A few months ago, a reader named Ginny D asked a question in response to one of my columns ^[1]. She rhetorically asked “Why is cancer so hard? Not only for patients, but for caregivers, friends, and family? Why, for example, does it seem harder than heart disease or other life-threatening illnesses?”

I think it’s a great question.

I’m sure that almost everybody has had to go through the gut-wrenching ex­peri­ence of having someone (either themselves or a loved one) be diagnosed with cancer. Ouch! That seemed like the worst possible news. The big C, what a disaster!

Why couldn’t it have been one of those “better” life-threatening illnesses, like heart disease, diabetes, or a stroke? I know that sounds harsh, and of course I’m joking – at least somewhat – but cancer seems to be the worst.

This doesn’t make any sense. These are all diseases that cause pain, suffering, and death. Why should cancer be the worst?

Ginny D pointed out that it may in part be due to the fact that many cancers were, and some still are, ex­treme­ly painful. I think this is pretty accurate. Not to mention that the treatment always seems worse than the cure.

Another probable explanation for this perception is that cancer still seems to be pretty incurable. I always believed that once you had cancer, practically any type of cancer, you were doomed.

This was such a strong belief of mine that I once recommended to a co-worker and friend who had recently been diagnosed with breast cancer that she get her affairs in order and make her peace with the fact she was probably going to die. I am horribly ashamed of this tactless behavior now.

I really wasn’t trying to be mean. I truly thought I was helping her face reality even if I was going about it in the least sensitive way possible. I believed that her death from cancer was inevitable. I believed that anybody who had cancer was going to die from it. If it wasn’t terminal right way, it certainly was going to relapse sooner rather than later.

My perceptions were cast in stone by witnessing my grandmother die from lung cancer in 1978 and a close friend from pancreatic cancer in 2011.

The only treatment available to my grandmother at the time for her stage three cancer was very toxic che­mo­therapy. She never got better, the chemo made her horribly ill, and she suffered until she died about three months later.

I was only 16, and it scared the hell out of me!

My friend’s recent death was also painful and aggravated by her chemotherapy, which did no good and only robbed her of her last two months, during which she would have been healthy enough to enjoy life.

I was only 49, and it scared the hell out of me!

I can counter those experiences with multiple others in my life involving heart disease, stroke, multiple sclerosis, kidney disease, and rheumatoid arthritis. All of these involved close friends or family, and each of these diseases caused lots of pain, suffering, and sometimes death. Heck, I even had two friends drop dead from heart attacks. However, none of these experiences scared me like the threat of cancer.

These perceptions, of course, no longer apply. At least not to me. Now that I have been “blessed” (huge sarcasm here) with multiple myeloma, I have learned the truth. I had to learn the truth. The perceptions were way too scary to live with.

It turns out that lots of cancers are survivable, treatable, and not necessarily that painful. More importantly, every cancer is very different. Not only is every type of cancer different, but each patient’s cancer of the same type is often very different.

The treatment of cancer has also evolved; it is not always the horrible road of suffering it used to be in 1978. As lots of us can attest to, the side effects of treatment are not only tolerable, but tolerable to the point that we can often lead full and productive lives.

One of the interesting aspects of this change in perception is that I think my disease is harder on those around me than it is on me – at least when it comes to the mental aspects of cancer.

Ginny commented that one of her sisters is so anxious about her disease that she can hardly talk to Ginny. I too have friends who have disassociated themselves from me because they are obviously disturbed by my cancer. We all know people who are very uncomfortable talking to us about our condition.

I think the solution is education. Once I became educated about cancer, I was less afraid.

I don’t know about you, but I now find myself constantly trying to explain to family and friends the differences between myeloma and other types of cancer, or why I don’t have to go to the hospital for treatment.

I try to be patient. I owe that and more to the universe to make up for the horrible lack of understanding I dis­played to my friend. If by some quirk of fate you are reading this, Ann, I sincerely apologize for my foot-in-mouth disease. It was entirely caused by my own fear.

Our world continues to change. The diseases our grandparents died of are different today even if they are the same.

We can be less afraid. Cancer doesn’t have to be so hard. Now we just have to explain this to everybody else.

Aloha and carpe diem!