Writing Through Cancer

To everything there is a season, and a time to every purpose under the heaven:

A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;

A time to kill, and a time to heal; a time to break down, and a time to build up;

A time to weep, and a time to laugh; a time to mourn, and a time to dance;

A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing;

A time to get, and a time to lose; a time to keep, and a time to cast away;

A time to rend, and a time to sew; a time to keep silence, and a time to speak;

A time to love, and a time to hate; a time of war, and a time of peace.

When the song, “Turn! Turn! Turn!” was recorded released in 1965 by the rock group, The Byrds, I was a college student caught up in the idealism and fervor of the sixties.  The lyrics were nearly verbatim from Ecclesiastes (3:1) of the King James Version of the Bible, but the song captured the sentiments of the time and quickly became number one on Billboard’s “Hot 100.”  The Byrds weren’t the first to record the song.  Earlier versions  by the Limelighters and Pete Seeger preceded the Byrd’s hit recording.  Over the next several years, many other artists recorded the song, including Judy Collins, Joe Cocker, The Seekers, Dolly Parton, and Nina Simone.  Is it any wonder?  The words from Ecclesiastes describe life’s journey, the inevitability of its cycles and seasons, the story of the entire lifespan.

Seasons have been on my mind a lot lately, triggered, in part, by witnessing the “coming out” of springtime in Toronto, realizing how much I miss the distinct change in seasons, and, later this month,  the passing of another decade in my life.  In the book, The Seasons of Life:  Our Dramatic Journey from Birth to Death, authors John Kotre and Elizabeth Hall describe how seasons are metaphors for life’s journey and how human life is intimately connected to the seasons of nature:  times of day, circling of the planets, phases of the moon, or growth and harvesting of the crops (University of Michigan Press, 1997).  In fact, the ancient Greeks used seasons to define life’s stages: childhood was spring; youth became summer; autumn described adulthood, and winter, the metaphor for old age.

The cyclical nature of life and living reflects what we witness in nature. I think of being in the autumn of my life now, described in a French Canadian film I saw many years ago as “the other side of spring.”  My life is still colorful, still vibrant, but I know the colors will gradually fade as I move toward winter, the years of elderhood and old age.

There are other aspects of life—and illness—that are described by seasons, including cancer.  In a 2009 article in Cure Today, Kenneth Miller, MD  described four distinct phases or “seasons” of cancer survivorship.

1. Acute survivorship: when a person is diagnosed and treated.
2. Transitional survivorship: when celebration is blended with worry and loss as a patient pulls away from the treatment team.
3. Extended survivorship: includes those who are living with cancer as a chronic disease and individuals in remission because of ongoing treatment.
4. Permanent survivorship: people who are in remission and asymptomatic, or,
   cancer-free but not free of cancer because of chronic late and long-term health or psychosocial problems. Others may even develop secondary cancers related to cancer treatment, or develop second cancers not related to the first cancer or its treatment.

Miller’s observations were informed not only by his patients’ experiences, but also by his wife’s.  He compared her stages of cancer and recovery to the seasons of nature:

I have learned just as much about cancer and the seasons of survivorship in my work as a medical oncologist as I have alongside my wife, Joan, he wrote, who was treated 10 years ago for acute leukemia and more recently for breast cancer. Her diagnosis was certainly like the cold, bleak winter, and transition like the rebirth of spring. And while each season was different than the others, each was beautiful in its own way. (http://www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/1142)

It turns out that seasons may be more than metaphors in the cancer journey.  In a 2007 study, researchers from Norway and Oregon found evidence suggesting that men diagnosed with prostate cancer in summer or autumn had better survival rates (see:http://www.medicalnewstoday.com/articles/80625.php for more details).  Vitamin D—the sunshine vitamin–plays a part.  In other studies with early stage lung cancer patients,  high concentrations of Vitamin D appeared to contribute to a better survival rate post-surgery.  Patients whose surgeries occurred in sunny months (May – August) had a 30% higher survival rate than those who had surgery in winter. “Season,” epidemiologist David Christiani noted, “had a pretty strong effect.”

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Whether we’re diagnosed or treated with cancer in summer or winter, the seasons of our illness can dominate our lives.  Marilyn Hacker’s 1994 collection of poetry, Winter Numbers, invokes the darkness and cold of winter as she details the loss of many of her friends to AIDS or cancer as she struggled with breast cancer.  Dan Matthews, using seasons as metaphor, chronicled the journey of his wife’s terminal breast cancer in a poetry collection,  Rain, Heavy at Times: Life in the Cancer Months (Arago Publishing, 2007).  John Sokol wrote about his cancer in a poetry collection entitled In the Summer of Cancer.  And in one of my favorite poems by Barbara Crocker, “For a Friend Lying in Intensive Care Waiting For Her White Blood Cells to Rejuvenate After a Bone Marrow Transplant,” the season of springtime signals a time renewal and rejuvenation:

The jonquils. They come back. They split the earth with

their green swords, bearing cups of light. ‘

The forsythia comes back, spraying its thin whips with

blossom, one loud yellow shout.

The robins. They come back. They pull the sun on the

silver thread of their song.

The iris come back. They dance in the soft air in silken

gowns of midnight blue.

The lilacs come back. They trail their perfume like a scarf

of violet chiffon.

And the leaves come back, on every tree and bush, millions

and millions of small green hands applauding your return.

(From:  The Cancer Poetry Project, 2007, www.cancerpoetryproject.com)

This week, think about how seasonal metaphors describe your life.  Write about the seasons of your life, whether the cancer journey, a marriage, loss and grief, adulthood– any of life’s seasons that have been important or significant to you in some way.