Hope Beyond Cure

How do you describe someone with advanced cancer? A cancer sufferer? A cancer patient? Struggling with cancer? Fighting cancer? Being treated for cancer? Having a terminal illness? Having the Big C?

It’s hard to know really. Is there an etiquette we should follow? In the last week or so I’ve been introduced to others both as a cancer survivor and as someone who is dying of cancer. Sounds to me like two different people!

I’ve found the whole terminology thing awkward for a long time. Earlier this year we joined in the Relay for Life and I was invited to walk a lap of honour as a cancer survivor. Seemed strange to say the least. I wasn’t long out of hospital. I was still coming to grips with my diagnosis. You could hardly describe me as a survivor. I’d only just begun the journey and the prognosis was bad. Surely I’d need to be in remission, have no evidence of disease, or be pronounced ‘cancer free’, in order to qualify as a survivor! Last week I was introduced to a gathering of people with lung cancer – and their carers – as a cancer survivor. It seemed a little more reasonable now. I was still alive and I’m approaching my one year anniversary.

Am I survivor? The reality is I am. I’m still living, breathing, and at this point I’m in better health than I was when diagnosed. I’ll be a survivor until such time as I die. But to be honest, I’m keen to do much more than survive. I don’t want to be defined by my disease. I want to live well – not indulgently – but in a way that honours God and others. I want to have the life and death of Jesus at work in me, to serve others rather than serve myself.

I’ve also been described as dying of cancer. It’s understandable to speak in this way, because it’s potentially the most unique or distinctive thing about me. I’ve been described as ‘husband of Fiona’, ‘father of Luke or Matt or Grace or Marcus’, ‘son of Norman and Ruth’, ‘Pastor of Crossroads’, ‘chaplain to the Brumbies’, ‘keen on fishing’, ‘friend of someone or other’, and lots of less charitable things! At the moment, the characteristic I’m best known for is ‘having cancer’.

But, am I dying of cancer? I’ve been told what I have is incurable. The treatment is not expected to eradicate the cancer. The survival rate over 5 years for lung cancer is only 16%. Few people ever fully recover from lung cancer. Initial diagnosis at Stage IV is seriously bad news. So, am I dying of lung cancer? The truth is that I don’t know. Nobody does, not even the oncologists. People do get healed. God is completely capable of healing me. Will God heal me? I‘ve got no idea! Modern medical options are amazing. They’re discovering new things about cancer all the time. New treatments are being invented at a rapid rate. Who knows what the future holds? Many people die with cancer rather than of cancer. How will I die? High odds on it being the cancer that causes my death, but ultimately only God knows. And I’m happy about that!

The one thing I do know is that I am dying one way or the other. But it seems strange to introduce me as someone who is. After all, we’re ALL dying. It’s not unique to me. I’ve been reminded in this past week of how true this is. There was the sad story of the teenage girl who plunged to her death from the 22nd floor of a Gold Coast building, during schoolies week. Bryce Courtenay lost his fight with cancer, dying in his Canberra home at the age of 79. On Saturday I joined with others in celebrating the life of my good friend, Chappo, who passed away at the age of 82, because his body was no longer able to fight the infections. Another friend has just lost her sister. It may be sooner or it may be later, but we should recognise the fact that we’re dying. We need to take stock of this reality. In fact, a friend reminded me of this again recently, when she asked me what was on my bucket list!

I know it’s awkward, and it’s so hard to know how to say things, but maybe cancer survivor or dying of cancer aren’t the best ways to describe me. At present, I’m living with cancer. But I don’t want that to define me either. Yes, I’m dying, but I was dying before my cancer diagnosis. In reality, nothing has fundamentally changed. Maybe I’ve got a better idea of the time frame, but then I hope that I don’t! I’ve survived so far, thanks to God, but will I survive my cancer? In this life, I can’t say. But I firmly believe that this life is not all there is. I look forward to the day when there will be no more death or mourning or crying or pain, for the old order of things has passed away. (Revelation 21:4)

Can I encourage you to do the same?

(extract from macarisms.com on 26/11/12)

You’ve probably heard of Movember. During the month of November moustaches sprout on men’s faces everywhere. The aim of this campaign is to raise funds and awareness for men’s health, specifically prostate cancer and male mental health. The mo has played an important role in lifting the lid on some huge issues that have been kept private for too long.

I wasn’t aware until very recently that November is also Lung Cancer Awareness Month. It comes hot on the heels of the global pink month, promoting awareness of breast cancer. Whereas pink ribbons are ubiquitous, I’ve never noticed the pearl or white ribbons for lung cancer. Nor did I realise that there are purple, blue, jade, periwinkle, orange, violet, gold, green, and a whole bunch of other coloured ribbons promoting awareness of many different cancers. Without taking away from the importance of increasing awareness for all cancers, there are some particular issues facing the lung cancer community.

Worldwide, lung cancer is the bigger killer of all the cancers in both men and women. It kills more people than breast cancer, prostate cancer and colon cancer combined. Sadly, five year survival rates for those diagnosed with lung cancer are very low. It’s seriously bad news to be diagnosed with lung cancer. However, it’s not the statistics that matter most, it’s the people affected. Men, women, mothers, fathers, wives, husbands, grandparents, parents, children, neighbours, isolated, lonely, leaders, labourers, politicians, teachers, workmates, unemployed, you name it! Real people, with real lives. People shocked, hurting, scared. People with hope, people without hope.

Some month’s back I don’t think I knew anyone with lung cancer. Now I’m meeting more and more every week: a dad, like me, with a wife and four kids; a young woman in her 30s; an older guy in his 70s; a large spectrum of age and sex and life circumstances. I’m learning that lung cancer doesn’t discriminate.

Some of my biggest surprises have been very personal. If you’d asked me last year to name what causes lung cancer, I’d have said quite simply ‘smoking’. We hear this message daily. The campaign against tobacco smoking is now huge. Of course, smoking often does cause cancer, but my mistake was that I thought it was the only cause of lung cancer. But now I had lung cancer… and I’d never smoked (other than a small number of experimental cigarettes in my teens). Nor was I a passive smoker, as I hadn’t spent much time in the company of smokers.

I learned that there are different types of lung cancers, and they’re not all caused by smoking. I had what could be described as a ‘non-smokers lung cancer’. It’s usually difficult, if not impossible, to determine what causes this cancer. We’ve wondered about a range of personal and environmental factors, but we really have no idea. In my case there are genetic factors involved, but much more research is needed to understand this cancer, and more still to keep improving treatments and ultimately find a cure.

As I’ve learned more about lung cancer and met some of the people who are battling it, I realise that many are battling another issue as well… stigma.

The reality is all cancer is awful, nobody wants it, and nobody asks for it. Most people will be impacted seriously by cancer at some stage of their life. No one is out of reach. It’s tough to say, but it could hit you and it could hit those close to you. It’s worth asking, “How would I want to be treated if I have cancer?” and “Would it make any difference if it was lung cancer?” I think I’ve got a pretty good idea of your answers. Lung cancer doesn’t discriminate, and neither should we.

We need to move beyond the stereotypes and stigma. People with lung cancer need your support. Our society, our governments, our charities, our big business, our scientists, our researchers, our medical profession, our drug companies need to invest in tackling this killer. This takes commitment, time, and money.

(extract from macarisms.com on 31/10/12)

It began with a crisis. Taken to hospital, rushed through Emergency, hooked up to an ECG machine, off for x-rays, back for a CT scan, a massive fluid build up around the lung… looked like there could be a tumour. A whirlwind of people, activity and emotion. Within hours people were visiting, offering help, gathering to pray, preparing meals, picking up cars, contacting children. Within days I’d become the centre of attention, everywhere, it seemed! It was confirmed that I had cancer and the prospects didn’t look good. So many people from so many places turned up to see me. The nurses complained that there were too many people. Letters, cards, Facebook greetings, emails, came in from all over. Meals kept turning up at the right times. A small army of people unpacked our belongings and refurnished our house. Fifteen hundred students gathered in small groups at a conference to pray for me! It was intense! It was life and death in our faces every day.

I’ve seen our family cope pretty well with a crisis. We’ve had a few now! We made some very big decisions very quickly. We put new plans into place. We made the adjustments. We had the tough conversations without too many problems. We just did what we had to… and coped. We enjoyed the support from others. We were conscious of God’s strength and comfort and we prayed a lot.

But…

Things have changed. The pace has slowed. The crisis has gone and left us with the chronic. It’s become three weekly by three weekly, rather than day by day. Life is now shaped by chemo cycles. One week sick, two weeks better. One week sick, two weeks better. On and on. It’s exhausting and we don’t seem to be achieving much else in life. Sometimes we feel like we’re just drifting with the current or stuck in a rut going nowhere. It’s not so much action that’s needed now, but patience and perseverance and gentleness and self-control. And that seems so much harder. It doesn’t come naturally. We absolutely need the help of God’s Spirit.

But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control.  (Galatians 5:22-23)

In many ways the excitement of the crisis has given way to the mundane of the chronic. The daily grind is hard work. Perhaps, even more challenging than the mountain climb. In the crisis I think to pray. In the chronic I’m more tempted to forget. Gratitude easily gets replaced with grumbling. Matters of eternity give way to matters of trivia. Urgency steps aside for complacency. I can forget to number my days and begin again to take for granted my months or even years. Oh, how slow to learn I can be!

I think it’s harder for others also. Initially, people were making every effort to visit, bending over backwards to offer support… as we tend to do in a crisis. But as time goes on it’s harder to sustain the effort. Life fills up, another crisis gets in the way, we have our own lives to look after. We forget to drop in, make the call, check up on each other, see if there is anything we can do.

To be honest, it can be rather lonely having a chronic illness. You feel just as sick and powerless and needy, but you’re pretty much left to manage on your own. There’ve been times when I’ve felt disappointed in people. Why haven’t they called? It wouldn’t be too hard to drop in. It’d be awesome if they’d just ask Fiona if there’s anything they could do to help. I long to hear what’s going on in people’s lives. I’m interested in knowing about work or family or the latest sporting achievement. I’d love to have people offer to come and pray with me, or read the Bible and talk about stuff. Hey, I’d even be up for a regular game of real Scrabble! Even a quick phone call just to say they’re thinking of me!

I shouldn’t whinge. Fiona tells me I shouldn’t write posts when I’m feeling revolting from chemo and she’s probably right! I have so much to be thankful for and I keep being overwhelmed by how many people tell me they’re praying for me. But, I’m trying to be honest and I’m learning lots about myself as well. As I reflect on many years of pastoral ministry, I don’t think I had begun to appreciate what it was like for some people struggling with chronic issues. People with physical or mental disabilities, people with CFS unable to get out of bed for much of the day, women with debilitating pregnancies, people without transport or living in nursing homes. I had so many opportunities to be an encouragement to others that I simply overlooked. As a pastor, I was always up for putting on my superman cape and dealing with a crisis… but the chronic was often forgotten. Out of sight, out of mind perhaps.

Jesus is the Pastor Supremo. He came to overcome our alienation from God, which is the biggest crisis we will ever face. He did so at enormous personal cost, sacrificing his life on the cross to bring us reconciliation. But we also see Jesus caring for those with chronic disabilities, people who are outcasts and isolated from others. He was willing to hang with lepers, prostitutes, tax cheats, and those despised by the religious leaders of his day. Jesus had a pastoral heart that didn’t overlook the needy and he called those who follow him to have the same attitude.

Then Jesus said to his host, “When you give a luncheon or dinner, do not invite your friends, your brothers or sisters, your relatives, or your rich neighbors; if you do, they may invite you back and so you will be repaid. But when you give a banquet, invite the poor, the crippled, the lame, the blind, and you will be blessed. Although they cannot repay you, you will be repaid at the resurrection of the righteous.”  (Luke 14:12-14)

Here’s a thought. Next time you think of putting on a BBQ, think about people you know who might rarely get invited out. Are there lonely people at work or church who’d love an invitation? Perhaps, there’s someone who’s not well and you can make a special effort to include them. Maybe even offer to take the BBQ to their place if that’d make it easier!

On another occasion Jesus told a parable to describe those who belong to him and those who don’t. They’re challenging words.

“Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’

“Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?’

“The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’  (Matthew 25:34-40)

The mention of brothers and sisters shows that Jesus especially has in mind the way Christians are called to treat each other. If we’re part of the same family, then we’re called to love our siblings. There’s a lesson here for those of us in churches to care for one another in our times of need. It should never be out of sight out of mind. But, I wouldn’t be too quick to say this stops with how Christians should treat each other. We’re called to do good to all, as we have opportunity. Do you know someone needing a place to stay? Is there neighbour down the street who never gets visitors? Is there someone at work going through a difficult divorce? Is there old friend with CFS who’s been doing it tough for so long that they’re embarrassed to even mention it? Do you know a single mum who never gets any time to herself? Would a friend appreciate you doing some shopping, spending time in the garden, running a few errands, taking the kids for a while? Is there someone you should get onto right away, just to check they’re doing okay?

How can you make a difference?

(first published in macarisms.com on 19/10/12)

Sickness, loneliness, trouble at work, struggles in marriage, financial pressure, wayward children, car accidents, overlooked for promotion, slandered, mocked, imprisoned, persecuted. Who wants a piece of that… any of it? And yet James writes in the Bible:

Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds…  (James 1:2)

What was he thinking?! And he doesn’t simply say, look on the bright side, cheer up, things will get better. He says to consider it pure joy (or all joy) whenever you face trials. And he doesn’t restrict the range of trials. I take it this covers pretty much the full spectrum of nasty things that could happen to you. How do you adopt such a view of life? And is this any different to the power of positive thinking?

Perhaps we need to consider the meaning of joy. The temptation is to equate joy with happiness or a bubbly personality or a permanent smile. But joy runs deeper than an emotional response. It has to do with contentment and trust and confidence. In James’ words he calls us to a thinking response more than an emotional response. He’s not telling us how to feel about the trials we’re experiencing, he’s telling us how to think about our circumstances, to consider it pure joy when we face various trials. But why?

…because you know that the testing of your faith produces perseverance.  (James 1:3)

The experience of facing trials puts our faith to the test. It shows up what’s real and not real. Theoretical faith is no faith at all. Genuine faith is shown by it’s action, it’s fruit, the changes it produces. And the real test is perseverance, keeping on when things are tough, and finishing the race.

Sadly, I know a number of people who have claimed to have faith in God, who’ve claimed to be Christian, who have said most of the right things… but when pain and difficulties and trials have come along their faith has proved wanting. Perhaps they were presented with a false picture of God – one where he’d remove anything undesirable – and it didn’t stand up to their experience. Maybe they hadn’t really come to the point of trusting God at all. When life is good, when we’re healthy, wealthy and happy, it’s easy to think we’re in control and not bother trusting in God.

Trials of various kinds give us the opportunity to live out our faith, to demonstrate a faith that works. I would never have planned it this way, but my experiences with cancer over the past year have given me many reasons to examine my faith and look again to God. Will I trust God with what I do not like? Can I be contented and joyful in the midst of painful chemotherapy? Can I count it as pure joy to have an ‘incurable’ lung cancer? Please note, I’m not saying that the cancer is a good thing. God is sovereign over all, but he teaches me that cancer, disease and death is part of this cursed world that he will ultimately restore. I don’t go looking for trials, but they will come and the question is how I respond when they do.

I’ve had a number of people say to me that they’ve been observing my faith more closely since I’ve got sick. They’ve heard me preach and teach and counsel people over the years, but now they are watching how I respond personally? Is my faith really real? Does it stand up? Will I persevere or turn away? My prayer is that I will persevere as my faith is tested and consider it pure joy when I face these and other trials, because of what God is doing through them.

One of my problems is that I’m so short sighted. All I can see is the immediate trial. Right now, it’s the effects of chemo: the headaches and nausea and rashes and fatigue. Another time it’s the struggle of a difficult relationship, or the criticism of others, or my disappointment in myself. God is calling me to get the bigger picture, to grasp his perspective. James continues…

Let perseverance finish its work so that you may be mature and complete, not lacking anything.  (James 1:4)

The God who reveals himself in the Bible doesn’t promise health and prosperity… in this life. He doesn’t say that he will remove all our suffering and take away all our pain… in this life. But we can be confident that God is at work in all situations. He is growing our faith muscles against the resistance of trials and difficulties. He is strengthening us to persevere through the trials, that we might become mature and complete in him.

Do I always have this perspective? Sadly, no. Sometimes the end is hard to see behind all the hurt and the pain. And at these times God promises to help.

If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you.  (James 1:5)

This is a wonderful promise. When we’re blinded to the truth of God at work in our lives, we should ask God for wisdom to see things more clearly, to see things through his eyes. And he promises to give generously. God knows it’s hard, he knows it hurts, he knows we’re weak, and he doesn’t find fault. He gives us the wisdom needed to be able to count it pure joy.

When I was younger I remember singing the song, ‘What a friend we have in Jesus’. It’s a great song, but I think this second verse means more to me now than it did back then…

Have we trials and temptations?
Is there trouble anywhere?
We should never be discouraged;
take it to the Lord in prayer.
Can we find a friend so faithful
who will all our sorrows share?
Jesus knows our every weakness;
take it to the Lord in prayer.

And so I will pray…

Heavenly Father,
Please give me the wisdom to see things your way.
Please help me to look beyond my current circumstances,
to be reminded that you are working within me,
to strengthen my faith,
to enable me to persevere,
and grow into maturity.
I ask that you will help me consider it pure joy as I face my trials.
Amen

(first published in macarisms.com on 16/10/12)