Cancer and Faith Q&A

[Note: After my previous article about how my faith ultimately cured my post-cancer mental health issues for my company’s internal website, I engaged in an extended Q&A about this, which I’m publishing here.]

The blog cover image is of the spires of the Russian Orthodox Church in Nice, France, which we visited recently on our trip to France in April 2023. No connection to the story, just a fascinating place we’ve visited, especially considering that I am part Russian ethnically.

Q: What type of cancer did you survive?  

A: I was diagnosed with Stage 2 Testicular Cancer. Little did I know, it’s the most common form of cancer in men ages 15-35, yet there's still very little public awareness about this type of cancer.

Q: At what age were you diagnosed with the cancer? How was it discovered?  

A: I was diagnosed in 2011 at the age of 33. I had a strange pain in my right groinal area for a few months, but thought one of my children had run into me, or that I had pulled a muscle somehow. The pain never went away and kept getting worse and worse, until one night it became so bad that I couldn’t even sleep. I finally did a thorough testicular self-exam, and discovered a solid mass at the upper rear of my right testicle. My heart literally skipped a beat. I'll never forget that moment.

Q: How was the cancer treated?  

A: My cancer was treated first with an orchiectomy (testicle removal), and then with a combination of four rounds of “EPx4” chemotherapy over 12 weeks total, followed by a highly invasive surgery called an RPLND. From diagnosis to being discharged from my final surgery, was 5 months in total.  

Q: How did this season in your life impact you (your outlook, job/school, relationships, physically, etc.)? 

A: Testicular cancer is an aggressive, but fortunately highly curable form of cancer. The flip side is that the treatments for it are also quite aggressive, and can really leave a mark on you. The chemotherapy made me feel like my body was getting ready to pack up and die, and there was a complication during my RPLND surgery in which I nearly did die, all of which fueled downstream mental health issues. I had recurring nightmares about all of this for years, and struggled with anxiety, depression, and PTSD, including a few suicidal episodes where it had all just become too much.

Everything changes after cancer. There’s never a good time to get cancer, but especially as a young adult and with young children at home, it can be especially traumatic. We have our whole lives in front of us and young children depending on us, when suddenly we feel as though we’re at death’s door. Cancer really puts into perspective just how fragile life is and what matters and what doesn’t, but is a terrible thing to have hanging over your head at such a young age. You truly have to evolve at all levels to beat cancer not just physically, but mentally and spiritually as well.

Q: Besides your faith, what other help did you receive? For example, did/do you see a therapist? Have you changed your exercise or eating habits? Did/are you taking medicine? 

A: It's a long story, but I realized early on that my mental health challenges were more spiritual in nature and thus needed to be resolved spiritually, and that anxiety and/or antidepressant drugs just weren't the correct path for me. I sought out cancer therapists which I knew can be amazing after the fact, but a 4-6 week wait for an initial visit at a time when I needed urgent help wasn't going to work, either. 

The cancer community and especially the close-knit young adult cancer communities online quickly became a huge source of support for me. No one fights alone, and there I found plenty of others in similarly distressed states. It was easy to find mentorship, guidance, and inspiration from those that were further along in their cancer survivorship journeys.

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Writing and running became my main outlets, all inspired by other cancer survivors. Writing, initially in the form of private journaling, helped me start to unravel what I was feeling and why. This really took off once I made my writing public, as there were virtually zero young adult male cancer survivors writing about the challenges of cancer survivorship at the time, and it was a perspective that people really needed to hear. Many thousands of people across the world have benefited from my writing, which was cross-posted and shared at Livestrong, IHadCancer, StupidCancer, the Cancer Knowledge Network, CURE Magazine, The Mighty, and more.  

Running was also fantastic, and not only helped rehabilitate my body physically, but helped me manage my PTSD and get it under initial control as well. There's something very primal and satisfying about running outside, not in a gym and not on a treadmill, with wind on your face and scenery passing you by, when you're in such a distressed state. It gave all of this free-wheeling inner anxiety a place to go, and it also helped get my post-cancer chronic pain issues under control as well. I'll never win any awards for my running like I have for writing, but running was a win-win for both mind and body.

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Q: Why did you turn away from religion as an adult?

A: Without getting into the specific church or denomination, I'll just say that I was never able to form a solid connection to God at the church of my youth, and that there's no shortage of adults of all ages that have had similar experiences. The lead pastor at my current church once answered in a Q&A session of the type of church I attended as a youth, that any connection to God formed was more likely to be in spite of that type of church rather than because of it, which was quite unfortunate for myself and many others, and a huge missed opportunity.

As a young adult, I also had far too much faith in the world and man's abilities. I was never an atheist but rather agnostic, and just didn't think I needed God or religion in my life. The decades that have passed, the challenges I've faced, and what I’ve seen of the world have completely humbled me, and I now see just how naïve and foolish I had been in so many ways.

Q: What other life occurrences besides cancer helped bring you back to God?

A: When I finally sat down to meditate on this early one morning and came up with the answers, I closed my office door at home even though it was just me and the dogs that day, grabbed a large box of tissues, and wept the entire rest of the morning. It was a good exercise and cathartic in a way to release a bit of pain that had been kept locked away for so long, but also quite the trip down memory lane.

It was so many things over such a long time, but was ultimately the completely unchecked and unmasked evil running rampant through the world starting in 2020 that brought me back to God. The illusion finally broke for me as to the true nature of this world that we live in. The Lord gave me eyes to see, and I cannot unsee what I’ve been shown. There should be no question about who and what is really running this world, and it brought me straight back to Christ. 

But complete spiritual demoralization had already occurred even prior to this. The 2010’s had been quite turbulent for my family and I, with a seemingly endless string of toxic and self-destructive people wreaking havoc in all areas of our lives prior to and still long after my cancer fight, often leaving only ourselves to clean up the messes and to deal with the consequences. It all became completely exhausting and intolerable to the point of becoming a bit of a recluse in the latter years of the decade, and then the events of 2020 and beyond started unfolding. I just wanted to be left alone, but that’s not how the world works, and I ultimately tired of feeling so alone in this world spiritually. 

Whilst in prayer and a deep state of despair one day in 2021, I felt a warm breathe and whisper from God on my shoulder, and He led me to my current church where I’ve found the connection to God, hope, guidance, fellowship, and so much more that I’ve long needed. 

Q: What state/region is your church located? 

A: I attend Frederick Christian Fellowship (FCF) Church in Frederick, MD. It's a non-denominational Christ-centered, Bible-believing church. You can read more about the church itself here, and my personal story of returning to church after 25 years here. It’s a truly amazing church that transformed me the very first time I attended services. The lead pastor gave a nearly hour long sermon that day that explained nearly everything I had been in such a deep state of distress about above, as though the message was for me personally. My only explanation is that God wanted me in that church, on that day, and to hear that message for a reason. If I had a church anything like this during my younger years, I never would have turned away from God and the church.

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Q: At what age were you baptized as an adult?  

A: I was baptized for the second time in my life last year at 44 years old. I was originally baptized as an infant, but baptisms are meant to be an outer expression of an inner transformation towards God, and a conscious choice one makes. This isn't something you can develop as an infant, and so infant baptisms aren’t performed at my church. Second adult baptisms such as my own are actually quite common!  

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Photo by Pat Kauffman

Q: What type of changes have you made in your life since you regained your faith?  

A: By the grace of God, I continue to be transformed by my faith for the better. I pray daily, keep reading and studying the Bible often, attend church groups and social functions when possible, and don't allow myself to keep worrying about too many things to list, including cancer. There's no question I've had that hasn't been answered in the Bible, and I've learned to put all of my faith and trust in the Lord and in His eternal plan. As my faith grows, the last of my mental health challenges fades away, instead replaced with great hope and confidence for our eternal future in Christ! 

"Fear not, for I am with you;
be not dismayed, for I am your God;
I will strengthen you, I will help you,
I will uphold you with my righteous right hand." ‒ Isaiah 41:10

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How Rekindling My Faith Cured My Mental Health Issues

[Note: My company asked for 400 word submissions for Mental Health Awareness Month in May for their internal website and blog, and so I wrote one.]

As a young adult cancer survivor, I’m no stranger to mental health issues. My cancer fight a decade ago was brutal and left numerous physical scars, but the mental ones went far deeper and took many years to overcome. All of the uncertainty after cancer fueled endless cycles of anxiety, depression, and even PTSD. Cancer had long left my body, but the mental fight within raged on silently for years. 

Life was challenging but spares no one, and eventually other tragedies and resulting traumas found their way into my life, some of which almost made my cancer fight seem easy. Moreover, the sorry state of our depraved world can be completely demoralizing to anyone, with all of its evils and injustices, endless wars, and unrighteousness of all kinds. Through all that I’ve faced, I’d considered taking my own life on more than one occasion, thinking it might be easier. Starting to redevelop my faith is what finally put a stop to it.

Born and raised a Christian, I had turned away from religion for the entirety of my adult life. It was actually current and former [Company] employees who saw my struggles through the years, that planted the seeds within me that helped rekindle my faith in God. A current colleague gifted me a beautiful set of Bibles a few years ago which I read faithfully, and soon after started attending weekly services at the church a previous colleague had long ago invited me to. I was baptized for the second time in my life the year after, having commit myself to leaving the foolish ways of my old life behind, and putting all my faith and trust in the Lord. These small gestures changed my life.

Peace in my soul has replaced endless worrying, understanding has replaced so much confusion and angst, and hope and joy for God’s eternal Kingdom has replaced the utter dread and hopelessness I’d felt for our earthly world and existence. 

“But first seek the kingdom of God and his righteousness, and all these things will be added to you.” Matthew 6:33

Never underestimate the power of faith to heal from mental health related matters. I discounted faith and religion for many years only to continue to suffer, but now offer myself as living proof of its truth and power. All that I had been seeking, I have found through my faith. 

StevePake.com

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10 Mental Health Tips for the COVID-19 Pandemic

Nine years ago this month, I had just finished 4 brutal rounds of chemotherapy fighting testicular cancer, and was on deck for a highly invasive surgery the next month in June. You might be surprised to learn that this was all the “easy” part of my cancer fight. What was hard was overcoming all of the mental health issues that many cancer survivors experience in the aftermath, such as anxiety, depression, and even PTSD symptoms. Learning to overcome all of this at a younger age has perhaps left me better prepared for other challenges in life, including the COVID-19 pandemic, so here are some mental health pointers for Mental Health Awareness Month.

The first step in overcoming a painful situation is acceptance. Just like my cancer diagnosis so long ago, there’s no sense in asking how or why it was all happening. “These things can happen” is as good of an answer as one is ever going to get. Years ago it was cancer. This year it’s a global pandemic. Okay then…  

Next, accept whatever it is that you’re feeling inside. “It’s okay to not be okay.” This is a painful situation for many, especially for those that may have lost someone. Be your own best friend and advocate, and allow whatever it is that you’re feeling to process, without beating yourself up for it. Never be ashamed of what you feel. We’re all human and feel so many of the same things inside. 

Just turn off the news, or if you must, stick with your local news once per day as a maximum. Local news tends to be more grounded and relevant for situations like these, far less sensationalized, and thus better for one’s mental health and managing your local situation.

Be present in your lives. Don’t allow yourself to be haunted by what happened yesterday, nor worry about what might not ever happen tomorrow. Focus on the here and now, and do your best to make today as productive and enjoyable as you can. Deal with tomorrow when it comes.

Do something that will put a smile on your face every day. This is a year to truly appreciate the little things and small moments in life. We might not be able to go everywhere, nor do everything we want this year, but it doesn’t mean we can’t find other ways to enjoy our lives, and often they’re right under our noses. This won’t just uplift yourself, but others around you as well.  

Get some fresh air and exercise at least once per day. Go for a walk, a run, or a bike ride, and keep your body moving. Fresh air, the wind on your face, and a change of scenery will all work wonders not just physically, but mentally as well.

Keeping busy with healthy and productive hobbies and outlets are important. Especially during my earlier years after cancer, an idle mind was an extremely dangerous thing in that it allowed all of the anxieties and worries to creep back in. I continue to enjoy my photography hobby, long bike rides with my kids, more time with my family, my backyard fire pit, doing a little writing, and a road trip here and there when we can manage one. I don’t give myself time to worry, and no amount of worrying about cancer ever truly helped my situation. Worrying just made me miserable in the present, and it’s no different for COVID-19.

Socially distance yourselves from toxic people as well. There are some people, especially on social media, who just can’t help but go on and on about how awful everything is. Our attitudes and beliefs are self-fulfilling prophecies in many ways, and so these negative thoughts are often reflections of what’s inside of these individuals. Choose to believe positive things, and surround yourselves with more positive people, and distance yourselves from those that are less than that. You deserve better.

Take some time off when you need it. It’s not a good thing that we’ve all been stressed out and worried, while also working ourselves into the ground in remote or home “office” setups that are often far less than ideal, and unable to take the vacations that many of us had planned. Take some time off anyway. We all need mental breaks and some down time to avoid mental burnout, and you can do that no matter where you are physically.   

Breathe. There are all sorts of numbers out there, but the bottom line is this. While the coronavirus is definitely much worse than the common flu, the vast majority of people are not going to get it, and the vast majority of those who do are going to be fine in the end, especially if you’re aged 60 or under and have no chronic underlying health conditions. Be smart, follow the latest guidelines, live a healthy lifestyle, and believe and have faith that things will all work out in the end.

Best,
Steve Pake

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Does The Burden of Cancer Ever Go Away?

I still remember how optimistic I was when I had reached two years cancer free, thinking that this terrible burden of cancer would be gone, and this huge weight would be lifted off my shoulders. It was a great moment when my oncologist declared me still cancer free, and I sent out a big note of thanks to friends, family, and colleagues that had been there to support me. I thought this was all done, but the truth was, I was still just as afraid of cancer in the weeks and months after my big two years cancer free milestone as I was before, and I was disheartened and continued to struggle in life. I still had anxiety issues, I still suffered from periods of depression due to cancer, and yes, I still suffered from posttraumatic stress as well.

When I reached five years cancer free, I thought that would be the big moment. I didn’t even technically need to be followed by an oncologist anymore, and opted to be “fired” and have what minimal annual checks I ought to have done taken care of by my primary care at annual physicals. I had evolved so much by this time, had found ways to find peace and fulfillment in spite of having had cancer in my life, and release so many of the fears that I had been holding onto. As fate would have it, someone I had cared for so deeply passed away from a late recurrence of his cancer right as I was going through my five year checks and formal discharge from oncology. My friend's late recurrence came seven years after his original fight had ended, and he died nine years after his original diagnosis. How then could I possibly feel truly at peace and at ease with cancer at the five year mark for my own cancer, right as I was preparing to fly out to be by the side of my friend’s family and speak at his celebration of life? If it happened to him, it could happen to me too. Even at five years, the fear never left me.

Turning 40 last year was definitely a huge deal for me, because for years I’d just felt cursed and accepted in my mind that I would never make it to 40, and have lived my life accordingly. I spent most of 2017 as a 39 year old being a little freaked out, as this small part of my mind just wouldn’t let go of this idea that I wasn’t actually going to make it to 40, whether due to cancer, a freak accident or tragedy, or anything else. Turning 40 definitely reset things for me, and redefined my own impossible. For the first time I’ve been able to think about my future as if I might actually have one, this thing called a career, and long-term goals. The burden of cancer, however, remains.

As I celebrated Christmas with my family as a newly minted 40 year old “middle-aged adult”, I couldn’t help but wonder once again, would this be the last one? Strange pains are never a good thing for any cancer survivor, but guess what's common for cancer survivors that have been through harsh treatments and invasive surgeries, guess what's more common in the cold winter months, and as anyone gets older? Yes, strange pains throughout my body, some localized and some spread out, and along with that the fears of my cancer having returned and facing the same fate as my friend, or a second cancer having developed, and all of the worries, fears, and anxiety that comes with that. Once you've had cancer, it never truly leaves you.

Once you've had cancer, it never truly leaves you. Sadly, in the months after I turned 40, I just felt that much closer to the inevitable.

Sadly, in the months after I turned 40, I just felt that much closer to the inevitable, and whatever cancer or disease or terrible tragedy was going to happen next. Not that I was really expecting it, but there was no warm and reassuring blanket of security wrapping itself around me, and telling me that I was going to be okay now. You lose that security blanket forever as soon as you hear the words “you have cancer” and have to learn to live without it. I enjoyed every moment of our 40th birthday celebrations with our family and friends. The smiles and the laughs were all real, and I have the poundage on me to prove we've been eating well. But in the midst of all of this, another round of anxiety and depression from which I’ve struggled off and on with for years because of cancer. It’s a blessing to live in a time where cancers such as mine can be cured, but life is never easy as a cancer survivor, and the burden of cancer never truly goes away.

The way I see it is this. I’ve been blessed with seven amazing years since cancer, and I’ve lived my life so fully each year since, that my cancer diagnosis feels like it was an entire lifetime ago. I know there’s never any guarantees for the future, but if I keep living my life the same way I have been, I’ll have felt like I've lived an entirely new lifetime in the next seven years and will still be considered young by many at only 47. And that's exactly what I plan to do. As we've gotten 2018 vacation plans finalized, it put my mind at ease, because if this is going to be my last year, dammit it’s going to be so amazing, again! This is how I've lived each year since cancer, and it's the only way I know how to live. As I reflect back on my seven years of cancer survivorship and having graduated to middle adulthood, I see a lifetime of so many amazing memories and adventures with family and great friends to look back on, and I’m “only 40”. I’ve lived more each year since cancer than I had in all of my previous 33 years combined before. Whenever the time comes for me to go, there's no question that I'll have lived a rich and full life.

"A man who lives his life fully is prepared to die at any moment." - Mark Twain

It took me a long time to understand this quote by Mark Twain, but I get it now. The burden of cancer never truly goes away, but turn it into a force for good in your life. Live your life positively, love yourself, love others, make a difference in the world, live your dreams, and enjoy every moment of time that you have with your family and friends, and people that truly mean something to you. Appreciate every day, every moment, every smile, every laugh, and every opportunity. When you so immerse yourself in the moment like this, you have a very rich life experience where you don't miss a thing, and you feel so complete. We all have a time and a moment coming where our lives are going to change. I pray I have many more years coming, but knowing that I’m living my life completely and not wasting any time helps to put me at ease when I once again face uncertainty, and I always have a wealth of positive memories to draw comfort from. I live the rich, full, and complete life that I do because of the burden of cancer that drives me. 

The richness in my life, the depth of my experiences, and the force for good that I've turned this burden into far outweighs the occasional pain that I continue to endure from it. I would not have my life any other way.

StevePake.com

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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.

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The Power of Behavioral Change and Self-Love After Cancer

The vast majority of what I've written over the years about surviving cancer as a young adult, has been about empowering survivors to make the changes that they've needed to make in their lives after cancer. Cancer is not just a disease of our bodies, but a disease of our minds as well, which can be the most difficult challenge of all. I read commonly of others who are still afraid, or experiencing depression or anxiety about cancer 10 or even 20 years after it had entered their lives, which just goes to show how challenging cancer can be. This isn't a race. We all have individual journeys, but I'm not afraid of cancer anymore, I no longer experience cancer-related anxiety, depression, or posttraumatic stress, and that's an achievement to be proud of when it's only taken me 5 years to get there. Personal behavioral change after cancer has been the key to that.

That Cancer "Red Pill"

Whether seen as a disease of body or mind, cancer is relentless, and you have to be relentless right back at it. When I've realized that a way of thinking, a behavior, a philosophy, or that something or someone in my life was causing me harm, I've never been shy about tearing that down and starting over again, even if I had no idea what was next, or what I should be doing instead. It was so terrifying the first time I let go like this, but I've done so so many times now. As it turned out, one of my own worst enemies after cancer was me.

For years after my cancer fight, I had trouble accepting that "I Had Cancer." Cancer was never in my life plan, and young adults just don't get cancer. It's a terrible thing to have to deal with and have hanging over your head, all while managing careers and families. I never stopped living my life, but there was this part of me that could never accept cancer in my life, and with it came periods of depression. I'm the type that's always needed the cold hard truth about things. Deep inside, I knew the answer to my questions - I was resisting, but had to let it go and accept the truth.

The red pill: The truth is, the lifetime risk of cancer is 1 in 2 for men, and 1 in 3 for women. It's inevitable that at some point in your life, either you or someone you love is going to have cancer, and there's nothing we can do about that yet today. Cancer is just a part of our humanity. Cancer can happen to anyone, including to young adults and children. We have little control over if we get cancer or not, but we can control if we accept it or not, and how we feel about it. I relented and accepted, but only after I could hurt no more trying to deny it. I came to accept that there were never any guarantees for anyone, that cancer and so many other diseases can happen to anyone at any time, that there's nothing I could do to protect anyone that I loved or cared about from such things, and evolved my thinking and my way of life around these undeniable truths.

"Accepting cancer" was the hardest and most painful pill I've had to swallow in life, but once I did, it couldn't hurt me anymore, and my depression about it went away as I evolved my life around this new reality. Be present in every day, never waste a moment, enjoy life today, go places that you've wanted to go, and do meaningful things with your life. Tell the people that really mean something to you how much you love and appreciate them, because they might not be around tomorrow to hear it. Live your life without regrets.

There's Nothing Wrong With You

As if having cancer as a young adult doesn't make you feel broken enough, try experiencing posttraumatic stress after cancer, and get back to me. Scratch that. I would not wish PTSD on my worst sworn enemy, it's that bad and inhumane. PTSD was so bad for the one six week period where I actually had the full blown disorder and couldn't get it shut down, that if cancer wasn't going to kill me, I almost wanted to do it myself. I'd never felt more broken in my life than when I experienced posttraumatic stress, but in most cases this is very normal to experience, and is NOT something that's wrong with you, it's what's right!

We have incredibly powerful instincts that are designed to protect us from harm. If your house burned to the ground and you narrowly escaped with your life, you can't tell me that it wouldn't be "normal" to go running outside for your life whenever you smelled smoke or heard a fire engine. In the case of cancer, it's our own bodies that figuratively tried to burn themselves to the ground, yet we lack the ability to run away from and escape our own bodies when something reminds us of that danger. Maybe you see now just how difficult life after cancer can be. Our instincts tell us to run the hell away from the one thing we can't - our own bodies.

I was hurting because of posttraumatic stress, and then hurting more on top of that for feeling as though it was "wrong" to feel at all, but once again, you have a choice. I finally choose to accept what I was feeling, and embraced it and worked with it, rather than fighting against it. My posttraumatic stress after cancer told me to run away, and so I did. Almost every day for three years I went running over lunch, just to burn off this energy. I embraced it and gave myself an out, and learned to accept just how useful these instincts really are. Human beings haven't come to our position of dominance on our planet because we have poor instincts. We have extremely powerful instincts that shouldn't be told they're "wrong" or not listened to. You're only doing yourself more harm when you don't listen to what your instincts are telling you. My periods of posttraumatic stress would be followed by periods of depression because I felt so defective inside, but once I learned to accept my instincts and work with them, it made the posttraumatic stress that much easier to deal with, and I no longer suffered the secondary depression that I had. You have a choice. Choose you.

Embrace Every Bit Of Yourself Exactly As You Are

Another thing that I used to beat myself up about was being "too emotional", and feeling things too strongly. I beat myself up for being too afraid, too sad, and too depressed about an "easy cancer", when everybody thought I should be ecstatic. There were more days than I care to admit where I was holed up in the corner in tears, because I was terrified out of my mind that my cancer was going to come back, and that I was going to be next. 

Well for starters, there's no such thing as a good cancer, and on top of everything else I'm also a Scorpio, not exactly known for having mild emotions. I've always had very powerful emotions, and having cancer (not the sign!) is what finally forced me to confront my powerful emotions in order to gain control over them, and make them work for me rather than against me. All of those Scorpio memes you've seen are true for me, and my mind felt like a Category 5 hurricane of emotions in my years after cancer. I could have kept beating myself up for this, but instead I learned to harness all of that energy into writing about what I was experiencing, and today I have an award-winning cancer website as a result of that.

Tell me again that there's something wrong with me for having powerful emotions? There isn't. It's just me, it's what I've always been, and finally allowed myself to be, and what I've done with it is something to be proud of.

Even hurricanes have a purpose.

Love Yourself Unconditionally

What I'm talking about in all of this, is self-love. We're all exactly as we were meant to be, we feel exactly what we were meant to feel, and all you have to do is love and accept every bit of yourself, without judgment or criticism. Why are you a certain way? Don't even question it. Our perceived faults are not flaws, and can be our most powerful assets. I didn't change my behavior to become something or someone else, I changed it to allow myself to be exactly what I was all along. After cancer, I just needed to be that person for once in my life, because cancer had already pushed me far beyond my limits. Be your own best friend, and not your own worst enemy. You can't control cancer, but you can control how you feel about it, and how you feel about yourself. Choose to love yourself. There's nothing wrong with you. You're exactly as you were meant to be, and are perfect as is.

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Overcoming Post-Cancer Depression

I happen to be a good baseline for what post-cancer depression can feel like, because there had never been even a single depressive ‘bone’ in my body prior to cancer. I was always upbeat and optimistic about everything, believed that there were solutions to every problem, and did not have pre-existing issues with depression or anxiety. My cancer diagnosis at the age of 33 is the first time I faced any mental health issues in my life at all, and they hit me like a load of bricks.

Forget About All the Statistics

First off, forget about any statistics you might have read about post-cancer depression, anxiety, or posttraumatic stress. I don't know of a single cancer survivor that hasn't experienced mental health related issues after cancer, it's just a matter of what it is, and how bad. You should never feel bad about yourself if you find yourself suffering from depression after cancer, because how could you not be depressed after something like this?

Post Cancer Depression Can Happen At Any Time

I thought I had been doing pretty well my first year or so after cancer, all things considered. I struggled in various ways, yes, but the heavy-hitting emotional fallout didn’t hit me until nearly two years later, when friends I had made started dying. Watching friends die of cancer is what finally made all of this real deep inside my mind, and not just a bad dream. Reaching two years out from my cancer diagnosis was a huge milestone. I should have felt like I was on top of the world, right? No. With one friend in the ground and another in hospice care, I was terrified out of my fucking mind, and felt like if something was going to happen to me, it was going to happen sooner rather than later, and I had the fear of God in me.

I didn't want this anymore. I was tired of feeling so afraid, tired of feeling so vulnerable, and tired of having my own body scaring the hell out of me with all of its strange post-cancer pains and behaviors, making me think my cancer had returned. I lost interest in various hobbies and things that had interested me, didn’t want to be around anyone besides my family and a few extremely close friends, and didn’t even really want to be around myself. I largely withdrew from the world, and stopped being social for a long time. I finally hit an emotional rock bottom and a very deep depression, two years after my cancer diagnosis and fight.

Nobody Could See My Depression

I didn’t stop living my life, but my inner struggles were invisible to the world. I would go out on weekends with my family, or with friends, and have the time of my life. We enjoyed great trips and vacations, and had so much fun together. But whenever we returned, this misery was always there waiting for me, the waiting, the wondering, the fear and the doubts. How could this not drag you down? I felt so vulnerable, defective, and worthless inside. I was literally damaged goods. Who would want to be around someone like me? Even I didn't want to be around me, or my body, but what choice did I have? I was so haunted inside, and just felt trapped. I wanted out of this experience and would have given everything I had just to escape this miserable life experience of continually waiting and wondering. Cancer is merciless. It will push you well past your limits until you break, listen to you screaming for mercy, and then just keep on pushing you relentlessly. The only person that could hear my internal screaming was me.

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I enjoyed literally every second of this blissful week at Disney World with my family in the spring of 2013. Can you tell that I was in the midst of a terrible post-cancer depression here?

So What Can You Do?

1. Live Your Life Balls To The Wall. That's actually an aviation term, and nothing to do with male anatomy! Whatever you want to call it, just live your fucking life. It's okay to be a wreck, it's okay to be scared out of your mind, but never stop living your life. Don’t let cancer rule you like that. Keep living your life at full speed ahead, and don’t slow down for anybody!
   

2. Stop Worrying. I had to learn to let go. Worrying never got me anywhere, but it did distract from my ability to enjoy my time right now. I was depressed because I was so worried, and the more I worried, the deeper my depression became. It was a viscous cycle. Just let go, realize you have no control, and live your life in the moment.
   

3. Find Faith. I replaced my worry with faith. I was so afraid that my cancer was going to come back, and that I was just going to die of cancer anyways. Developing faith and an independent system of beliefs helped to relieve me of those fears.
   

4. Stop Identifying With Your Body. Repeat after me. “You are not your body.” We're so much more than that. I had to learn to stop seeing the shortcomings of my body as some sort of personal failure, and to recognize the true me for me, the beautiful soul within. Your body’s failure is not yours personally, so stop beating yourself up for that as though you’re any less of a person than anybody else. You’re not. You are beautiful, scars and all.
   

5. Find Forgiveness. Part of why I was depressed was because I feared dragging my whole family through this hell again, if my cancer were to return. I had to learn to forgive my body for failing me. This is the true nature of life. These things can happen. There are no guarantees for anybody. I stopped identifying with my body, and learned to forgive it for doing what bodies sometimes do.
   

6. Find the Right People. There are a few amazing people out there that just had a magical way of connecting with me that would immediately put me at ease, relax my fears and my mind, and help me to just live in the moment. Soulmates, soul brothers, and soul sisters, they’ve all meant the world to me. There are people out there just like this for you, too. If you haven’t found them yet, keep looking.
   

7. Find a Purpose. With apologies to my many engineering world colleagues, I knew that I was never going to make the difference in the world that I needed to make doing engineering things. My non-profit work and writing about life after cancer has been a purpose fulfilled, a great method of coping and healing for me and for others, and has reached hundreds of thousands around the world to help them heal and find their ways through this, too. If I were to get bad news right now, I know that I’ve done something meaningful with my time here, thus taking away another fear and source of depression. I've lived my life well, and have done meaningful things with it. That matters.

Periods of depression are inevitable after cancer, even many years later. You can’t necessarily stop cancer-related depression from happening, but you have the power and control over your inner and outer environments to make sure that such periods will be shallow and brief. With the right people, the right coping mechanisms, and the right inner and outer attitudes, you can power through these periods of darkness, and get back to thriving after cancer again!

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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Cancer Is Not Just Rogue Cells - And Not Just Inside the Patient

A few words for World Cancer Day 2017.

As I approach six years of cancer survivorship, never has it been more clear to me that cancer is not just a disease of our physical bodies, but a disease of our minds and souls as well. Thus, the argument that many make, is that cancer is not just a matter of eradicating the rogue cells from one's body, but of curing the entire patient. To rid a patient of the physical disease, but to ignore the residual emotional and spiritual disease, does not a cure make.

In these six years after cancer, there's much more that I've had to overcome than a bit of testicular carcinoma. The chemotherapy did a number on my body, and I've had to overcome chronic fatigue because of chemotherapy induced peripheral neuropathy, but those were the easy parts. My anxiety was overwhelming at times, and I constantly feared that my cancer would come back. Some friends of mine didn't make it, and on several occasions, I thought for sure that my cancer had returned, and that I was next. I fell into depressions several times, and suffered from posttraumatic stress. I struggled emotionally for years, and even four years out from cancer, I couldn't stop being afraid.

Irregular hormonal levels for several years didn't help, either. Doctors of testicular cancer patients all seem to believe that because men have two testicles, that the other will "pick up the slack" and that we'll be able to keep flying along as normal, like a twin-engine aircraft. We survivors know otherwise, that it's not necessarily true, not nearly that simple, and that there's actually no evidence out there to support such assumptions, as no studies have ever been done! Because our testosterone levels might still test in an impossibly wide "normal" range, we're sent packing. Meanwhile, our moods, energy levels, and mojo can be flailing around all over the skies from 30,000 feet down to treetop level and back again, barely able to stay in the air at times. While having to contend with so many post-cancer fears, we're also having to contend with non-compliant bodies, and doctors that don't understand our problems. Life after cancer can be so cruel and unfair.

Loved ones and caregivers suffer right along with us, and should not be overlooked anymore, either. Where there is love, there's transference of emotion, transference of anxiety, and transference of cancer as a disease of our minds. Yes, caregivers suffer from the disease called cancer as well, and for them, it tends to be a more silent battle. They need to be strong and the pillar of support for the ones doing the physical fighting, but feel the same fears and anxieties as the actual patient does. Caregivers are fighting cancer as a disease of their minds, too, and deserve equal consideration for care. Don't just ask how the cancer patient is doing - ask how their caregivers are doing as well. It's entirely possible that no one has ever asked, while they're crumbling inside in the same way as the patient.

Survivorship care has come a long way in six years, but there's still much to this fight that's not well understood in medical professional circles, and so the drive to share in our journeys and our many struggles after cancer continues.

StevePake.com

Originally written for World Cancer Day at the Cancer Knowledge Network

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On The Power of Writing to Help You Heal

Writing became an important coping mechanism for me many years ago, when I was really struggling after cancer. My post-cancer demons had me in such a dark place that I had contemplated suicide as a means to an end, and it was at that point that I realized I needed help. My wife did her best to support me, and to make me feel loved and valued at a time when I felt completely worthless. I called my oncologist's office for a therapist, I called my cancer mentor for help and guidance, I started running every day over lunch to bleed off the extreme anxiety that I felt on a day to day basis, and, I started writing. The writing in particular really stuck, and as this website is proof of, has never really stopped. 

Writing About Cancer Isn't Easy

Writing about cancer and all of this inner pain that it had brought into my life has never been easy, but the rewards for doing so have always far outweighed the hardship. It's one of the hardest, but also simultaneously one of the best things I've ever done.

My wife, Debbie, came up to me one day a year or two ago with a very befuddled and frustrated look on her face. I was in tears at my computer once again, doing some writing with a glass of wine next to me. She asked, "why do you write if it hurts you so much?," obviously not wanting to see her husband in pain. The answer wasn't that I was hurting because I was writing, I'm writing because I'm hurting, trying to release more pain, and trying to find ways to heal and keep moving forward in life. I was four years out from cancer at that point I think, and couldn't stop being afraid. I was fearful of developing a second cancer, or experiencing an extremely dangerous recurrence of my first, and frustrated to no end. We don't have conscious control over very deeply rooted feelings like these. I couldn't stop being afraid, but refused to live in fear any more, and vowed to do whatever it took to overcome this perpetual post-cancer fear once and for all.

The blog that I ultimately published in late-2016 about overcoming fear after cancer, was probably my biggest blog of the year, getting many thousands of hits, comments, and shares on social media and at the IHadCancer.com website. Cancer isn't just a disease of our bodies, it becomes a disease of our minds also, that can persist and continue to haunt us for years, long after cancer has left our bodies. Thus, the argument that we make in cancer advocacy circles, is that healing someone from cancer means healing the whole patient, and not just eradicating their bodies of the cancerous cells. I saw this all over the comments in response to my blog about overcoming fear. There were no shortages of comments from those that were many years or even decades out from their cancer fights, and still living in a state of fear from it all. Many of these people had been cured or in full remission, yet cancer still continued to affect them as a disease of their minds, in the form of the fear it leaves inside of us.

Writing Is One of The Most Rewarding Things I've Ever Done

Cancer as a disease of the mind had persisted inside of me for years, too, and that's why I've continued to fight it, in the form of writing. The process of writing, and of putting raw emotion down on paper, has always helped me to channel what I've been feeling into something more coherent. Writing is a cathartic experience, and the writing process helps me to understand what I'm feeling and why, and ultimately, what I could do about things. Once I've written about something, I feel as though I've overcome it. Then, the only thing you have to be willing to do, is finding the courage to make the changes that you need to make in your life in order to keep moving forward. Or maybe you don't need to do anything at all, and just needed to get it out?

Writing has always been a bit of a damned if you do, but more damned if you don't affair for me.  It's easier to not write at all, yet if I don't process pain that I've felt inside it's impossible to ever move beyond it, like posttraumatic stress, and perpetual fear after cancer. When I write, it does bring a lot of painful memories from the back burner to a full boil. Why not just leave them on the back burner? Because I grow weary of having them there, resent the needless mental clutter with these worries in the background, and occasionally they sneak up to a full boil on their own and make a mess, when I'd rather just be free of it all. If I bring it front and center and just crank it up to eleven and burn it all off through writing, then it's gone for good and will never bother me again. Isn't that better? It is, but it can take time to finally get there.

Writing About Cancer Takes Time

Contrary to what many think, when I publish something about cancer, it's not something that I'm experiencing right now. In almost all cases it's been at least a year ago, and even moreso now, many. Some of the things I'd been through with respect to cancer had been so painful and traumatic that it took me a few years just to open up and start writing about them at all. My physical fight against cancer was in 2011, but it wasn't until 2013 that I really started "writing" about cancer, and not until 2014 that I started doing so publicly. Posttraumatic stress after cancer had hit me hard at the tail end of 2012 and the beginning of 2013, and I suffered from it throughout 2013. It wasn't until the tail end of 2015, nearly three years after its onset, that I was finally able to publish my first of three major essays about PTSD. 

It takes that long to find your way through it, for the pain to lessen, and for thoughts to mature to the point that you can write in a way that doesn't cause yourself harm, and is uplifting and beneficial to others. When it came to writing about PTSD, which is something I really needed to do, as soon as I would go there mentally it would trigger all of those terrible protective instincts again, and I just couldn't. When I write about a very hurtful topic, it's often because I'm finally fed up enough with those repeating back burner flare ups that I'm ready to finally take something head on, and rid myself of it for good. I've not had any issues with PTSD in years now, and it was only after I took this elephant in the room issue head on, and worked my way through it via my writing, that I was finally able to heal from it and move on. 

On Writing Publicly About Cancer

You don't have to have a blog or a website, nor do you have to write publicly about something to benefit from writing. You can write just for yourself, in a private journal of some sort, just as I did early on. The decision to write fully publicly about my cancer experience was a big one, but I'd had a ton of encouragement from a few close friends who had seen early drafts of my first cancer survivorship essay. They knew that writing like this could make a big difference for so many people, and that it had the potential to not just help young adults such as myself facing a cancer crisis, but anyone facing a crisis or difficult period of their lives.

I blog using my real name. Anybody can Google me and find out all sorts of things about me, that I've had cancer, experienced PTSD and suicidal thoughts, and either you're comfortable with that or you're not. Ultimately, I decided that I had nothing to hide, nothing to be ashamed of, and actually quite a bit to be pretty darned proud of. My story is a positive story, one of having been through some extremely dark places after cancer, but finding your way through it, empowering yourself to make the changes that you need to in your life, finally coming back into the light, and using that experience to help uplift others. I'm very proud of my cancer journey, complete with all of its dark and twisted moments. It's made me who and what I am, and not only am I proud of the person that I've become after cancer, but it feels so good to be recognized for that in a significant way as well.

YOUR STORY COULD BE THE KEY THAT UNLOCKS SOMEONE ELSE'S PRISON

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Don't Be Afraid to Share It.

There's a lot of things I enjoy about fully public cancer writing, but what I enjoy the most is helping people to know that they're never alone. Especially as young adult survivors, we have so few peers that have been through anything like what we have given that young adult cancers are so rare. Feelings of isolation are common. We all think we're alone in our struggles, but we're never alone. I love reading through the comments on my blogs and seeing "My God, this is me!" and "I thought I was the only one!", and then "I know I'm not alone now!" I love seeing people light up like this. We think we're all so different, and that we're so alone, but our humanity binds us. We're all human beings, we have the same thought processes, and when faced with a life crisis such as cancer, we all think and feel so many of the same things. Seeing such common responses to my writing has been a very unifying and comforting thing for me to witness as a writer. We're not so different after all, and we're never truly alone. I love all of the comments that I get, I love all of the interaction, I love the people that I get to know, and I love knowing that all of my efforts are not just helping me to heal and recover, but helping others as well. 

What I love more than anything though, are the occasional messages that I get that leave me speechless, and stopped in my tracks. Numerous people have told me that my first essay about surviving young adult cancer has changed their lives, and is the best thing they've ever read. A childhood cancer survivor who is now an adult, told me that they had felt every word of my essay and had wanted to write something just like it for years, but hadn't even known where to start. They finally felt the release that they had needed to feel for years, through reading the words of another. A testicular cancer survivor had been suffering from PTSD for years, but had never realized that was what it was, nor that it was even a possibility, until they read my PTSD After Cancer essay series. Another life changed, and another person unlocked from their own mental prison such that the true healing could finally begin. I've had a professional therapist send me a note, telling me that they were using my PTSD story to help patients that had been suffering from posttraumatic stress as well. I have much respect for professional therapists, but sometimes it's best to hear it from another real live human being that's really been there, too.

One of the best comments I've ever received though, was from another testicular cancer survivor a few years ago who was a 10 year survivor, but had never opened up to anyone about his cancer history. He had felt so trapped and alone for years, but felt all of the same fear and anxiety that so many of us do. Without any true outlets or people to open up to, he had found himself in such a depressive downward spiral that he had become suicidal. He read my essay titled, "The Best Way to Survive Cancer is to LIVE!", and found himself in my writing so strongly that it helped to finally pull him out of the depressive and suicidal downward spiral that he had been trapped in for years. In moments like these when I know that I've made such a profound difference in the lives of others, every bit of pain and frustration I've ever felt while writing, and all of the tears and sleepless nights becomes worth it. My writing mission doesn't just helping myself and others to heal, it's potentially helped to save lives as well.  

My young adult cancer survivorship writing mission hasn't just changed my life and that of others for the better, it's potentially helped to save lives as well. It can be terrifying to put such dark things out there about yourself, but the profound good that can be done by sharing such experiences is immense, and shouldn't be underestimated. 

How Do You Write?

I have a huge confession to make. I don't really know how to write, nor how to describe any particular writing process! I'm a guy and and actually an engineer, so obviously I can't write, but I just write, and am now an award-winning writer about a very challenging subject no less. I asked my good friend and writer pal, Hanssie, for help, hoping that maybe she'd know of some sort of formal process to help people get started, especially knowing that she was a teacher. Hanssie writes about the painful divorce she's been through at her website in the same manner that I write about cancer on mine, but she wasn't of much help either! Hanssie did provide us with the only thing that one really needs to know about writing as a means of coping or healing, in the form of this Ernest Hemmingway quote.

"There is nothing to writing. All you do is sit down at a typewriter and bleed." - Ernest Hemingway

Perfect! That's really all there is to it, and pretty much where my writing has come from. As Hanssie described to me, "I realized I could write when I was teaching my 4th grade class on creative writing. I wrote a bit when I blogged about photography and then I 'bled' after the divorce when I just didn't know what else to do to keep moving forward."

It was the same exact experience for me in the aftermath of cancer. I had always known that I had some inherent writing ability that I could utilize, and many people had told me over the years that I had great writing skills. I figured nearly ten years ago, long before cancer entered my life, that I ought to use that ability someday and write a book, but I didn't know what to write about. Alas, this decade of my 30's has given me plenty of material. I finally started tapping into this ability when I'd reached rock bottom from my cancer experience, and just starting "bleeding" into a private journal. The journal writing evolved after a year into my first major essay about cancer survivorship, then onto fully public writing about cancer at the Testicular Cancer Awareness Foundation, IHadCancer.com, and now my very own award-winning website. Not bad. :) 

If you want to give writing as a coping and healing mechanism a try, just sit down and write, and see what comes out? You have nothing to lose, and it could change your life. 

StevePake.com

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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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PTSD and Suicidal Thoughts

This morning, my wife asked me if during my darkest days of PTSD, I ever had thoughts of killing my entire family. No. Never. There's a terrible story in the news, one of those murder/suicide "family delete" type tragedies, where a woman had been suffering from PTSD and possibly other things, stemming from a health crisis in one of her young children. I know that it was a little more complicated than that, but the woman was getting help, seeing a therapist, and was on a common type of anti-depressant drug, but still allegedly killed her husband, her three young children ages 2 to 8, and then herself. 

At my absolute lowest point, I was so distressed and afraid that I had contemplated suicide, because I was hurting so badly inside, and didn't know how to stop hurting. A friend of mine had just died of cancer, and others were dying, or having recurrences. I had a terrible cancer recurrence scare myself, and just felt like I was next. I felt doomed and threatened constantly, and just wanted it to end. I knew that suicide wasn't the answer; I had too much to live for, but I was terrified of my cancer coming back, and couldn't bear the thought of having to break such news to my family, having them watch me go through this hell all over again, and possibly having to watch me die a very slow and painful death from it. 

At my worst, I just wanted to be driven out to a field in the middle of nowhere, where no one would ever find me, because I was so spooked and convinced that my cancer was going to come back, and didn't want to hurt anybody else when that happened. I didn't want my children to see their daddy die. I felt so worthless and like a huge liability to my family, and just wanted to be abandoned. I was never a threat to anybody. That was the end of 2012 and the beginning of 2013, and it took me all of 2013 to recover from that and get myself on a more even keel again, and a full recovery from PTSD didn't actually come until late-2015. I don't miss those times, but I do remember them like they were yesterday. You can't ever forget it. 

When I hear a story like this in the news, it's like driving a knife into my soul a bit, because I understand pain like this all too well, and I'm so sorry to see a tragedy like this take place. It's a bit haunting as well, because I had been down to my last frayed thread of sanity. I was a completely shattered and broken person inside. I didn't "snap," bit it wouldn't have taken too much to have done so, and to have been that close still hurts to think about, even many years later.

I'm not going to read about this story (I can't), and so I'm not going to assume anything or cast judgement on anyone. The only thing I'll say is that I'm sorry that the help this person found wasn't ultimately successful in helping them through such a distressful time in their life, and in averting a tragedy like this. It was a perfect storm of internal and external elements in my life, including my own inner demons, that formed to break me. Why am I still here today, and why am I so grateful to so many? Because it was also a perfect storm of love and support that helped to pull me out of such a terrible period in my life. I either already had everything that I needed, or very quickly found it. Love and support from my family, the right friends, the right mentors, the right outlets, and on and on. It's not cancer that truly changed me as a person, but rather the PTSD that I experienced after cancer that did. Key to my post-cancer and post-PTSD survival has been the fact that no stone was left unturned, and that I changed almost every aspect of my life. I adopted new attitudes, new beliefs, new routines, new friends and social circles, and new everything. Cancer and especially PTSD turned my life upside down, and so it makes perfect sense that I had to flip everything in my life over in order to get things oriented in the proper direction again..  

Two things that were never involved in my PTSD recovery were therapists, nor any sort of drugs. A big problem that we have as cancer survivors is the lack of people out there who truly get what we've been through, and the terrible things that our minds are telling us, besides other cancer survivors. Even oncologists who treat cancer patients for decades, who are then diagnosed with cancer themselves later in life, have admitted they had no idea what their patients were going through until the tables were turned, and they became the patient. A therapist was certainly an option for me, and I'm not saying they're wrong or that it's the therapist that failed the patient in this case, but I simply didn't trust a therapist to be able to handle ME. It doesn't help that I'm a Scorpio, and that my mind is already a very complicated and turbulent place, and that it already takes quite a bit for us to trust anyone. A therapist just wasn't the right option for me. And every drug I had ever taken for managing various post-cancer issues always had far worst side-effects for me than whatever relief they were supposed to have provided. I'm not saying that they're wrong or to blame either, but when it came to an anti-depressant for me, which I arguably ought to have been on at various points, it was just another non-starter. 

No therapists. No drugs. This definitely wasn't easy path to have taken through all of this, and it was arguably very risky as well. We all have to find an approach that will work for us and that we can place our full trust in, but you can overcome depression, PTSD, suicidal thoughts, and the existential crisis that life throws at us without such things. There are other ways to do this. I can check all of those boxes, but I've only grown through all of this, and am spiritually sound today. I want people to know that it's possible, and that I'm living proof of it. 

National Suicide Prevention Lifeline - 1-800-273-TALK (8255)

StevePake.com

[Note: The facts of the mentioned case came out, and it turned out that the woman's husband apparently did it. This is still a relevant topic to discuss and figured I'd write about it, since it came up, but I'll rework this blog a bit later.]

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PTSD After Cancer Part III - Managing Life After

PTSD will hollow you out inside. After these fires had raged inside of me for six solid weeks, there was nothing left of me but smoldering piles of rubble. My mind was scattered into a million pieces on the ground, and I hadn't a clue on what was supposed to go where, nor what the final picture was even supposed to look like. I was just gutted. As much as my life changed after being diagnosed with cancer, it changed just as much if not more after I started suffering from posttraumatic stress in the years after cancer.

PTSD After Cancer Part I - What It Feels Like
PTSD After Cancer Part II - Coping and Overcoming
PTSD After Cancer Part III - Managing Life After

In Part 1 of these essays, I described what posttraumatic stress felt like to experience, and in Part II, I described the various things that I did to cope with and recover from it. In this final essay, I'm sharing the things that I've done to manage my life after suffering from posttraumatic stress after cancer.

1. POSTTRAUMATIC STRESS IS NOT WHAT'S WRONG WITH YOU, IT'S WHAT'S RIGHT

If your home burned to the ground and you lost everything, and only narrowly escaped with your life, you can't tell me that the smell of smoke or the sound of a fire engine coming down the road wouldn't make you cringe, and possibly want to run out the door. This is a normal, healthy reaction to traumatic events in our lives. Human beings haven't evolved over billions of yeas to our position of dominance on our planet because we have poor instincts. We actually have extremely powerful instincts, and posttraumatic stress represents our protective instincts kicking in, trying to remove us from harm and situations that are perceived as threatening. You should never feel ashamed if something or someone that reminds you of a traumatic event, makes you feel afraid months or even years after the traumatic experience. It matters not weather it was a house fire, a plane crash, a war, or fighting cancer; when we experience things that remind us of our past traumatic experiences, it's the same protective instincts that kick in, trying to remove us from perceived harm.

PTS is not what's wrong with you, it's what's right. Act like it.

If something or someone reminds you of a traumatic experience, you're supposed to be afraid, you're supposed to want to run away, or hide, or fight back. Posttraumatic stress isn't what's wrong with you, it's what's right! It's a sign that all is well, and that your mind is working exactly as it should be!

2. POSTTRAUMATIC STRESS IS NOT "PTSD"

There's a huge problem with perception out in the world with how posttraumatic stress is perceived. Posttraumatic stress after a traumatic event, such as fighting cancer, is very normal. Such episodes might last anywhere from an hour to a few days, or maybe a week. Full blown posttraumatic stress disorder is when you have all of the symptoms of posttraumatic stress for extended periods of time, several weeks or more, and that never seem to let up even after being removed from the stimulus that had triggered the posttraumatic stress episode. This is a very serious situation that requires professional help or treatment, but because any sort of posttraumatic stress is generically only referred to at "PTSD", too many people feel like there's something wrong with them when there isn't, and might be more reluctant to seek the help and support that they need. Rest assured that feelings of posttraumatic stress after cancer are very normal to experience, and that there’s absolutely nothing wrong with you. These are our self-protective instincts coming to the surface, trying to remove ourselves from situations that have been perceived as being threatening.  

3. ACCEPT WHAT YOU'RE FEELING

The extreme feelings of fear and anxiety that posttraumatic stress can cause us to experience come from our sub-conscious, and thus we have no conscious control over such feelings. We can't just tell ourselves to not be afraid. All we can control is how we consciously react to these sub-conscious feelings and instincts that come to the surface. We can beat ourselves up, and berate ourselves for being afraid when we feel like we shouldn't be, but this is denying ourselves. We're hurting inside, and beating ourselves up just makes things even worse. A far better approach is to simply accept what we're feeling, without criticism or judgment. Instead of criticizing yourself for being afraid, simply accept that you're afraid, and try to find healthy and productive outlets to channel those feelings into. Write about how you feel, or dump this energy into an exercise routine, for example.

4. STAY CLOSE TO YOUR COPING ROUTINES

As suddenly as the posttraumatic stress mechanism in our minds can be switched off, it can also switch back on again. Thus, it’s very important to stay close to whatever routines you’ve developed to help manage your posttraumatic stress. I took to running as a form of therapy to help manage mine, and I always made sure that my running shoes and clothes were prepped and ready to go so that there wouldn’t be any delays, should I suddenly need to go for a run. If I’d come home from lunch dealing with PTS issues in my mind and didn’t have my running gear ready to go, that’s 30 minutes wasted trying to track everything down with that terrible, panicking, freewheeling energy burning me up inside. It’s best to have ready-to-go “turn key” coping methods at your disposal that you don’t even have to think about, whenever the need arises. Stay close to your coping routines. 

5. STAY CLOSE TO PEOPLE THAT BRING YOU COMFORT

As important as it is to stay close to whatever routines you’ve developed to help you cope with your posttraumatic stress, it’s important to stay close to the friends and people that help you to cope as well. Most people in my life genuinely cared about me, but just didn’t know quite what to do for me, or how to support me. Posttraumatic stress was just as foreign for them as it was for me, and some tended to shy away simply because they didn't want to cause any harm. There was a highly select group of people that just “got me” in some way, as though there were a very deep soulful connection in play that just engaged naturally when I needed it to. With or without having ever experienced anything that I had or not, these friends of mine have always known what to say and do, and not once have they ever run afoul of me or done anything that’s come even close to upsetting me in the years that I've now known them. These are the people that I needed to spend my time with, because they helped me feel normal and at ease, and gave me a break from this terrible hurricane in my mind. To have friends and people in my life that could help me forget all that I was in the midst of during such a terrible storm, was an unbelievably great gift and blessing to have. These select friends of mine know who they are today, and it’s a very deep and soulful love that I have for them.

6. NEVER STOP LIVING AND ENJOYING LIFE

Don’t ever let posttraumatic stress keep you down, and stop you from enjoying life. As I wrote in PTSD Part II, I pushed hard against the boundaries that posttraumatic stress was trying to keep me within, and made sure to get out with friends that I felt fully comfortable around. This is why it’s so important to have or find friends that really get you, even if you don’t understand how or why. Go with what feels right, even if you don't understand. These friends of mine helped to rescue me from the inner turmoil in my mind, and allowed me to keep busy, keep active, and keep enjoying life even during these times of great distress. The best way to survive cancer, is to LIVE!

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A photo collage of our adventures in 2015, while I was still struggling to sort out inner post-cancer demons, and sources of posttraumatic stress. It didn't stop us from having the time of our lives. Get out and LIVE!!!!

7. Find little things to enjoy everyday.

When I was suffering from posttraumatic stress, I felt like an endangered species and like my life was being threatened everyday. As those of us that have experienced this have felt, posttraumatic stress can feel like you're walking around with a loaded gun pointed at your head constantly. You feel like a marked man, and the level of stress I felt from this were unlike anything I had ever experienced in life, even while fighting cancer! Weekend activities with family and friends, and vacation planning wasn't enough. I needed to find little things that I could enjoy everyday, and that gave me some sense of comfort and happiness. You have to eat everyday, so why not eat well? Treat yourself daily. I’ve become a well-known foodie to friends, and post all sorts of food pictures over social media and especially Instagram, when I had almost never done so before. I tried to pinpoint the time that I really got into food and became a foodie, only to realize that this was borne out of my posttraumaitc stress, and my desire to find things that I could enjoy in life everyday, no matter how small. A nice "last meal" everyday, because at the time, I felt like it could be. 

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"It's amazing how healing the power of good food and company is", says my friend Alexia Karanikas (lower right), co-survivor to her husband Nate, who also had testicular cancer. I couldn't agree more!

8. THE IMPORTANCE OF SELF-LOVE

For years, I lectured myself and beat myself up for being afraid, when logically I knew that there was no reason to be. I had a highly curable Stage II cancer. I went through a chemotherapy protocol that was a virtual guarantee of being cured, and then did the retroperitoneal lymph node dissection surgery on top of that for good measure. If there was even one stupid little sub-detectable cancer cell floating around my body after four rounds of chemotherapy, I just wanted it gone. I know what the stats are; I’ve read the medical literature. Almost no one whose had a Stage II testicular cancer that does both primary chemotherapy and the RPLND surgery ever experiences a recurrence, yet I was still so afraid and terrified. Allow yourself to be. Don't fight yourself! Love yourself by accepting what you feel, without judgement or criticism. Beating yourself up for what you feel just compounds the pain and makes things worse, and your sub-conscious will never let go of what it feels. Stop denying it. Love yourself, forgive yourself, accept your feelings, and work with them rather than against them. Be your own best friend.

No one expresses the need for self-love better than cancer survivor and author Anita Moorjani, who wrote about her incredible experience in her book, "Dying To Be Me".

9. FIND SOMETHING TO BELIEVE IN

My lack of firm spiritual beliefs ended up being another source of pain and difficulty for me in the aftermath of my cancer, and especially while dealing with posttraumatic stress. What makes the aftermath of cancer so terrifying? It’s because we fear our cancers will return, and that we’ll die. Firming up my spiritual beliefs helped to take the wind out of the sails of my fears of death, which in turn helped me to stop being afraid. We live in a society today that seemingly shuns religion and spiritual beliefs, and looks upon them with contempt. Yet, it’s my own independent spiritual beliefs that I fully developed and embraced that helped me to overcome my posttraumatic stress issues, and fears of dying of cancer. In the crazy world we live in today where mental health is at the forefront, why are we shunning and vilifying things such as religions and spiritual beliefs that can help us feel more at peace, and understanding of our place in the world? I feel that this is a huge mistake. If you’re suffering from anxiety, depression, or posttraumatic stress, but don’t have firm spiritual beliefs, reconsider why you don't, and that the lack of such beliefs might actually be contributing to the very anxiety that you're suffering from. This was the case with me.

10. TIME DOES HEAL

I've been asked, and I don’t think you can ever completely heal or cure yourself from posttraumatic stress, but it does get easier with time. Once you’ve been through a traumatic event or two in your life, and associations are made that trigger these fiercely protective self-preserving instincts, it can be difficult if not impossible to break them. That said, I have broken some associations, with extreme difficulty, but to this day I don’t think I could casually walk back to the infusion lab of my oncologist’s office to say hi to some of the wonderful nurses that I know back there, without breaking out into a nervous sweat, or my heart rate jumping through the roof. The mere thought of it sends shivers down my body, and that’s still posttraumatic stress in the background. I'd have to do something to break that association, but I can’t un-experience all of the hell that I’ve been through fighting cancer, such that the associations were never made in the first place. 

As time has gone on, the posttraumatic stress reactions have become much less intense, my sub-conscious has seemingly become a bit more trusting of my conscious ability to keep myself out of danger, and plenty of positive memories made in the passing years has helped to write over the painful memories of the past. Another thing I had feared? Never really getting to live and enjoy my life. I've done that and then some in the past few years, and this has brought me a great sense of peace and comfort as well.

The best you can do is love yourself, care for yourself, forgive yourself, be your own best friend, and cope as best you possibly can. Finding the help that you need, the friends that know how to support you and make you feel right, hobbies and activities that serve as effective outlets, and that keep you present and engaged as much as possible, are all a part of the "cure" for posttraumatic stress. There's a reason why the center photo below appears on my homepage, as it represents all of the above in one photo. An enjoyable activity with my family, and with friends that just get me and that have always made me feel right. 

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The annual Blackberry Festival at Shenandoah National Park in 2014, with some very near and dear friends.

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Final Thoughts

When I first started suffering from posttraumatic stress in my years after cancer, I scoured the Internet, but couldn’t find even a single real-life accounting and example of an actual cancer survivor experiencing posttraumatic stress. I had no idea if this was something that others had experienced or not, what it even felt like, nor how anyone might have managed to find their way through it. All I ever found were dry, clinical sounding pages that merely listed the symptoms. I never felt more alone in my life, not knowing what to do, nor if there were even anyone else out there who had experienced what I had. I think after experiencing posttrauamtic stress, that most people just don’t want to think about it again after they get through it in whatever way they manage, or don’t even know how to begin describing what they had felt inside. This leaves a great knowledge gap and void, and it's one that I wanted to fill with this writing. The world now has a first-hand accounting of a cancer survivor that suffered from post-traumatic stress, what it felt like, what it took to pull themselves through, and all that's been done to manage life in the aftermath.

Many tears and bottles of wine went into the making of these essays. It took me two years after I had started experiencing posttraumatic stress to even begin writing them at all, and over a year of writing in bits and pieces to get these series of essays together, because small bits at a time was the most I could handle. I’m currently five years out from cancer as I write this, and three years out from the point that I started suffering from posttrauamtic stress, and I finally feel completely at peace and at ease with everything. It’s my hope that these essays find their way to those that are suffering and in need of perspective, and that the sharing of my experiences helps others to find their way through this and heal, as I have.

God bless.

StevePake.com

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How to Cope with the Fears of Cancer Recurrence

The thorn in the side of every single cancer survivor out there, is that we never really know if our cancers have truly been cured or not. The best status we ever get from our doctors is "NED", no evidence of disease, but this doesn't mean that no disease is present, it simply means that none can be detected. The passage of time without any new evidence of disease is the only way that we ever get to "cured", and that makes for a very challenging waiting game in our years after cancer. Nothing has been more terrifying to me during these years than the fears of recurrence, and every strange pain or irregularity in our bodies brings these fears to life.

Cancer casts a permanent dark cloud over our heads in that because we've had cancer once, we're statistically far more likely to have it again. And because we've been through toxic chemotherapy or radiation treatments in order to cure our cancers, we're at additional risk for secondary cancers just due to that alone. Even after we're deemed "cured", it's tough to avoid worrying about our cancers coming back, or even developing a second one. These worries so overwhelmed me in my initial years after cancer that they broke me as a person, and I had to come up with a new philosophical approach to living my life. 

1. Realize that You are More Than Your Body

We're all so much more than our bodies. Does it make you any less of a person because you had cancer and that it scarred you inside and out, disfigured you, caused you to gain weight, lose your hair, or have so many other body image issues? Certainly not! I learned to stop identifying with my body. Why wouldn't I when it failed me in such a terrible way, and scared the hell out of me so many times afterwards? Our bodies are merely the vehicle through which we can live and travel in this lifetime. We're so much more than what we see in the mirror. 

2. Accept that You Have No Control

Especially while in the midst of recurrence scares, my mind had been grappling for control of things. It just needed to know that my cancer was gone forever, and that I was going to be okay, but we can never really know such things. We have no real control, and I had to learn to let go and free my mind from the burden of trying to "know" that I was going to be okay now, next month, next year, and forever after that. The reality is that there have never been any guarantees for good health for anyone. It was a difficult pill to swallow, accepting that I could never really know what I wanted to know, but it was one that I had to swallow.

3. Never Stop Living and Enjoying Life

What more reason or motivation does one need in our uncertainty filled years after cancer, especially while dealing with fears of recurrences, than to get out and truly live your lives? What are you waiting for? Make plans, go somewhere that you've always wanted to go, or do something that you've always wanted to do. Live and enjoy life the very best you know how, and spend time with people that bring you joy and happiness, and can add to your life experience. Never let a weekend go to waste, and always have plans for something in the works. Staying engaged with life and living today, will help to keep your mind off of this darkness in the background. The best way to survive cancer is to LIVE!

4. Have Faith

What makes the worries of cancer recurrence so frightening, is because we fear that we're going to die. It's death and dying that we're really afraid of. I'd struggled with my spiritual beliefs for years, which only made things harder. I didn't know exactly what I believed in, nor who or what we really are, and organized religions had only made things more complicated and conflicting for me. Finally firming up and going all in on an independent set of spiritual beliefs as far as who and what we really are, and where we go afterwards, helped to take the wind out of the sails of my fears of dying due to cancer. I live my life with purpose and confidence today, even with my history of cancer in the background, and take great comfort in having full faith in my spiritual beliefs.

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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.

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PTSD After Cancer Part II - Coping and Overcoming

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This is Part II of my three part series of essays on my struggles with post-traumatic stress after cancer. In Part I, I described what the whole experience felt like, and in this part I'm sharing the story of all that I did to cope with and overcome it, and all of the wonderful people that helped me get there. Fighting cancer was the easy part. Recovering from PTS after cancer is many orders of magnitude  harder, because you have no idea who or what you're fighting against, only to realize it's you.  

PTSD After Cancer Part I - What It Feels Like
PTSD After Cancer Part II - Coping and Overcoming
PTSD After Cancer Part III - Managing Life After

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Post-traumatic stress gives you the feeling of internal panic as though your house were on fire, with you in it, but there's no window or doors in which to escape, and you can't simply run outside. It's your mind that's on fire, where you live, and it's all going up in flames. You’re panicked because you feel trapped and don’t know exactly what you’re supposed to do, or if you can even escape. When I first started suffering from post-traumatic stress after cancer, this is exactly what it felt like to me. I didn't understand what had started the fire, nor what was feeding it. I just knew that my mind was on fire, and had to do whatever it took to save myself.

PULLING THE PLUGS

As I look back on my journey through post-traumatic stress after cancer with the wisdom that a few years have brought, it's very clear to me now what had been going on, what my sub-conscious mind was seeing and feeling, and what my triggers had been. At the time, however, I hadn't a clue. I was blindsided and dumbstruck. There had been some signs earlier in 2012 of the trouble that was brewing within me, but I thought I had been doing perfectly fine. It wasn't any one thing that set me off, but rather a seemingly perfect storm of bad external stimuli that had hit me from all sides at once that did it. 

With my mind ablaze, I did the only thing I knew I could do at the time, and just started pulling the plugs, on everything. Anything and anybody that didn't need to be in my mind or in my head space, just needed to get the hell out. The news and its daily death count and all of the terrible goings on in the world is enough to get even normal people on edge, and that was the first to go. I've not been a consumer of what they call "the news" for three years now, and haven't missed it for a day. Television and the Internet were all shut off, and I simply ran "cold" for awhile. 

I had to do a bit of house-cleaning in my personal life as well. A person's eyes are the windows into their soul. I needed to be able to look someone in the eyes, and just know that they were good for me, right for me, would never bring any harm to me, and that I could trust them with my life. I needed to feel this level of trust towards anyone who was going to be in my life going forward because PTS made me feel like my life was endangered constantly, even if it was all in my head. Most fell into a large middle group of people who I knew cared and were concerned, but just didn't know quite what to do with me or how to support me. I tried my best to distance myself from such people. These were all good people, but good wasn't enough. I needed nothing less than the very best for me, someone that could stand by my side with confidence, and who just knew exactly how to support me.

There were, unfortunately, a person or two in my life who when I peered into their souls, I saw ulterior motives and hidden agendas. These people were gone from my life in an instant, without so much as a second thought, and were made very aware that they were no longer a welcomed presence in my life. I had sensed trouble within these people, and bridges were burned to prevent any more of this trouble from finding its way into my life. These were survival mode instincts. Get out, and stay the hell out. Right or wrong, fair or not, simply having caused me to doubt their intentions towards me was enough to fail me as a friend. These were not the types of people that I could have anywhere near me during this time. I was terribly hurt and wanted nothing more to do with these people, and banished them from my life.   

Cancer changed so much about me as a person, but PTS and having "demons inside" changed me even more. It raised my bar for friendships through the roof, and a lot of people simply didn't make the cut, through no faults of their own in the majority of cases. The only people I could have anywhere close to me needed to be rock solid, dependable, trustworthy, and positive people. I could count on one hand the number of people that I felt this way towards. Cancer is already such a lonely experience, but experiencing PTS is even moreso. I withdrew from people I had loved and considered friends, I withdrew from interests and hobbies, and I withdrew from everything and anybody in my life because at the time, I didn't know exactly what was hurting me and why. I pulled the plug on everything.

I know there are some people that I've pushed away that have been very hurt, and I'm sorry for this. How the hell do you explain to someone that your house is on fire in your mind, and that whatever their deal or issue was, they just needed to get the hell away? This is how survival mode instincts work. You're fighting to survive, and nothing else matters. My conscious mind was no longer working, and all I was operating on were survival mode gut instincts. If I didn't feel at that instinctual level that someone was good and right for me, you were potentially registering as a threat, and simply couldn't be anywhere near me. And sometimes, this meant being alone.

YOU DON'T FIGHT A FIRE BY YOURSELF

As many people as I had suddenly pushed away, I knew full well that I needed help, but from whom? You don't fight a fire by yourself! You need the help of as many people as possible, from people that you know without a doubt are on your side. A critical mistake I had made during my first few years after cancer was actually trying to take the advice of many well-meaning people, including some of my doctors, to just try and "forget" all that I had been through and move on with my life. Maybe this works for some, but for me it was terrible advice. Scorpios never forgive or forget anything, and especially not something that had hurt us. 

Cancer Community Support is Essential Long After Cancer: I had become disconnected from the support I had enjoyed from fellow testicular cancer fighters and caregivers at the TC-Cancer.com forum, which was one of the first places I found on the Internet back in 2011 when I was at the start of my cancer fight. Many of these people had drifted away from the forum, but I quickly tracked them down and connected with as many as I could find on social media. We were scattered all about, but just having them psychologically closer like this helped me to feel better, and safer. I logged back into the forum for the first time in awhile and made a post about the terrible anxiety I was struggling with. I had thought I was all alone, but one by one the responses popped up from others who had been on my same timeline, and who had been facing similar challenges in their own lives. Just knowing that I wasn't alone and wasn't nearly as isolated as I thought I had been made an immediate and huge difference. There's nothing worse for any cancer fighter or survivor than to feel alone! 

One of the very best things about the cancer community is that we're always there for each other. When other friends fail you or just don't know how to support you, the cancer community just knows, and always has your back. Cancer community support can be a bit of a double-edged sword. There are plenty of sad stories, and not everyone you know is going to make it, but the support gained from this community of incredible people is simply invaluable and irreplaceable. 

Support from the Medical Community: I called my oncologist's office in January 2013 to get a fresh prescription for some Ativan, because my anxiety was out of control. I was immediately relieved when I heard the voice of Trish Traylor on the phone, the best and most incredible oncology nurse ever. What kind of oncology nurse can you chat with about cancer, life, fast cars, and guns? I hadn't talked to Trish in quite some time at this point, but just hearing her voice on the other end of the line helped to put me at ease and bring some calm back into my life. Trish and I talked on the phone for a bit, and when I told her what was going on she dropped me the numbers to some therapists. I gave them a call later, only to find out that the first available appointments weren't for another 6-8 weeks for one, and 2-3 months for the other. I couldn't believe it and knew it wasn't going to do. I'm sure there were other resources in the area that could have helped on a more timely basis, but my house was on fire now, and I needed help now. 

If I waited 6 to 8 weeks to get into a therapists office while experiencing PTS, there wasn't going to be anything left of me for therapy. 

My local medical system had failed me here, and I knew I was on my own. I was very grateful that Trish was willing to exchange personal contact information with me, because I knew she didn't have to. Trish was a "safe" person, and I needed more people like this in my life. I would have many pep talks with Trish over the coming months, on her own personal time. Trish became a huge source of encouragement and guidance for me, and I was so grateful for her presence in my life. If you ever want to know a real-life angel, get to know an oncology nurse! 

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Trish Traylor and I at our annual summer kickoff color party. Oncology nurses are the most amazing human beings ever!

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My friend from work, Claudia Ritchey, another angel in my life and an absolutely amazing human being.

Finding Your Innermost Circle: I also sat down for pep talks with my friend from work, Claudia Ritchey, quite often during this time. Claudia and I had bonded over the years and she just got me, and knew what I was going through not because she had been there herself, but simply because she was that brilliant and amazing of a woman. Claudia was a very spiritually connected person, and all it took was 5 minutes of talking to her and I would calm right down, and I just felt like everything was going to be okay. Claudia knew. I didn't know how she knew things, but she did, and I believed her. Claudia and I connected on a very deep and spiritual level, and she had always been a complete angel to me, except that she was leaving! Her last day at my office was the last Friday in that January of 2013, and I was going to have to find a way forward without nearly as much of her physical presence in her life.

Claudia had become like a big sister or sister-mom to me, with all of her southern gal warmth and charm to go with it. God bless her for being on-call for me throughout most of 2013. I knew she was far too talented and gifted to be sitting around as our office manager. She had sacrificed a very high profile legal career at the Supreme Court of the United States for her family, and clearly had callings elsewhere in life. God had other plans for her, and needed her to bless other people with her presence in their lives, and I tried my best to accept that she would be gone.

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My cancer mentor Kim (right) and her twin sister Kelly on a visit to the DC area in early 2013.

I leaned heavily on my cancer mentor, Kim. Kim is a friend that my wife and I had known for over 15 years by this time, who had been diagnosed with thyroid cancer the year before I was diagnosed with testicular cancer. I didn't know what a cancer mentor was or why one might be needed, but without even asking I already had one. Kim volunteered herself for this role when she learned of my diagnosis, and it never mattered one bit that we had different types of cancers, nor that she was a she. We're all the same inside, and feel the same things, and so much of the young adult cancer experience transcends cancer type and gender. Kim got me. Kim knew exactly what I was feeling, and just knowing that I wasn't alone made things better, but Kim was in Pittsburgh. I quickly saw the pattern.

People that were wrong for me had been too close, and those that were right were too far away. 

I found some important support that I needed and which helped to shore me up, yet still felt alone and abandoned at the same time. I didn't know what the answers were, and still had terrible amounts of anxious energy inside of me. All I knew was that I needed to find outlets for this, something, anything, or else it would eat me alive. What was done with some others in my life was done, and what needed to be done. No regrets. If something or someone was wrong for me, they just needed to go. I had closed various doors and slammed shut a few others, and there was no going back. As frightened as I was, it was much better to be alone for awhile than to allow hurtful people to continue to be a presence in my life. I simply prayed that the right doors would open in time, and tried to find the outlets that I needed to manage on my own.

FIND HEALTHY AND PRODUCTIVE OUTLETS

When I was diagnosed with cancer, there was little time to be stressed, or sit around and worry. I had chemotherapy sessions, surgeries to prep for, consultations, and tons of other appointments with this doctor or that doctor while struggling to keep my body afloat through treatments. Now, I was just waiting around and going crazy. I needed outlets, and I needed them now, or else I was just going to burn up inside. I couldn't even sit still long enough to go out to lunch, it was that bad! I felt threatened constantly, and like a sitting duck if I was waiting around in some restaurant. I had to keep busy, and I had to keep moving. 

RUNNING. I had just started running at the tail end of 2012, which as it turned out, happened to be the origin of all of the strange pains I had been having when I was suddenly exercising muscles that hadn’t gotten much if any use in quite some time. Running would prove to have many benefits for me, such as helping control terrible nerve pain issues I was having, and keeping my hormonal levels cranked up. Most importantly, there was something very primal about running, specifically outside with the wind on my face, and trees and scenery passing me by. It gave all this energy inside of me a place to go, and fulfilled a sub-conscious desire to literally just run away from everything that I had been experiencing. No matter how anxious I had been that day, running would always help to bring back some calm without fail, and I needed that.

While dedicating an hour of time to go running or walking, it was also an hour of OFF time just for me where I could shut out the rest of the world and focus within. Running over lunch became my private "FU Cancer" time. I never listened to music when I went running, but rather got myself into semi-meditative states where I could playback a particular moment, or re-experience something awful that I had felt in a more controlled and safe environment. I could either process it, or just allow myself to feel something for the first time while in my "safe zone." I told myself that as long as I kept running, that cancer couldn't catch me. I knew this wasn't how things worked, but cancer plays the most terrible head games with you, and you have to play head games back! I knew it wasn't true, but it felt good to say it! 

Taking up running is one of the best things I ever did for myself after cancer. It’s an entire chapter of my life, going from hardly being able to get up a single flight of stairs without wheezing after cancer, to being able to run 5K's in well under 30 minutes. 

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Becoming a running addict, and my first sub 30-minute 5K in April of 2015 after two years of trying fighting terrible peripheral neuropathy and muscle fatigue issues from chemo!

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Not my bumper sticker, but so true!

RANGE THERAPY. A little shooting range therapy went a long ways too. I just couldn’t get this terrible flashback sequence of all of the worst moments of my 5 month cancer fight out of my head. It replayed itself over and over and over again, traumatizing me every time. It was so bad one day that I just had to leave work. I went to the NRA Headquarters shooting range in Fairfax, VA and put up a bunch of paper testicular carcinoma targets that a friend from NIH had hooked me up with. With the terrible imagery of these cancer fight flashbacks playing through my head and tears streaming down my face, I rapidly unloaded magazine after magazine into these cancer targets. I fucking hated cancer with all that I had at this point, and with every fiber of my being. I took great pleasure in ripping these stupid cancer cell prints to shreds. Cancer had caused my body to betray me, had taken my life hostage, and now even after cancer it was still finding ways to fuck with my mind. From then on, whenever this terrible cancer fight flashback sequence would start playing through my mind, I would immediately roll the new clip of shredding paper cancer targets with a 9mm pistol in its place, and I was never tormented by this flashback sequence again.

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Range Therapy in January 2013, in the midst of the absolute worst of this. I had to take the day off of work, and I can't put into words how good this felt.

VIDEO GAMES. Yes, I even turned to video games as a form of therapy! I laughed out loud when I saw an article in 2015 talking about the potential benefits of video games for cancer survivors and those experiencing post-traumatic stress, because I knew how true it was. I would wake up in the middle of the night either naturally or due to a nightmare, and then my mind would just start racing with cancer-related thoughts and worries, and wouldn't stop. I had terrible insomnia, but there was no way I was going to sit around and worry about cancer all night long, so I would fire up my PS3 and play Gran Turismo 5 in the middle of the night, and race myself to oblivion. It forced my mind to focus externally, and any sort of video game that requires intense external concentration will do that! In the article they had mentioned Tetris, but a good racing game would keep my petrolhead mind just as occupied. It would stop the cancer thoughts from flowing, and I would go until I was so damned tired that I could drag myself back up to bed, and immediately crash and fall back to sleep. Taking drugs like Lunesta would help reduce the cancer insomnia, but just made my day miserable by making my peripheral neuropathy and muscle fatigue issues so much worse. Video games were an ingenious distraction for these middle of the night mind games. My mind was already racing about cancer, why not give it something else to race?    

WRITING. I had been inspired by an article or two that Kim had been writing for the hypo-parathyroid association magazine that she had joined in the aftermath of her thyroid cancer. It just seemed like such a good way to vent, as I proofread a piece she had prepared in which she was venting her frustrations with her own young adult cancer experience. I knew I always had a knack for writing, and that it was an untapped talent that would never get any real use in engineering world in which I worked. Cancer sure as hell had given me plenty of material to write about, and so I started journaling my thoughts almost every single day.

Whatever terrible thoughts I was having, I dumped them into my journal in hopefully semi-coherent thoughts. There were a lot of terrible thoughts, and my journal quickly reached tens of thousands of words. It was through this private writing to myself that I started to get in touch with my true spiritual-self for the first time, and I began to understand who exactly I was, what my needs as a person really were, and all that was lurking inside of me. I took it all raw and head-on, numbed only by a bit of wine. I was never on an anti-depressant of any sort, and didn't want to be. I wanted to know exactly what was lurking inside of me so that I could learn how to grasp it, and then beat the shit out of it. 

FEEL WHAT YOU NEED TO FEEL, AND JUST LET IT OUT

On a run in early 2013, a huge and paralyzing wave of anxiety suddenly swept over me to the point that I had to stop mid-run. I sat down on the curb right where I had stopped because I couldn't even make it to a park bench that was a short distance away, and just started sobbing uncontrollably. I was completely paralyzed by fear, and it still boggles my mind to this day what I was even afraid of. I was afraid of having to get the dreaded retroperitoneal lymph-node dissection (RPLND) surgery done, except that this was January 2013, and I had already had this surgery done 18 months ago in June of 2011!!! I completed chemotherapy in May of 2011, and was so disappointed that my post-chemo CT scans showed that I hadn't gotten a complete radiological response from the chemotherapy alone, as we all had hoped. There was still a lymph node or two showing on those post-chemo scans that were greater than 1cm, which met the standard of care for recommending this terrible RPLND surgery. Because my tumor markers had always been negative, it was purely a guessing game as to what exactly was still in these lymph nodes. It could have still been active cancer, and I was so terrified and disappointed by this, but at the time I didn't blink an eye. "Well, guess I'm getting cut," I responded to my wife on a text message. 

I carried my warrior mentality with me straight from three months of chemotherapy hell, and right through the RPLND surgery that I had on June 22nd, 2011. I wasn't afraid of the surgery back then. When you're fighting for your life, a different mentality takes hold, and you just do whatever you need to do. My desire to fight and my desire to beat this stupid cancer and live far exceeded my fears. I never felt even an ounce of fear at the time, but it doesn't mean that I was never afraid. People have called me brave and heroic, but I've never felt that way about myself. We suppress our fears in order to get through extremely challenging life situations, whether we're fighting cancer or a war. I didn't know it, but I was absolutely horrified inside beneath this warrior spirit, and sitting on the curb on that freezing cold day January day, there all of those emotions finally came pouring out.

I didn't understand what was happening in the days that followed this particular episode, but through writing in my journal I came to realize the above, that I had simply been in a warrior mindset throughout my cancer fight, and that I had so many more emotions like these locked away inside that I just needed to release. I came to understand that I was hurting as I had been because I had never allowed myself to feel or express such powerful emotions, and that they were better out than in. After I sat on that curb for 10 or 20 minutes just letting all of that out, I was never afraid of that wretched RPLND surgery again, nor did memories from it haunt me as they had been.

I officially called bullshit on the notion that men aren’t supposed to cry or feel anything.

I no longer told myself that there was something wrong with me for feeling what I was. For the first time, I just allowed myself to feel whatever I needed to feel without judgement. I cried more in the first half of 2013 than I ever had in all the rest of my life combined. Every time I cried, I released a little bit more pain from the dark corners of my mind, and felt better after I did. All of the frustrations, all of the fears, all of the disappointments about life when your own body betrays you in such a terrible way, I just let them all fly out of my body through tears. I journaled them all, with a bottle of wine in front of me at 2am, and a heaping pile of paper towels overflowing the trash can I parked next to the couch. Mere tissues weren’t nearly enough to absorb this big boy’s tears. 

LIVE LIKE YOU WERE DYING

In this first half of 2013, two years after my cancer diagnosis and six months away from hitting the all important two years cancer free point, I just had this innate fear that it was inevitable that my cancer was going to come back. I couldn’t shake it no matter what I did. I had six months of active surveillance to go, and just felt like something was going to happen The closer I got to this two year finish line, the worse my anxiety became. I felt like if something was going to happen, it was going to happen sooner rather than later, and that my "last good day" could be any day now. Even when my PTS issues were switched off, I just couldn't shake this feeling. I was genuinely afraid that this was my time, and wanted to live the best possible last six months of my healthy life that I could. No rational or logical thought mattered. The high five year survival rates for testicular cancer were comforting at the conscious level, but we're always afraid that we're going to be one of those few percent that have something happened. When you’re spooked, you’re spooked. 

At a basketball game with my dad (left), and my longtime friend Richard (center), February 2013, just a matter of weeks after "ground zero."

FUN WITH FRIENDS. In February of 2013, I had tickets to go to the Wizards-Rockets game with some friends that had been planned a few months in advance. Bad thoughts were finding me that day and I almost didn’t go, but I refused to allow cancer and post-traumatic stress issues rule me. I forced myself to go, and it was a wonderful few hours spent with a long-time friend talking trash, seeing who could get the best photos of the cheerleaders, and maybe watching a little bit of the game. It was a few hours where my mind was solidly engaged on things external to the turmoil of my inner world. I enjoyed this time away from my own mind immensely. I don't think my pal Richard realizes just how important of a moment getting out for this game was for me, but he will now. It was the first time I said, "Fuck you cancer and post-traumatic stress, you're NOT going to stop me from living and enjoying my life." It was a huge moment that set me off on the right foot not just for the year, but for my entire life after cancer.  

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Hiking with Amit, Spring 2013.

THE GREAT OUTDOORS. I had always wanted to give hiking a try, but never found the time in my 35 years. My long time friend Amit took me on a hike around Sugarloaf Mountain in Maryland that spring. I loved it and took to it immediately, and enjoyed the fresh air and the scenery immensely. Taking all of this in while concentrating on the hike, and enjoying the company of another long-time friend meant another few hours where my mind was solidly focused externally, and away from the complete turmoil of my inner world. Amit and I followed this hike up with the 8-mile Catoctin Mountain loop, which was another few hours of solid external engagement for my mind, fresh air, great scenery, great company, and exercise as well. I'd loved to have gone hiking every single day if I could.

THE COMFORT AND JOY OF MY FAMILY. My wife and I went on our first private post-cancer getaway sans kids to St. Lucia in October of 2012 to celebrate our anniversary, and then went as a family to Disneyland over Thanksgiving. These were the most wonderful times of our lives, and I needed more of them. I needed to double down! We went to DisneyWorld in Orlando over spring break of 2013 where we were blessed with a week of absolutely perfect weather, and it was such a fun and wonderful time. Funny how it can be so easy to take family trips like these for granted. I loved and enjoyed every single second, feeling inside like this could be the last Disney trip I'd ever go on with my family.

We immediately hit the beach over Memorial Day weekend to our favorite beach, Rehoboth Beach in Delaware, and enjoyed a blissful beach weekend. Over the summer we finally went on the midwestern road trip that we had planned for 2011, but that my cancer fight spoiled the plans for. We spent a few days in Chicago, and finally paid a visit to Wisconsin Dells for the very first time. My wife and I had criss-crossed the Dells nearly every weekend for two years when she was in Rochester, Minnesota, and I was in Libertyville, Illinois. We had always wanted to meet halfway there one weekend, but we were young and had little money, and just didn’t want to spend it like that. We went to the Great Wolf Lodge waterpark and had an incredible few days, and became waterpark addicts. Our kids had so much fun that they didn’t want to leave even after a few days, but we continued on our way to Rochester, MN for my wife to meet up with some old friends, and then finally landed in Minneapolis for the Minnesota State Fair. It was a fantastic road trip, there was never a dull moment, and despite having travelled nearly a thousand miles by car, our kids were little angels the whole way and hardly complained.

My family was my heaven on earth, and I never wanted to leave them or be apart from them.

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At DisneyWorld, Spring Break 2013

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Our Summer 2013 Midwestern Road Trip, "The Bean" in Chicago

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Road-tripping up to the Minnesota State Fair, Summer 2013

Living like you were dying wasn’t just about going on big trips, though. Hiking was free, and going to a basketball game with friends was minimal cost as well. Every weekend we had things going on such as trips to museums, trips to the zoo, and other places of interest. Every minute my mind spent planning for, anticipating, or being engaged with an enjoyable activity, was a minute it wasn’t spending in a state of complete distress worrying about things I had no control over. It didn’t mean that I wasn’t still afraid because I was, and it didn’t mean that I didn’t still have terrifying thoughts because I did. Staying solidly engaged with living and enjoying life as much as possible had the effect of slowing down the awful thoughts I was having to a trickle. At that rate I could process them one by one, as opposed to being flooded with them to the point of drowning in them as I had before. 

IT TAKES AN ENTIRE VILLAGE TO KEEP CANCER SURVIVORS FEELING WHOLE

As wonderful as my wife, family, and friends were, I still needed more. Amit and his wife had just had their first baby and were busy with that, and my friend Richard and I were just on slightly different life rhythms, with kids just different enough in age that it made it difficult to connect. I was still too afraid to be alone, my wife commonly had to work on weekends and couldn’t literally be by my side at every moment, and too many of my other friends were scattered about the country.

If ever there was a time that I really needed a brother or a sister, someone dedicated to me and that knew me, and that I would feel totally and completely safe and comfortable around, this was the time. I needed someone that could fly in for a weekend if needed just to keep me company, because I was still hurting this badly inside, and couldn't be left alone. I actually do have a sister that most people don’t even realize that I have, but for whatever reason she’s just chosen not to be a part of my or my family’s lives, and I haven’t had any sort of relationship with her in over 20 years now. At best, my sister has just never really cared that I’ve existed, or at worst she's resented me. Not once have I ever felt like my sister has actually cared about me, all throughout my cancer fight I hardly even got a text message or an email from her, and as far as I know she never read even a single one of my CaringBridge online journal updates. For 20 years it didn’t really matter, but now, going through this, I really needed a brother or a sister in my life. Knowing that I had one but didn’t really have one just hurt, and it made the feelings of isolation and abandonment that I was already experiencing so much worse.

This was a herding instinct coming to the surface, and the feeling of safety in numbers. I had always been a very independent person, but suddenly became a people person out of nowhere. I needed my 'herd' to surround me and protect me, but who was my herd? There were definitely people that I felt close to, but weren't nearly physically close enough. I needed someone right down the street that I could feel this way about. I needed a miracle.   

THE MIRACLE OF THE RIGHT PEOPLE, AND THE RIGHT SOULS IN YOUR LIFE, EXACTLY WHEN YOU NEED THEM

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Natalie and Mark Way, and their daughter Josie. Beloved friends, and my second family.

On Saturday, February 9th, 2013 what I consider to be a miracle happened. My son William had a birthday party to go to for one of his daycare classmates, Josie Way. This was the very first week that I had managed to get my PTS turned “off” in the early days, although that does have to be used in quotations. PTS is like a trick light switch that wants to keep flipping itself back on. You can flip it off, only to have it flip itself back on again. I was still feeling so raw and vulnerable, and bad thoughts had been finding me again that morning. I didn't want to go. I was afraid, but it was all up to me. Due to a scheduling conflict with something that my wife and daughter needed to go to at the same time, if I didn’t take Will to his classmate's birthday party, he wasn’t going to get to go. I wasn’t ready to be around people yet, but I refused to give in, I refused to allow cancer to rule me like this, and I forced myself to go.

The party went almost exactly as I thought it would. I was struggling to hold back bad thoughts, I had tears welling up in my eyes, and I was still so spooked. I almost thought I was going to have to leave the room, but my attention started focusing on the hosts of the party, Natalie and Mark Way. They just seemed like a carbon copy of my wife and I, a very pretty and petite western appearing Asian woman, and a tall and goofy looking white guy. I had seen their daughter in Will’s class for at least a year and a half, but never remembered meeting them. I wondered how on earth I hadn’t until now, despite having been to dozens upon dozens of school birthday parties in the past.

It turns out that I have a very good sense for people, and if someone is supposed to be a part of my life or not. I knew within a week of meeting my wife that she was the one for me, and I've also sensed people that would be trouble well in advance as well. I took one look at Natalie and Mark, and whatever this sense that I have is, pegged the needle positively in a way that it rarely if ever has in my life. I had this huge sense that these were people that I was supposed to know, but was afraid to initiate a friendship. I had been hurt by others and couldn't afford to be hurt again, and I knew they’d quickly learn of my cancer story and issues with PTS. I was so afraid of being rejected, but listened to what my instincts were telling me, and took a huge leap of faith to initiate a new friendship the week after the birthday party. 

It didn’t take too long to realize that our new friends did practically all of the same things that we did! Seeing social media updates, our first few comments towards each other were along the lines of "hey, we just did that yesterday," or "we were just there last week!" Natalie and I got to talking a bit more, wondering how we had missed each other all these years, only to realize that we were just missing each other by not even 5 minutes most days in the afternoon for pickup, and that we actually lived in the same neighborhood right down the street from each other! And when they started seeing my cancer related updates on the struggles I was facing in life, they didn't run away from me as I feared they would, but actually ran towards me and were immediately supportive in a very positive way. My mind was blown.  

We had our first family playdate together a month or so later, after our schedules finally cleared. We met at a local park early in the spring of 2013 and then went to dinner together, and from there the most wonderful of friendships was born. Museum trips, hiking adventures, countless dinners, foodie adventures, park playdates, weekend trips, Game of Thrones, and even a co-coordinated vacation or two, and the list goes on and on. Whenever Debbie was tied up with work on a weekend, I could always sync up with these new friends of mine just a 5 minute walk down the street, and Debbie knew that I would be in good hands. 

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At Stony Man Summit in Shenandoah National Park for the Blackberry Festival, Summer 2014, and at our 2015 Summer Kickoff Color Party (right)

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One of the first things anybody will notice about Natalie is that she just radiates positive energy, and that she has a laugh that can fill a room. She’s also the most wonderful of hosts, and never leaves anyone in her presence unattended for even a moment. If she’s engaged with several people and someone steps away, you might suddenly find all of this positive energy that she has beaming solely onto you, which has actually caught me off guard on an occasion or two! But most importantly for me, Natalie is a very present person. Maybe we were getting just a bit of special attention, but you’ll rarely if ever catch her fiddling with her phone in the presence of others, and her mind never drifts months ahead or back to months ago. She’s just present and accounted for at all times with whomever she happens to be engaged with, and that's exactly what I needed in a friend and companion. As Natalie was fully present with me, it forced me to stay fully present as well. This kept my mind from drifting to the dark and rotten places it would go on it own, and having such similar lives and so many common interests made this unthinkably easy and natural!  

As for Natalie’s husband Mark, all I can say is that the man is a riot. He's one of those people without a filter that takes a certain type of person, with a certain sense of humor to be able to appreciate, and I was one of those people. On more than one occasion, my mind had been slipping back into the negative, only for Mark to say something completely off the wall funny, or he would send a funny text message that was so “out there," that it would snap me right back into the present. It would focus my mind on something far more engaging, like coming up with a witty reply or comeback! Natalie and Mark were a magical one-two combo that could keep the terrible darkness within me fully in check. It’s not that my other friends weren’t good enough. I was just in that bad of shape, had little to no control over my internal thoughts and emotions, and needed a level of friendship and companionship that was above and beyond anything else.

I'm so blessed to have found this level of friendship that I was so badly in need of with Natalie and Mark, at exactly the time I needed it the most. It quickly became the sort of friendship where you feel like you've known each other for your entire lives, despite only having known each other for a short time. The icing on the cake was that Natalie actually has a twin sister, Norma, who has the same energy and is just as amazing as she is. Natalie is everything I ever dreamed a sister ought to be, and now it was like getting a bonus sister for free! I very quickly fell in love with these two totally awesome Libra twins and their families, and they became beloved second families to me. 

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All together! Gearing up for a week of Spring Break 2015 fun in Orlando, while Norma was visiting with her family from Thailand.

A Huge Milestone

A year later on Martin Luther King Jr Day in 2014, our kids all had the day off from school and we had all planned to take the day off, except for Debbie who forgot! I went with the Ways to the National Air & Space Museum in Dulles, VA and spent a few hours there, and then we got lunch together on the way back. We had only planned to spend half a day together, but it was such a nice and unseasonably warm pre-spring day that we ended up hanging out at the neighborhood park during the afternoon too, and then we all got dinner together after Debbie finished up at work. This might seem like a fairly ordinary thing to do to many, but for me something hugely significant occurred on this day. It was the very first time in the three years since my cancer diagnosis that I had managed to go an entire day without even a single thought about cancer, without my wife being by my side for the whole day. It was then that I realized just what a huge blessing these friends of mine had been. Time and time again throughout this cancer journey of mine, it's been the power of the right people, and the right souls in my life at the right time, that have ended up making the biggest differences for me.

I’d wondered for the longest time over the years why we hadn’t ever met even in the grocery store right in our neighborhood in the previous six years, and the answer is because the time wasn’t right. I had contemplated suicide just weeks before we finally met, and needed the maximum benefit of the powerful new friendships that these two would provide to kick in exactly when I needed it the most. If their daughter's birthday party had been even a week prior, I simply wouldn’t have been able to go as I was in that bad of shape, and in no condition for any public appearance at all. I had zero control whatsoever over my emotions, and could be a wreck and in tears at any moment. And had I not flat out forced myself to take Will to his classmate’s birthday party even though I wasn’t feeling up for it, I’d have missed out on what has been the best and greatest friendships I’ve ever known thus far in life. Life is amazing. God winks.

Giving Thanks

Recovering from PTS after Cancer was an all-hands, all of the above effort. It took everything that I had, and everything that everybody else in my life had to help pull me out of it. It took every bit of love that my wife had for me just to keep me afloat. It took a deep commitment to self-care and self-healing, and finding healthy and productive outlets for such terrible energy I had inside. It also took great sacrifice, as my priorities and my focus in life had to change completely in order to handle this. There were people that just couldn’t be in my life anymore and that I had to say goodbye to, and others that I simply didn't have the time for anymore while having to put almost every bit of spare time and energy that I had into self-care and recovering, as I slowly nurtured my way back to good mental and physical health. I'm sorry to those that I had to leave behind. It doesn't mean that they weren't good people, they just weren't 'good for me' through this phase of my life and cancer survivorship. There were only a precious few seats for passengers on this ride, and I had to make sure that every single one of them was filled with the very best people for me. Nothing less would do, because I knew it was going to take everything to pull me out of this crisis.

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Amazed how cancer community friends of mine always have a way of capturing exactly what I'm feeling, right when I need to express it. Thanks Chris Hornbeek for sharing this meme!

As for these most dear and beloved friends of mine that were able to be by my side during this crucial time in my life, none have had the physical experience or memories of helping to rescue me from my burning house. They also won't have any memories of helping me to put the flames out and then rebuilding, yet this is exactly what these friends of mine have managed to accomplish, just by being themselves. I know what I feel inside towards these friends of mine, and there is no greater love, no greater friendship, and no greater appreciation. There are simply no stronger feelings that one can feel. I don't know how to express in words exactly how strongly I feel, but it's a very deep and soulful love and appreciation that I know transcends the limits of our physical world. I'm indebted and adoring, and will love these friends of mine forever.

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To my wife Debbie, my soulmate, and to my two totally awesome kids Katie and William, that never cease to put smiles on my face. To Claudia and Trish, to Amit and Richard, to Kim and Kelly, and to Natalie, Mark, and Norma. Thank you all, from the bottom of my heart, for being the right people, and the right souls in my life, at exactly the time that I needed you. Some of you I had only just met or known for a very short time. When others had failed me or just weren't what I needed, here you were, and not only did you help to rescue me from something terrible, but you helped me to find my footing, show me the way, and rebuild my life into something truly wonderful. I consider you all to be blessings, but the gifts of your love and friendships through such a crisis is not something that I can ever hope to repay. It's a blessing that can only be paid forward to others, to the next Steve Pake who needs it. This is all for you, in the hopes that it will inspire others to be that blessing to those struggling in their own lives, and to help those struggling find their way as you've helped me to find mine. Thank you for allowing me to share our stories together. Your support of me through such a terrible ordeal and period of my life will never be forgotten ever, and my love for you all shall be eternal.

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Enjoying a nice pre-Christmas dinner in December 2013, when I knew I had finally made it. I had conquered the very worst that my cancer experience had thrown my way, found a new philosophy on which to live life, and some amazing new friends to share it with. I'm brimming with energy and optimism in this photo, knowing that I was going to come back better and stronger than ever, and I did.

Continue to PTSD After Cancer Part III - Managing Life After

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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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PTSD After Cancer Part I - What It Feels Like

This is the first of a three-part series of essays about posttraumatic stress after cancer, what it felt like to experience, coping and overcoming, and all that I've done to manage life after. For a top level overview of these essays, please visit my PTSD After Cancer landing page.

PTSD After Cancer Part I - What It Feels Like
PTSD After Cancer Part II - Coping and Overcoming
PTSD After Cancer Part III - Managing Life After

PTSD Part 1 - What It Feels Like

Forget about how afraid you were the first time you heard the words “you have cancer.” When you’re first diagnosed with cancer, at least you have a very long to-do list of tests and scans and various doctor’s appointments to keep you occupied. The worst thing about post-traumatic stress after cancer is that you can have all of those same terrible fears, yet you have no idea what in the hell you’re supposed to do with yourself. You have no doctor’s appointments to go to, and no treatments to receive, but you’re left with all of this terrible freewheeling energy that just burns you up inside.

The best way to illustrate what post-traumatic stress (PTS) can feel like is with an example. Somewhere out there on the Internet, there’s a list of movies that have been compiled where the characters have suffered from PTS. I’m not particularly big on Hollywood movies, but I’d seen some of these movies, and while the characters themselves may have suffered from PTS, there was little to no depiction of that in the movies themselves. The best movie example I’ve ever seen of PTS is 1982’s Firefox, starring Clint Eastwood. Eastwood’s character, Major Mitchell Gant, is a Vietnam veteran who suffers from PTS episodes throughout the movie, and which becomes a critical part of the plot line when you’re left wondering if he’ll be able to make it through key points in the movie while in the midst of PTS breakdowns. Throughout the movie, viewers are given a visual depiction of what’s going through his mind through each episode. Ejecting out of his fighter over the jungle in Vietnam, being tortured and abused as a POW by his captors, and a rescue scene where almost everyone is killed with a gatling gun blazing from a friendly Sea Stallion helicopter. An innocent young girl that had just given him a sympathetic smile moments before, is vaporized in the next by a napalm bomb as she tried to flee.

The opening scene of Paramount's 1982 spy-thriller Firefox, and one of many depictions of PTSD throughout the movie.

I remember watching this movie as a kid, and wondering why he didn’t just stop thinking about such things if they were so painful for him. Never in my life did I expect to know the answer, because you can’t.

PTS episodes aren’t part of our conscious thought process, but rather sub-conscious and instinctual. You have no conscious control. A sight, a sound, a smell, or something or someone can remind us of a traumatic event in our lives, and it triggers our defensive instincts. We’re suddenly on high alert, and have so much adrenaline running through us. In the opening scene of the Firefox movie, all of those classic defensive instincts are on display, and set the tone for the whole movie. The Air Force flies out to see Major Gant about an important mission that they think he alone is capable of. They fly out in a CH-53 Sea Stallion helicopter, of the same type that he had a traumatic memory of in Vietnam. All it takes is the distinctive sound of that specific type of helicopter approaching before he can even see it, to instantly trigger his defensive instincts. He had been out for a jog, but goes into a full run, as if running for his life back to his cabin, and then hides and prepares himself to fight with his shotgun. The painful memories and flashbacks take hold, and he’s right back in Vietnam again reliving his terrible war experiences. Being mainly a visual medium, movies have to convey an experience visually, but a PTS episode isn’t necessarily a visual experience. They can simply be overwhelming and unexplained feelings of dread or danger, with no such visual sequence to clue you off as to what you're actually spooked about. The eerie musical effects in the Firefox movie help to convey the emotional feel of a PTS episode. 

What Triggered My PTSD

When I was first diagnosed with cancer back in February of 2011, I was already facing the rejection of a job loss at the end of 2010, victim of another mass layoff in the tech sector, and then suddenly being isolated from people that I had considered friends for the past few years. All of the strange pains in my right testicle started a month or two after, followed by my cancer diagnosis. It was a terrible situation to be in, having both lost a job and then being diagnosed with cancer, and I felt like I was being kicked while I was down. These were the external events that were encompassing my mind around the time of my cancer diagnosis. Strange pains, job worries, sudden isolation from friends, all of which lead to cancer.

At the end of 2012, things were so similar. I suddenly had strange pains all over my body again, eerily similar to the pains I had experienced when I was first diagnosed with cancer. When you're a cancer survivor and you have strange pains in your body, all you can think is that your cancer is back, and that you're going to be sucked backed into the hell of fighting cancer again. Strike one. I had found another job while fighting cancer that I had been working at for over a year, but a major project I had been working on was suddenly canceled, and I couldn’t help but have job worries again. Strike two. Elsewhere in life, I had a terrible falling out with a friend, and no longer felt the least bit comfortable leaning on an entire circle of friends for support when I needed it the most. Strike three. Everything I had felt and experienced around the time of my cancer diagnosis, I was suddenly feeling again. Strange pains, job worries, sudden isolation from friends. It was all so eerie, and I was getting so spooked, and then things just got worse. 

A cancer warrior friend of mine had just died, and then there was the terrible Sandy Hook shooting in which so many innocent children were killed. A pistol cartridge was then found on the grounds of my own children's school, and I couldn't help but think that they were next. I had just taken professional photos of a ceremony at Arlington National Cemetery for a high school friend's father that had passed away earlier in the year. To this day, these are some of the most powerful and moving photos I've ever taken as a photographer, but now I had fresh images of death and a family mourning the loss of a loved one floating around in my head. Strikes four, five, and six! 

There were so many bad omens both in my life and elsewhere in the world. It was so bad, and I started coming off the tracks. I could have handled one or even multiple examples of these awful external stimuli and stayed afloat, but to be hit from all sides at once was simply devastating and traumatic. I felt threatened and surrounded by death and destruction on all sides, and like my whole world was crumbling again. The pains in my body weren't going away and were only getting worse. I was terrified, and so distressed about life that I had been crying myself to sleep each night. I feared that I had just lived my last good days, and that this was it. I was all but certain that my cancer was back, and wondered what the hell I was going to tell my family as my next surveillance appointment loomed, just days before Christmas in 2012.

My innocence about fighting cancer was gone. I knew just what a brutal and miserable life experience fighting cancer was. I knew how bad a recurrence could be, and that I might not emerge out the other end. I was nearly two years out from my diagnosis, and my body still hadn’t come even close to recovering fully. I constantly felt so weak, and feared that my body would just immediately collapse under the strain of more chemotherapy or radiation, or whatever it was that I was going to need. I worried that it wasn't cancer that would kill me, but the harsh treatments needed to fight it that would. I hated my body, I hated feeling so weak, and I hated how it made me so afraid. I just wanted to run away, but you can't run away from your own body. I was terrified just of living in my own skin.

Alas, my appointments came and went, and everything was clear. I told my doctors what had been going on, and out of due diligence a few extra tests were even run for good measure. Blood tests, chest x-ray, and even a scrotal ultrasound was done, all of which were fine. It was nothing. My body was perfectly normal, and even the strange pains I had been feeling went away a day or so after these tests. It was all in my head. 

Deep inside I was relieved, but I was absolutely traumatized by everything, all over again. From the start of my treatments until I was nearly two years from diagnosis, I hardly batted an eye. I kept a brave face on, and was just a warrior through months of chemotherapy and brutal surgeries for the sake of my family, and now it was all coming out. All was fine with my body physically, but mentally and emotionally the floodgates had opened. Every fear I hadn’t felt, and every worry I hadn’t expressed in the preceding two years just started pouring out, and I didn’t know what the hell I was supposed to do with myself. These are the terrible mind games that cancer plays with you. My body was fine, but I had just died spiritually inside.

The Clinical Symptoms for Post Traumatic Stress Disorder

Symptoms for PTS are grouped into three categories. First there are re-experiencing symptoms such as flashbacks, bad dreams, or frightening thoughts. There are also avoidance symptoms such as wanting to stay away from places or things that might remind you of your experience, along with feeling emotionally numb, or depression, and losing interest in activities that were enjoyable in the past. The last category of symptoms for PTS are hyperarousal symptoms such as being easily startled, feeling tense or on edge, or having difficulty sleeping. If symptoms persist for more than a few weeks, it might be PTSD.

Yes. Everything. All of the above. I lit up the full list of symptoms like a Christmas tree, every single one of them, almost every single day for the better part of 6 weeks, and off and on throughout most of 2013. The most difficult year of my cancer experience wasn't the physical fight against cancer in 2011, it was the emotional fallout after cancer that finally hit me hard in 2013. Although PTSD is more commonly experienced immediately after a traumatic event, it's not uncommon for it to come to the surface months or even years after a traumatic event or life experience as it did with me.

Life In The Midst of Post-Traumatic Stress

On a typical morning when I was suffering from post-traumatic stress, I couldn't start my day until I stepped into the shower and had a good cry for 10-15 minutes. I was so afraid and felt so threatened, not just by cancer, but by everything and everyone around me. I was so tired of my situation, living my life month to month between scans and feeling like there was no end in sight. I felt like I was living my life with a gun constantly pointed at my head, and I just couldn't take it anymore. I couldn't go on like this. I couldn't do this anymore, and wanted out! I begged and pleaded to God to keep me safe and free from cancer. I feared being taken from my children and leaving them without a father. I didn't think it was possible to hurt this badly inside, to be having multiple breakdowns per day, every single day for over a month, and living in a state of complete fear.

After this morning ritual of weeping and praying in the shower, I’d pull myself together and get myself and our kids ready for the day. During this period of time, I was handling all morning drop offs at our daycare. I would hug them each goodbye, and sometimes the tears were already starting to flow again before I made it back to my car to head to work. As everybody else was casually heading out the door for yet another typical day without a care or worry, it was taking me every bit of courage that I had just to set foot out of my front door. I felt like I was stepping into a fire fight within a war zone, unarmed, defenseless, and completely vulnerable. My defensive instincts were in overdrive. Everything and everyone around me felt like a potential threat that I needed to protect myself from. I felt like I needed to run away, but to where? What was I running from? I was still cancer free, and my body was healthy!   

Once I got to work, I would sometimes cry a little bit more in a quiet corner where no one was likely to find me, and then just tried to focus on whatever I needed to do that day. One day, my thoughts were so bad that I just couldn’t be at work. I had a visual sequence playing through my mind not unlike the Firefox movie sequence, and just couldn’t get it out of my head. The misery of fighting chemotherapy, and the wind blowing through the trees on a beautiful spring day made blurry by the fog of chemo. The feeling of my body struggling through another round of chemotherapy, with my heart rate hitting 160 just to get up to go to the bathroom, and blacking out if I stood up for more than 30 seconds. My body couldn’t keep up, and felt like it was getting ready to pack up and die. That’s a memory that I could stand to live without, “so this is what it feels like when you’re dying,” but that feeling and that visual kept playing over and over again in my head. Another part of the sequence was the last few minutes before I went down for my RPLND surgery, seeing all of the terrifying tools in the operating room, and then the first few minutes after I woke up, and learning soon thereafter that I had nearly died when my vena cava was torn. They kept me under an extra 12 hours because I had lost 5 units of blood and nearly bled out, and it was too dangerous to wake me up. I nearly became a statistic fighting cancer the first time, which lead to such dreadful thoughts about having to fight it again if my cancer came back. All of the most painful or terrifying moments from my 5 months of hell fighting cancer just kept playing over and over in my head, just like how the Firefox movie depicted. I had kept all of these fears and emotions buried, but the recurrence scare I had suffered brought them all the the surface. 

My mind was so overwhelmed with negative thoughts and energy that I didn’t know what was real and what wasn’t anymore, so I was afraid of everything and everybody unless I knew without a doubt 110% that you were on my team. Everybody else just had to get the hell out of my life for awhile, and in some cases permanently. I felt like ‘Death’ was making his rounds, had me on his radar screen, and that I was next. My anxiety was so out of control that I had to take Ativan just to get myself calmed down enough to even be functional, but I hated Ativan. It made me feel loopy, and gave a euphoric false calm. I quickly gave up on the Ativan, and went with a half or full glass of red wine in the mornings instead, which took the sharp edge off these feelings. There are more than a few days when I rolled into work semi-intoxicated, but I was just trying to survive, and doing the best I could. I became completely withdrawn, and didn’t want to go anywhere or do anything except with those I had the utmost faith and trust in.

Everything about my life changed when I was diagnosed with cancer, and now everything was changing all over again when I started experiencing post-traumatic stress after cancer. I couldn't even go out to lunch with my new co-workers anymore. I loved them all and they helped me to feel normal again after cancer. Just having co-workers again and money to be able to go out for lunch was an amazing thing to experience after what I had been through. Cancer survivors take nothing for granted! But when post-traumatic stress kicked in, it created such a huge contrast between myself and others that just made me feel so abnormal. As they talked so casually about the news, sports, weather, or things going on in their lives, I was sweating out my next set of scans, stressing if they would be clear or not, and if I was going to live or die. A co-worker might mention something they wanted to do in a few years, but I was just worried about having a life to live at all through the next month! Oh, how I longed to be able to chat so casually about things and be so carefree! I loved these guys and still do, but just couldn’t be around them during this time. The same colleagues that had initially brought me so much comfort were now adding to my distress, simply because of the huge contrast between all of their lives and mine. I was so frustrated and disheartened, and just ended up feeling so awkward and out of place with people that I had come to love and enjoy the company of. I wasn't normal at all. I was in such a different place in life.

Just driving my car to go anywhere was terrifying while experiencing PTS, because I felt like every oblivious idiot on the road not paying attention was gunning for me personally. I still remember when one person turned across traffic in front of me a bit too close for comfort, and my whole body clenched up as if this was it. I realized how badly I had lost it when I actually caught myself ducking and sitting so low in my seat while driving around one day, as if an assassin were waiting for me at the next corner, ready to open fire as soon as they spotted me. This is how you feel when experiencing PTS, threatened at all times, on guard at all times, hyperaware of everything, and having to shape up everything around you as a potential threat. 

This wasn't me. It was my sub-conscious mind recognizing external patterns from around the time of my cancer diagnosis, relating them to similar external events that I was experiencing at that time, and then pulling everything together on me. Sub-consciously my mind had made the associations without my knowledge, equated past patterns with the present, and thus feared that the worst possible dreadful things were about to happen! Run! Hide! Fight! This is bad! Get the hell away from whatever this is! Don't you see?? Do something!!! 

I knew and understood consciously that this was all nonsense as I curled up in corners in tears day after day, but it's how my body and my sub-conscious mind was responding. It was the worst tug-of-war game between the conscious and sub-conscious minds. I knew things were okay, but my sub-conscious mind was panicking, trying to get me to run away, and going into meltdown mode because I had nowhere to go. I couldn't NOT be afraid. I had no conscious control, and was scared shitless for six solid weeks, and off and on throughout most of 2013. Post-traumatic stress is an entirely instinctual and sub-conscious response to just get the hell out of Dodge. But where do you go? Where was I supposed to run to? I wanted to run away, but had nowhere to run to, and just felt trapped. 

Hitting Rock Bottom

One of the worst things about post-traumatic stress is just how ashamed and worthless I felt. I was so afraid, but didn’t know or understand why. I was two years out from my cancer diagnosis when I was getting hit with PTS hard. Despite the scare I had had, all scans and tests came out clear. My odds of recurrence were down to less than 1%, yet I was more afraid than I had ever been in my life. My thoughts were almost entirely consumed by cancer, painful memories, worries and fears, and the defensive instincts to just run or hide. I was too afraid to be alone, yet afraid to really be with anyone all at the same time. I was failing as a husband, and failing as a father. I couldn't even enjoy a sweet moment with my family without it being interrupted by the voices of demons in my head. "This will be the last time... You'll never enjoy this again..." 

Rational thoughts didn’t matter. Ask any cancer survivor, and no matter how good their odds are or how little their chances of a cancer recurrence are, we all feel like it’s a 50/50 affair at best. A coin toss. It was more like 99/1 for me of being permanently cured, but that wasn’t good enough. These are rational and logical things, but post-traumatic stress is irrational, illogical, instinctual, and emotional. I just wanted this to be over and done with! I just wanted to wake up from this nightmare, but it was no nightmare. This was my real life. I had never felt so isolated and alone in my life, and didn't know how to make so many terrifying thoughts stop. 

I knew I had hit rock bottom when I contemplated suicide.

I knew I had hit rock bottom when I contemplated suicide as a way to get these terrible instincts to let go. I didn't know how to make it stop, but knew that would do it. I was done with this and ready to give it all up. I felt myself teetering on the edge of oblivion, and had not an ounce of strength in the entire fiber of my being to stop myself from falling, I was that broken. I had done so well and had held it together for so long, but my cancer experience finally broke me in the most terrible of ways when I was ready to give everything up, simply as a means to end the attacks not of cancer cells invading my body, but of the terrible demons that had been flooding my mind.

Being Lifted Up and Carried By Love

Do you know what it feels like to be letting go of life, only to feel yourself being lifted up rather than falling after you let go? It’s something that I hope no one I know personally ever has to experience, yet is simultaneously one of the most loving and uplifting feelings that I’ve ever felt in my life. My wife, my soulmate, got into my mind in a way that only a soulmate could, pledging to love me forever no matter what, and that she would go to the ends of the earth for me if that’s what it took. She could have run away, and she could have given up and left. I know the thought had crossed her mind, but she never gave up on me, and never left my side, and finally found a way to get through to me. She got inside of my mind and beat these terrible demons off of me at a time when I was unable to fight back anymore. She found this song by Jason Mraz, "I Won't Give Up", and shared it with me as the perfect expression of her love.

I felt just like the scarred and battered soldier in the video. I felt so broken and worthless, but there was his beautiful woman by his side, who was never going to leave him as her love was unconditional. Imagine feeling pain so unbearable that you're ready to end your life just to make it stop in one moment, yet feeling the joy of such extreme and unconditional love lifting you up in the next. There aren't the words in the English language to describe how this felt. It was the feeling of going down in flames in a terrible death spiral and dying inside, yet the feeling of being reborn and renewed with such loving and positive energy at the same exact time, by angels and the unconditional love of a soulmate. I had never cried so intensely in my life in the last few days of January 2013. Extreme tears of pain and sorrow in one moment at having been ready to give everything up, but equally extreme, blissful tears of unconditional love and joy in the next lifting you up, and overpowering everything. My wife's love, and the way she found to deliver it, was the perfect message and expression of love that I needed to hear, at exactly the time I needed to hear it. I had let go inside, but my soulmate, surrounded by a few other angels, lifted me up with everything she had, and in that moment my demons were defeated. Six weeks of savagery in my mind were over. Love won.

It was the beginning of February 2013 now. The Superbowl had just wrapped up. Emotionally, I had missed the entirety of the holidays, most of December 2012, and all of January 2013. What was supposed to have been the happiest time of the year had been entirely consumed by and lost to PTSD after cancer. I felt just like Clint Eastwood's character in Firefox the entire time, but was happy that these terrible defensive instincts that lurk within all of us had finally relaxed their death grip on me. I no longer felt like my life was in danger, and the loaded gun pointing at my head was finally gone. I was so emotionally blown out that I just felt numb and shell-shocked in the days that followed. I still didn't even know what had hit me, but knew I had fallen so far, so fast. I thought I had been doing so well, but the inner world of my mind was shattered into a million pieces, and I was nothing but smoldering wreckage inside. I was absolutely wrecked, and a shell of a human being. This was my emotional ground zero after cancer. It didn't happen during cancer, nor in the months after my cancer fight had ended, but rather two years after my diagnosis.

The climb back up seemed impossible, but I felt surrounded by loving energy and knew that I could do it if I tried. It wasn't my time to go yet. My wife needed me, my family needed me, and I still had work to do here in this realm. Inspired by the love and energy that surrounded me, I started what would be my year long climb back up in February of 2013.

I had thought I was past everything, only to realize I was still at the beginning, and had so far to go.

My angel, my soulmate, and the one I get to call my wife. My God, what a blessing. Photo taken in June of 2013 at Rehoboth Beach a few months after this madness. I was still hurting so badly inside and feeling so raw from the whole experience. I didn't know it at the time, but I was finally starting to find my way.

Continue to PTSD After Cancer Part II - Coping and Overcoming

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Coping With the Uncertainty of Cancer

A friend of mine has really been struggling lately. She lost her brother to cancer a few years ago, and he would have turned 31 on October 28th, the day after my own birthday. Cancer runs in my friend's family. She's already lost numerous other family members to cancer so early in life, and many of them living today have also tested positive genetically that makes a particular type of cancer almost inevitable. My friend, however, did not test positive for this particular cancer linked gene to her great relief, but which has also brought out terrible 'survivor's guilt' feelings in full force. Where there's so much love there's also transference, and I know she feels the cancer related fears of her family members as her own, in addition to still having other cancer scares of her own! 

A snippet of our exchange, posted with permission.

DLG: I'm so happy that you have come through to the other side of your ordeal. I think of people like you and my brother everyday. I can't even begin to imagine. I'm terrified just to get in your heads for a minute. I just had a moment an hour ago. I've been waiting for biopsy reports for two moles I had removed (I've had many atypical moles removed over the years and both my dad and my sis have had skin cancer). Of course I leave the house without my phone to drop the kids off at school and doc calls. No message. Heart pounding, worst thoughts as I wait on hold. Doc is on phone with another patient. I cry, think of [my husband] and the kids over and over and cry some more. Finally, nurse hears my desperation (okay, full on heart attack, hysteria) and gets the okay to tell me mole on back is moderately abnormal but all margins are clear. No cancer. First thing I thought of, besides [my husband] and the kids and my thankfulness to God....my brother, my siblings and family members who have the stupid fucking [withheld] gene, you and people like you, all the people who won't get the same call as me.

I do need to work on the survivors guilt, when's my luck up, I'm next, mentality. It's very hard. Because I've been faced with so much death at a young age, I believe it has me always looking over my shoulder. And especially when I "dodged" the faulty gene bullet. I know I'm always thinking "okay, this is it, brace yourself". I did it this morning. I have to work on that. It's not a healthy not happy way to live.

I'm so grateful and I'm so sorry that you ever had to go through what you did and are still going through. Keep writing, for you and for all of us. Keep telling us so we don't forget for one second what it could be like. People get complacent. You know the danger in that. Keep telling them, because every time I read your posts I get perspective and empathy. I never want to be anything but grateful to be here. Thanks for the e-hug. Sending one back!

My friend lamented about the damage cancer had already done to her, and how it had reshaped her life and robbed her of so much joy despite never having had it. She wondered how someone who actually had cancer could even begin to cope with so much uncertainty. 

This is how.

1. Accept

Accept that you have no control. My friend has never actually have cancer, so it's not actually cancer that's terrorizing her life, but rather the uncertainty and complete lack of control that cancer is presenting that's doing so. We all want to believe that we have so much control over our lives, but when you hear or even fear those words, "you have cancer", it takes all of that away. In a moment life can change, and someone that you love and care about can be taken from you. It matters not whether it's cancer, a disease, or a terrible accident or tragedy, as these are all things we fear and have no control over. We wrestle in our minds over the belief that we actually have control, but it's a losing battle when the circumstances of life prove irrefutably that we don't. 

I know what it feels like to hear those terrible three words, "you have cancer", and just how quickly and easily it all happened. Having been there, I'd been torn apart inside at the fear of something happening to others in my family. I wanted to believe so badly that I had some ability to control life or protect them, but you have no defense against such things. As life progressed after cancer through my survivorship years, through recurrence scares when I thought for sure "this was it" and that I was going to die, through depression and post-traumatic stress, and through the deaths of numerous cancer warrior brothers who did die, I finally came to the realization and full acceptance that we have no real control in life. It had been an illusion all along. It was a tough pill to swallow, but enough tears helped to finally finally wash this terribly painful lesson down. 

We have no control. This is how life really is. 

Once you fully accept and buy into this complete lack of control in life, what would you do? What changes would you make in your life to adjust for to this new reality?

2. LIVE

Live, love, laugh, and enjoy life like crazy. Fully accepting that anybody you love can be taken from you at any moment is what unlocks your ability to love them, enjoy them, and appreciate them like crazy everyday. Tell someone in your life that you love them for the first time, if you've been afraid. What are you waiting for? Tomorrow could be too late. Tell a friend how much you love and appreciate them, the difference that they've made for you, and how much you've appreciated their presence in your life. Laugh together, cry together, and let the tears flow. Bond, love, embrace, and enjoy such a moment together. Say that you're sorry to someone that you know you've hurt, and offer forgiveness to those that had really hurt you. You know all of those things you might do when you're on your death bed, those last words and last wishes? Why wait until that point? Do this today while you're still living. Free your heart and soul of such pain and resentment. Why carry this through life? Don't be afraid. Release such terrible feelings so that you can live life fully today.

When I wake up in the morning, I have such incredibly powerful puppy dog like feelings of love and adoration for a wife that's really been there for me. My God, what a blessing and what a gift to have in life. I love her and appreciate her like crazy every day, and I always try my best to show it. When I drop my kids off at school in the morning, I give them a hug, and I really hug them. Will something terrible happen to them today? Everyday I pray no, but I hug them as if the answer could be yes, because I know that it could be. My God, do I love my children. Such beautiful young souls that I've been blessed with, and I just love taking every bit of them in. And from there, I'm just getting warmed up. 

Make plans, go places, do things, with your family, with your friends, or anyone that you love, and whose presence you've appreciated in your life. Keep a full schedule, and never let a moment go to waste. I've never really lived life like I was dying, but there was a period of time when that's about how my life felt, and is pretty much how we lived. If my time was really coming, I wanted to live the best possible life that I could in the time that I had left. We haven't ever really stopped, and found some friends for life while in the process. One weekend we're up in the mountains, the next weekend we're at the beach, and the following weekend we're enjoying a fantastic dinner at some swanky place down in DC with beloved friends, living and enjoying and cherishing every second of it. 

Heaven is not a place but a state. Create your heaven on Earth by living and loving in your life like crazy today. Release all of the pain from your soul, and fill it up with love and joy instead.

3. believe

All of the fantastic trip and vacay photos, and all of the smiles, the love, and the laughter that friends have seen have all been real. We've been living and loving and enjoying life to the max, but most have never had any idea of just how much I had still been hurting inside, because I was still so afraid. What if something happens? What if my next scans don't come out clear? What if I don't make it? What's next? What's at the end? What do I even believe in? 

I'm so blessed to have had numerous friends looking out for me spiritually, who invited me to their churches when they knew I had been struggling. You have to believe in something, and not knowing what I believed in was the source of a lot of fear and anxiety within me. I grew up in a Christian church-going household, but I never felt the essence of the religion in my heart and soul. Organized religions haven't ever worked for me, and I saw and felt the conflicts in all of them. I felt torn between my Christianity by birth and my wife's Buddhism, part of the challenge of a multi-cultural household. Which was the path forward? What was I supposed to believe in?

The answer is, whatever you feel in your heart.

My wife and I have both seen and experienced things in our lives and over our 19 years together that have been suggestive of what comes next, that something or someone is out there watching over us, and that there is something next. I knew what I felt and believed inside, but it wasn't aligned with any major religion, and didn't know how to connect all of the dots together.  It was the fascinating story and experiences of cancer survivor and author Anita Moorjani, who died of her cancer but was able to come back, that finally helped me to connect all of those dots. She had felt the same things, and had felt torn in her life in the same ways! I wasn't alone after all, and no longer felt "wrong" or conflicted for believing in what I did. I don't think I believe in something today, I know I believe in something.

It matters not weather my beliefs fully align with any major religion or not. It's my spiritual journey, it's what I feel, and it's what I believe in, and it's brought me great comfort. If you have any beliefs such as these, bring them all in so that they can help to heal you, and take away another layer of this anxiety. Finally being able to affirm what I believed in took the wind out of the sails of my fears of death, of my cancer coming back, and is what has allowed me to finally live my life without fear, and without apology.

4. Lather, Rinse, Repeat

This takes time, and it takes practice. It's not so easy to give up on beliefs that we've held dear for potentially decades of our lives. You can't half-ass any of this. You can't kind of accept that we have no control, you can't kind of live, and you can't kind of believe. You have to go ALL IN with all of it, because it's only full acceptance at one step that enables the next. It's only fully accepting and embracing the fact that we have no control that releases your mind from the struggle of fighting for the illusion of such control in the first place. When you cut free every last thread of these old beliefs, suddenly your mind is free and fully focused on the moment, when it's made to understand that there might not be a next one. 

In my years after cancer, I had to give up on the belief that I would age gracefully, that I would make it to the big milestones in life such as turning 40, 50, and beyond, seeing my kids grow up, and walking my daughter down the aisle. Retirement? As a young adult cancer survivor, that cloud over our heads never really goes away. Because I had cancer once, I'm at elevated risk for all sorts of other cancers. Because I went through very toxic treatments to cure my cancer, even that elevates my risk for other cancers. My mind was fighting to hold onto the belief that I would live a healthy life, but I had to let go of that. There were too many risks, and too many pitfalls. I knew it might not be true for me. I cut that last thread that my mind was holding onto away. You panic and free fall for awhile, but eventually you find your footing, and gain a new approach and new philosophy by which you're going to live your life. 

Step 1. I'm not healthy, I might not make it to even 40, I might not get to see my kids grow up or walk my daughter down the aisle. I have no control over this. What do you do? Step 2. Live, love, laugh, and enjoy life like crazy today. Never let a day or a moment go to waste. Step 3. Believe, in something. Relax about what comes next. Worrying about what comes next takes away from our abilities to enjoy today. We're here to enjoy life. It's only going all in, accepting, living, and believing, that allows you to maximize your potential in life, and to create your heaven on Earth.

Keep repeating.

---

Life asked death, “why do people love me but hate you?”, death responded, “because you are a beautiful lie and I am a painful truth.”

A cancer survivor friend of mine, Mark De Raismes, found this quote a gave it quite a bit of thought. This is what he had to say.

"I'm reminded almost daily of friends that have lost loved ones way too soon. I'm reminded almost daily of those I care about that have faced or are facing that painful truth. I remember clearly facing that truth myself. I'm not even sure what I'm trying to say here except maybe, live people. Truly try your best to really live. I think it's only a beautiful lie if you ignore the painful truth, and the truth is only painful if you ignore it." - MDR

This is brilliant, and I couldn't agree more. I didn't want to believe this painful truth about life, but fully accepting it is what has made my life more beautiful than its ever been. 

Dedicated to my friend, DLG.

StevePake.com

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What Cancer Surveillance and Scanxiety Feels Like

25 Appointments and Counting...

On the eve of my 4 year check-up for cancer, I rather foolishly clicked on a news video link of Virgin Atlantic Flight VS43's emergency landing in Gatwick last December. I've watched emergency landing videos before, but this is just asking for trouble around surveillance appointments, and I should have known better. As the Boeing 747-400 came down without its starboard main landing gear deployed, and with emergency vehicles lining the runway that were prepared for the worst, it was as though all of the collective fear, anxiety, and tension of the passengers on-board that aircraft found a way to channel straight through me. I could relate to this so well, because I know exactly what this feels like, and it's how I had already been feeling at the sub-conscious level. This is what I've been going through for 4 years now, over and over again, as an 'S.O.S.' cancer patient, "stranded on surveillance."

Virgin Atlantic Flight VS43, a Boeing 747-400, makes an emergency landing at Gatwick in December of 2014, without it's starboard main landing gear (outboard) after circling for hours burning off fuel.

Nobody chooses to get on an aircraft that's going to have an in-air emergency. Who would possibly make such a decision, and how could you possibly know? Nothing like this was ever supposed to happen to you, yet there you are, settling in for your flight as the Captain comes on the PA system, announcing that there's been a landing gear malfunction, and that you might not be able to land safely. As in, we all might die. Your heart skips a beat. The words "you have cancer" are similar. All of a sudden, all that you've been working towards, and all of your hopes and dreams are, literally, up in the air. Your future, including weather you'll even have one or not, is now entirely dependent on weather you're able to get off of this plane alive or not. You're absolutely trapped and helpless, and there's not a damned thing that you can do about it.

The worst part is the waiting, circling the airport for hours while tens or even hundreds of thousands of pounds of fuel are either burned off or dumped, and the pilots exhaust every option they have trying to free the stuck landing gear. Flying around for hours reduces the weight of the aircraft as much as possible as fuel is burned off, which minimizes potential structural stress on landing, not to mention flammability. The wait is excruciating, but increases the odds of survival. Yes, survival. You could spin out of control on landing, or go up in flames. It really puts things in perspective for you when your life is on the line like this. That time spent in limbo gives you a lot of time to think about life, and what's truly important to you. It's the same for cancer survivors getting scans and blood tests done, and then having to wait forever to know the results. Back on the aircraft, the tears really start to fall when you start flipping through photos on your phone of your kids, your spouse, and your family and friends, wondering if you're going to live or die, and if you've already seen them for the last time or not. It's slow and agonizing mental torture.

Hours later, the moment of truth finally comes. You're on final approach, and emergency vehicles are ready. Either the pilots will be able to safely land the plane, or they won't. Either your scans and tests are going to come back clear, or they won't, and all you can do is pray. Feeling so helpless and out of control like this is what finally brought God into my life again, and man have I prayed. I haven't just prayed to God in these past few years as a cancer survivor, I've begged and wept so many times. "Please God, let me live for my children," I used to pray over and over again through tears. But most suddenly and unexpectedly, you hear the engines surge and you start gaining altitude? What's going on?? That familiar "dong" chimes, and the Captain comes on the PA system, terribly apologetic. "Sorry folks, but there's going to be another delay. There's a scheduling conflict - your oncologist isn't going to be in the office that day, and we need to move your appointment to next week." Ugh! But I had been spooked and finally managed to mentally prepare myself for this moment. You mean, now I'm stuck twiddling my thumbs in limbo for another week, and am going to have to go through this wretched mental process of preparing for what could potentially be my last moment all over again? F*ck me!   

This is my twenty-fifth time going through this now.* That's twenty-five emergency landings. Each time it's a a little different, but still very much the same. It gets easier with time, but is it ever really easy? We get nervous and irritable, our moods sour, our anxiety levels go through the roof, and our imaginations run wild sweating every little ache or pain. We might become withdrawn and not really want to talk to anybody, as I have now as I write this. My wife and I both recognize this all too familiar pattern by now. My emotions are being held hostage again, and I'm going to be circling the airport for quite a long time before yet another emergency landing.

"There's a zillion reasons to be having strange pains in your body, but when you've had cancer, all you can think about is that your cancer is back."

I somehow kept making it through these moments for awhile, but after my fifteenth emergency landing at the end of 2012, I completely lost it. I was so spooked and afraid, and thought for sure that this was going to be the time that I would finally go up in flames, or maybe crash into the water and drown? There were so many strange things going on with my body, along with some other bad omens in the world that had spooked me. I was fine. Extra tests that were done came back negative. There's a zillion reasons to be having strange pains in your body, but when you've had cancer, all you can think about is that your cancer is back.

US Airways Flight 1549, successfully ditched in the Hudson River in January of 2009. Imagine having to go through something like this every other month.

Maybe this one was a bit like US Airways Flight 1549, when Captain "Sully" Sullenburger famously had to ditch his Airbus A320 in the freezing Hudson river in January 2009, after losing both engines to a dual bird strike. Miraculously, everyone survived, but man did I sink. That one broke me. I just couldn't go on. I was so done. I couldn't do this anymore. I just wanted to run away from life and let whatever was going to happen to me happen, but my network of supporters lifted me with their love, and carried me when I could go no further myself. I was alive and breathing, but drowning in cold and traumatic memories of all that I had been through, that I had somehow managed to keep locked away and repressed up until that point. After that time, and that landing, it all started pouring out. On my sixteenth emergency landing, two months later in February of 2013, I was so emotionally blown out from feeling so much, that I couldn't feel anything at all for awhile. I was still numb and broken. After my seventeenth emergency landing in April of 2013, I sat in my car and just cried for a half hour afterwards. I was so happy and relieved to be alive, despite the fact that this was killing me, too. I just needed this all to be over with, but knew I still had such a long ways to go, and that I would have to find better ways of dealing with this pain.

It's not my five-month long fight against cancer that's marked me and changed me as a person, but rather the repeated emotional trauma of one emergency landing after another in the years after on surveillance. Every single time, it's the same feelings of endangerment, yet having nowhere to run and nowhere to hide, and just having to wait it out. It's ironic how these rigid surveillance protocols are designed to catch recurrences of our cancers as early as possible, and give us the best chance of survival after decades of accumulated medical knowledge, yet the extreme stress that the protocols themselves bring on can kill us at the same time. Mental health issues such as post-traumatic stress and depression are common in cancer survivors, and it came as no surprise to me whatsoever that post-traumatic stress is common in airline passengers that had been involved in emergency landings as well. Sadly, even suicides were common for the first generation of young adult cancer survivors, in the absence of all of the knowledge and support that we have today in the connected world. It's always been a blessing to be alive, but it's been a hard life to live. 

The thorn in all of our sides is that we never really know if our cancers are gone or not. Passage of time without any new evidence of disease is the only thing that proves that we're cured. It's not the surveillance that kills us, but rather living with so much uncertainty all of the time, and the constant reminder of just how fragile our lives have become. We want to know that we're going to be healthy and that we'll never get sick again, but there's never been a guarantee for anybody. It's a false sense of security about life that we lose after cancer, and we never get that back again. It's been so hard learning to live without that.

"No cancer survivor should ever be left alone and without support."

A successful cancer survivorship is marked by our abilities to adapt to our new lives, to find outlets that help us cope and relieve this extreme stress, and by finding the support that we need. This can't be done alone, and no cancer survivor should ever be left alone and without support. Consciously, I know that there's little reason for me to be so afraid at 4 years out, as my surveillance appointments are mostly a formality by now. It's post-traumatic stress and my defensive instincts kicking in that's causing me to be this way, so withdrawn, irritable, and tense. It's that same feeling of dread coming back to the surface, as you approach yet another emergency landing. We can't just turn off our instincts. Oh, how much easier life could have been these past few years if there was just an 'off' switch for this, but these are hard-wired into us and they're always on, always alert, and some of us have stronger defensive instincts than others. We have to find ways to work with these defensive instincts of ours, and so I run. I run as hard as I can go at times, consequences be damned. I write, I spend plenty of time with family and friends, and never stop LIVING in between these emergency landings. Doctors and well-meaning friends will say that you'll adjust to a "new normal" after cancer. They haven't the slightest clue what they're even talking about, but this is it. Welcome home. 

As VS43 touched down, almost teetering on the edge of balance as the pilots delicately applied flight and then ground controls without its starboard main landing gear deployed, a passenger can be heard weeping on an in-flight video that someone took as the aircraft finally rolled to a stop. It's such a different situation, yet emotionally, exactly the same as what we go through as cancer survivors on surveillance. Who would volunteer to do this over and over again, if somehow they knew a flight was bound for trouble? They'd rightly be called a fool, a daredevil, or an adrenaline junkie not long for this world. I'm not one of these people and never have been, yet this is my life on surveillance after cancer. We endanger ourselves for real if we don't subject ourselves to this, but it can easily overwhelm and push our mental sanity far beyond our limits when we do. Going through this broke me as a person, forcing me to rebuild my life from the ground up in order to accommodate such extreme stress and pressure. Sometimes it takes everything I have to just survive, and I have to utilize every source of support and coping mechanism that I've developed just to get through some days. A well-stocked liquor cabinet, or in the galley on the plane, is your friend, too.

Here we are at last, on final approach for real this time, emergency landing cancer surveillance check #25. Some deep breathes and a final prayer said, and one last "F*ck You, Cancer!" just for good measure. What will happen this time? You just never know, and have to learn to live with the uncertainty and your life being constantly thrown up in the air like this as best you can. 100 feet, 50 feet...here we go again.  

Brace! Brace! Brace!

StevePake.com

* My cancer surveillance protocol by Memorial Sloan-Kettering Cancer Center for Stage IIB non-seminoma testicular cancer, treated successfully with combination EPx4 chemotherapy and the RPLND surgery, is the most aggressive (conservative) I've ever heard of. I've had H&P, blood tumor marker checks, and a chest x-ray every month for the first year, every two months for year 2, every three months for year 3, and every four months for year 4. These short intervals are what help to detect a potential recurrence as quickly as possible, which gives the patient the maximum odds of survival. It's part of why testis cancer centers of excellence like MSKCC have the highest survival rate for testicular cancer in the world. I would never even think of becoming non-compliant, but the rigors of being on such an aggressive surveillance protocol have certainly left a mark, and taken a huge emotional toll on me. 

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