Preparing the battlefield

Melanoma, like all cancers, is an unthinking, unreasoning enemy. This enemy only knows how to do one thing, proliferate while remaining invisible to the immune system. Unlocking the immune system to wage war on your behalf will be the subject of research for many years to come, and this isn't a "how to"...as if I actually know, how to. Rather, this was my approach and I know that it helped me. What works for you, what is helpful for you, may look very different but I am convinced there are some universally helpful pieces to the mental game.

Cancer may be unreasoning, illogical, and immune to emotion...but humans are not.

I would love to tell you I didn't struggle with this diagnosis, I would love to tell you that, but it isn't true. Oddly, I struggled most at the early stage, stage II to be exact. I felt crushed, cheated, sad, angry, and anxious all at once. I felt like I had been robbed...of everything, at the age of 43. I threw myself a pathetic pity party for several days. I searched to the ends of the internet, consuming information (most of it bad) with a voracious appetite. I found little comfort in doing this, I knew a lot more about the enemy but all signs pointed toward  bad outcome, for me. (Note: Resist this temptation early in the battle, it is demoralizing, it will frighten you, Google is not our friend at this time).

My fiance had had enough with my new obsession of researching doom and gloom and told me as much. Now, she knows me well and knows that the person she was now looking at was not the same guy she'd known for the past 4 years. She is also one of the most compassionate and empathic people I've ever known. If SHE was telling me to get a grip, I needed to get a grip!

I am a relatively private person, partly due to my military background but more so, due to having been raised by stoics who did not overtly complain about much, ever. So she was the only person outside of my medical team who knew anything about this. I would keep it this way for most of the battle with the exception of my best friend, and I've known him since kindergarten. I'm not a person who derives strength from numbers or a large support system, true to my stoic upbringing I'd rather sort it out in my head or with a solitary confidant, but usually my default setting is to suffer in silence. I don't want sympathy and absolutely do not want others to pity me.

It was time to go to war. I'm no stranger to cancer. I've lost my mom (breast cancer), my grandfather (stomach cancer), and my step-dad (kidney cancer). I got a front row seat to the destruction of a human body by cancer, chemo, radiation, and organ failure. This was not for me, I wouldn't do it. I wouldn't put my kids through it, I wouldn't put my fiance through it, and I wouldn't put myself through it. My logic was, for what? A few extra miserable months maybe a few years if I was "lucky"? I would not just fade away, I needed  a plan. I needed to get my mind right for this battle and refuse to go gently into this good night.

Despite all of this, I had previously made peace with my own mortality while on combat deployments...perhaps I had just forgotten? In dangerous places where people want to kill you, you have little choice but to accept that it could happen and today could be "your" day. Thinking about your own demise constantly will drive you to insanity...so you come to a place of acceptance . An understanding that you do not control the universe and every variable within it. But, you do control some things...you control what YOU do, you control how you respond to the environment, and when things go "kinetic" you ultimately decide what you are going to do to the enemy who is trying to do things to you. 

In some ways, this was like combat. In fact, in some ways, it was easier. Let me explain. In combat you don't always know who the enemy is (for the past few decades we hadn't fought a uniformed army that was easy to spot). In this war I had the advantage of knowing exactly who the enemy was. I also knew that some weapons were effective against this enemy, sometimes. The enemy in this war no longer had the element of surprise on its side, it had been identified and I had home field advantage. I didn't need to assume that the enemy was planning its attack, it was attacking all the time. 

I was going to take the fight to the enemy in every way I could conceive, From relinquishing my fear of defeat, to stacking the deck in my favor in every aspect of this fight. I decided I was going to win today, then do it again tomorrow. Some days winning just meant living life, not living in fear, not letting this bastard get the upper hand and dictate my schedule or activities. On other days, it meant strengthening myself mentally, spiritually, and physically. 

That same best friend that I mentioned earlier had coached high school and youth football and he coined the phrase "Leave No Doubt". When he coined it, it meant leave no doubt that you gave everything you had to the fight, to the game, leave it all on the field and you can hold your head up high knowing that you gave it your all no matter the outcome,. This phrase became my battle cry, my mantra if you will. I would battle this enemy and leave no doubt at the end of the fight. He sent me a shirt with this phrase on the back and it became my go to war shirt, I wore it to treatment, I wore it to surgery, I wore it after surgery, and I wore it when the tables turned and I started to gain the upper hand....and yes, I washed it between wearings.

The mental aspect of fighting, and beating cancer, is the most important. I visualized victory every day. I mean I actually visualized it, I would meditate on my immune system attacking individual cancer cells. I would visually see an army of T-cells mobilizing and closing in on cancer cells. I would see the battle taking place at the cellular level and I would see my highly disciplined, highly organized, and highly lethal immune system laying waste to the cancer. I downloaded a picture of what that looked like, specifically, and stored it on my phone until I had it etched into my mind and no longer needed to reference it, I don't know to what extent this helped, I just know it was empowering to mentally command my killer cells to kick some melanoma ass.

I would visualize this every morning, every night before bed and any time I had a little time to think. I still visualize this, although not as often and I have now been cancer free for nearly 18 months...just in case some of those sneaky bastards are operating covertly as insurgent cells. When you are in the fight of your life with an enemy who's sole purpose is to kill you; it is highly advisable to get very focused on exactly what you are going to do to kill that enemy first.

I understand that a cure for melanoma has not been found. I had no misunderstanding of this fact when the battle began and I defined victory in two ways. First, I could win against this enemy by living life well, enjoying the life I had left whether that be 3 months or 30 years, and taking time for things that I had previously been "too busy" to be bothered with. Second, I would destroy the cancer, and declare total victory on the physical front. Ideally, I would do both. So far I've done the second, and I'm still working on the first, but it is never far from my mind. In retrospect, the second definition is incomplete without the first. If you beat stage IV cancer and learn nothing from it, what have your really won?