake up every morning feeling like a blessed man with my wife by my side. She makes all that’s been so wrong, so right.

Like all too many young adult cancer survivors, I’ve suffered a complete loss of fertility as a result of my cancer treatments as well, which I'm revealing in public here for the first time. And with that loss, any hopes of my wife and I having more children together were gone with it. What a blessing it’s been then, to have the two awesome children that we had in the years just prior to my cancer diagnosis.  We had maybe wanted a third at some point, but this is an impossibility now. I’ve shed tears over this, but we’ve made our peace with the situation. We both love the two children that we have so dearly. They’re our lives and our everything, and literally irreplaceable. For all too many young adult cancer survivors though, the dream of ever experiencing the joy of a family and children of their own at all are fraught with challenges, and for some the dream is lost for good. It can become yet another layer of devastation in the life of young adult cancer survivors.

And what a great gift it’s been for me to both work in an environment where my needs and challenges as a cancer survivor have been so well understood from the top on down, and to have such a wonderful network of friends and supporters that have helped me along at every step of the way, almost like a relay team of angels. Not everybody is so lucky to have the supportive work environment that I’ve had, nor the network of support that I’ve had in my personal life, and the lack of either can cause very big problems for cancer survivors, too.

So perhaps a final lesson that can be learned as a result of the sum of my experiences as a young adult cancer survivor, is to appreciate the blessings that you do have in your life. Life doesn’t always turn out how we expect it to, and we don’t always get what we want. When you’ve reached rock bottom and have lost all hope, and feel as though you have nothing left as I had, simply appreciate the air that fills your lungs. For as long as you keep breathing life is going to go on. And as sure as the sun rises every morning, God’s blessings will be coming too. Have faith, and be open and ready for these blessings. Lastly, always know that you’re never alone in this. There are more and more young adult cancer survivors just like me around everyday. We understand because we’ve been through it all ourselves, and we’re ready, willing, and able to help. This is pure hell. Don’t be ashamed. If you’re sitting in the dark alone and afraid, reach out to us, and we’ll help guide you back to the light.

God bless,
StevePake.com
April 30th, 2014

Dedicated to all of the wonderful people that have been a part of my life in the past few years, and especially in 2013 when I had been struggling so badly. Thanks for making a difference in my life.

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