When Cancer Eases Pain – Healing and Being Treated Are Not Always the Same

We often forget—even as physicians—that health means physical, psychological, and social well-being, focusing only on the physical effects of disease. Below, we share a story emphasizing that health must be considered comprehensively and is itself part of quality of life . A patient receiving cancer treatment should not feel alarmed when reading this article, because cancer is physically and psychologically challenging. Alongside its physical effects, patients must also contend with emotional and social difficulties. Their responses to treatment and the changes in their lives are therefore very important. In this article, Mrs. P.'s story highlights the importance of responding to cancer treatment and how life can change afterward.

Mrs. P., whose thin voice suggested that she had smoked for many years, began rapidly recounting fragments of her life, pausing intermittently, as soon as she entered my office. As I listened to her describe her work as a clerk in a children's library before she became ill, I looked at the enormous stack of reports and images she had accumulated over the years. Each was carefully placed in yellow folders organized by study type—MRI, CT, X-ray. Across the desk, a visibly tense Mrs. P. rubbed her hands, her eyes fixed on the floor. I was the new person in the clinic, and this was a familiar scene. People came to me because they had not found the answers they sought elsewhere. I could usually infer something about their situation from the thickness of the files they brought. A file like hers told me the story would not be simple and, more importantly, would usually have no solution.

The symptoms, mainly fatigue and pain, had begun several years earlier. As they worsened, Mrs. P. had been forced to make changes in her life and eventually leave her job. Her family relationships had also suffered: with all her energy and attention consumed by symptoms, she could not attend to her college-age children or husband. She could sense her family's disappointment. Like everyone else, Mr. P. wanted his lively, creative, fun-loving wife with a purpose in life back. The children visited less often, leaving her feeling they came mostly out of obligation. All Mrs. P. desperately wanted was a name for her suffering. In her eyes, it stemmed from her own weaknesses, and she assumed others thought so too. Although she considered herself strong, she blamed herself for what she was experiencing. With each visit and set of results, what we were facing became a little clearer, and her symptoms, which had initially seemed to arise from her back, began to change. Earlier reports about the pain contained notes from orthopedists, neurologists, and physiotherapists. Tests and scans had yielded no answer. Food allergies developed over time, and after a necessary endoscopy, she began trying different diets. She was convinced the problem was caused by yeast and was dissatisfied with the doctors' answers. She then saw numerous rheumatologists and neurologists, and suspicions of MS (multiple sclerosis), a neurological disorder, led her to repeat testing. Could her results be normal despite an inflammatory condition? Throughout all this, emphysema was our only definite diagnosis, but she insisted that breathing was not the problem.

After some time, Mrs. P., who had been admitted to a clinic for her pain, came to ask me for a prescription filled with narcotic medications. Although she reassured herself that she was improving, she could no longer imagine life without them. Everything changed when a routine mammogram revealed microcalcifications that had not been there before. The report even described them as "suspicious." I always hesitate when I have to tell a patient they may have cancer, but I had never encountered the absence of worry or fear in Mrs. P.'s response. "Breast cancer, then?" was all she said. She seemed to have an epiphany, as though she had put the clues together and caught the villain at the end of a mystery novel. She asked only one question: "What do we do now?"

After we established a treatment plan involving surgery, radiotherapy, and chemotherapy, I began seeing Mrs. P. less often. She changed remarkably, even abruptly stopping her narcotic medications. She focused entirely on cancer, and her anxiety diminished along with her symptoms. Her husband and daughter, who had rarely accompanied her to the clinic, now usually came with her. Between treatments, she returned to old hobbies, reconnected with old friends, and began reading to children at the library where she had worked. She also made and sold crafts. Everyone, including Mrs. P. herself, thought she was doing better than she had in years. Eventually, treatment ended, and she was told she was cured. At several subsequent visits, I noticed that neither her daughter nor husband accompanied her and that she seemed low. Her determination to achieve her goals during treatment had disappeared. She seemed to have returned to the struggles of life before diagnosis, and after a while, she stopped coming to the clinic altogether.

My days were busy, so it took time to notice. I began wondering how Mrs. P. was doing and suspecting she might have moved on to another doctor, hoping to obtain the answers I had not given her. A few years later, I called Mr. P. He told me she had died in a nursing home. "She was admitted to the nursing home with a COPD diagnosis shortly after our last visit with you. After admission, she never saw a doctor again and died of respiratory failure. She spent her final years peacefully, hardly leaving home." When I asked whether the cancer had returned, Mr. P. said, "No, it didn't return. She had been cured. As always, she had done an incredible job."

For years, I found myself reflecting on the lessons I had drawn from Mrs. P.'s story. Dozens of questions ran through my mind, and they kept multiplying. "Why was she so determined to give her illness a name? What traumas did she occasionally hint at but never clearly describe? If we started again today, what would I do differently?"

I am still unsure of the answers. The only thing I know is that Mrs. P. had defeated cancer but had never truly healed...

Every cancer patient's story is different, and everyone responds to treatment differently. This distinctive aspect of cancer is crucial and should not be overlooked. Patients facing physical, psychological, and social challenges need to preserve hope and remain committed to the treatment journey they undertake with their doctors.