Chat transcript: Joel Nathan on surviving cancer
July 28, 1999
Web posted at: 3:39 p.m. EDT (1939 GMT)
(CNN) -- The following is an edited transcript of a chat with Joel Nathan, author of "What To Do When They Say 'It's Cancer.'" Nathan joined the chat from Australia ( where it was 3 a.m. his time!). The chat took place Friday, July 23, 1999.
Chat Moderator: Welcome, Joel Nathan!
Joel Nathan: My pleasure.
Chat Moderator: Nathan, how has having cancer made you a better person? Was there ever a time of bitterness about your cancer?
Joel Nathan: Initially I felt angry and asked, "Why me?" No, bitterness was never an issue. I just wanted to get better.
Chat Participant: I know there are basic "stages" of grieving following a death. Are there "stages" of coming to terms with the fact that one has cancer?
Joel Nathan: Elisabeth Kubler-Ross talks about these, and she was the first to identify them. However, I don't feel that people experience these stages in sequence as she defines. We are all different, and so we respond differently; sometimes these responses occur in different sequences and sometimes all at once. Some people never experience these stages.
Chat Participant: Joel, does hope lead to disappointment and excessive focus on treatment and cures, or is acceptance and focus on living a remaining life better?
Joel Nathan: There is realistic hope and unrealistic hope. I believe hope is one of the key ingredients to a successful recovery. Hope is the hand you hold onto in moments of darkest despair, but it can be a positive influence if it directs you to want to take charge and find the best treatment possible.
Chat Participant: I agree with taking charge, but I have seen too many other cancer patients desperate for cures only greatly depressed when none comes. Joel, any advice for single parents of adolescent children with a diagnosis of incurable cancer?
Joel Nathan: Establish close communication. Hold nothing back. Join a support group. This is a hard issue to address if you have no support network.
Chat Participant: Joel, have you detected a move by people to simply accept they have cancer and get the medication they need on their way towards their end, and are the painkilling medications effective?
Joel Nathan: There is no one answer to this. Painkilling medications are effective and, in the hands of the right doctor, can alleviate most pain. Many people accept their condition and accept the treatment offered; others struggle at first and then realize the best course to follow is to heed the advice of their oncologist.
Chat Participant: How widespread is hospice care in Australia?
Joel Nathan: It is very widespread and highly effective. However, government health cuts have made it harder.
Chat Participant: Is it as readily available as in the United States?
Joel Nathan: I believe it is, but again, health care reductions have made it harder to deliver the quality of care patients need.
Chat Participant: Did you trust the doctors, or did you head for the nearest reference library?
Joel Nathan: I headed for the nearest reference library! Initially. Later, I learned to trust some doctors. I think you have to be very selective. There are good doctors and there are lousy ones. Just like handymen!
Chat Participant: Are there environmental conditions in Australia that make certain cancers more prevalent?
Joel Nathan: Lifestyle and smoking are common. The biggest problem in Australia is skin cancer. We have the highest rate and incidence in the world.
Chat Participant: How many doctors' opinions would you recommend a patient get before deciding on a treatment path?
Joel Nathan: As many as makes sense without going overboard. There will come a time when you have to take a leap of faith and decide which opinion is best suited to you, as an individual with specific needs and depending on the experience of the doctor. If you have breast cancer, for example, you want a specialist with the best experience in breast cancer, not some other cancer. And you need to know their success rate. Ask them!!
Chat Participant: What do you do when they say it's treatable? Do you believe this, or what? I'm still fighting. I was told I had thyroid cancer, and I don't believe it's gone. I have had two radioactive iodine treatments. What's next if this scan is not clear? It's in my throat.
Joel Nathan: All cancers are treatable, some more easily than others. The doctor who tells you your cancer is treatable is a fighter! The ones to worry about are the ones who say there is nothing more they can do. Keep fighting. There is a paradox here. There will always be a time when no matter what treatment you receive, you will succumb -- if not to the cancer you now have, then to some other affliction. We all have to die. It is what we have to accept with grace at some point. In the meantime, keep fighting!
Chat Participant: Joel, considering the advances in genetics, are we any closer to ridding ourselves of this killer?
Joel Nathan: Yes. But how long is a piece of string? I owe my life to a genetically modified drug. It wasn't available when I was first diagnosed but did become available a few years later. It was worth hanging in!
Chat Participant: There was talk in the news a while back about some report released that recommended full mastectomy for women who were at risk. What's your opinion of this? Is it better to stay on side of caution, even if it seems extreme?
Joel Nathan: This is a gray area. It all depends on the pathology results, family history and the age of the patient. All things considered, aggression is probably the best way to go. Leaving treatment too late can create more problems. By aggression I meant aggressive treatment. In some cases, no treatment is just as effective. It all depends on the case history.
Chat Participant: My friend, age 24, was just diagnosed with cancer in his lungs, lymph nodes, liver. What should I say? How can I offer him support?
Joel Nathan: Tease his fears out of him. What was the initial diagnosis? What has the doctor told him? Your best support is to be there for him. To accept what he is going through is the most difficult for you. What does he want to do is the key issue. Can you discuss this with him? What I mean is that you should be open; don't be afraid to discuss anything. Your silence is not what he needs. Don't isolate him by being silent. Also, don't talk about things he doesn't want to talk about. Be sensitive to his needs. So, as I said, ask him what he wants to talk about. Also, don't criticize his decisions. If he is afraid, hold him. Physical contact is the antidote to isolation. Holding. Cuddling. Also, be a sounding board so he can try out his ideas on you -- but without your judgment. If you can, enlarge his support network. One of the best caring support mechanisms is to join a cancer support group. Most patients find this comforting, to be in the presence of people who have been through a similar experience. Also, studies have shown that people in support groups fare better -- with longer survival times.
Chat Participant: Joel, have you any idea how many people have been cured from cancer by the Hallelujah diet?
Joel Nathan: Hallelujah diet. Never heard of it. Is this another novel one or a resurrection of an old one?
Chat Participant: Mr. Nathan, you should look into this. Many people have been cured from cancer by taking on this diet.
Joel Nathan: I have tried just about every diet you can think of, and none of them worked. Also, none of my patients have recovered from cancer from diet alone.
Chat Participant: The basis is, cancer cannot grow in a body that has been cleansed from all the chemicals.
Joel Nathan: Maintaining a good diet is essential to good health -- but it will not cure cancer. It's all a moneymaking business.
Chat Participant: By eating live food only, vegetables and fruit, you don't have to be sick! It has cured many cancer cases.
Joel Nathan: For the diet-promoting folk, cancer is a growth business!
Chat Participant: Mr. Nathan, what kind of alternative treatments did you undergo? How did you find out about them, and do you think they helped?
Joel Nathan: If you have all day, I will list them. For example, I tried the Gerson program, laetrile, wheat grass, coffee enemas, raw liver and carrot. I tried a 10-day fast, then a seven-day fast. I tried acupuncture and Chinese medicine. Macrobiotics. Psychic surgery. Nothing worked. I even had psychic surgery from the Philippines. Alternative medicine cost me a fortune.
Chat Participant: Do you think genetics and molecular biology will offer any significant advances in cancer treatment in the next 25 years?
Joel Nathan: Absolutely, yes. Indeed, molecular biology holds the greatest promise. When you consider that cancer is cells gone rampant, it makes sense that treating the disease at this level would be the most effective.
Chat Participant: Is your book intended for the cancer patient, or friends and family of cancer patients?
Joel Nathan: My book is aimed at patients, their families, as well as their doctors and other caregivers. It's the book I wish I had when I was first diagnosed.
Chat Participant: My last scan showed activity in my liver due to a concentration level from the radioactive iodine. Should I worry?
Joel Nathan: No. It will pass. Literally. I presume your liver is OK generally.
Chat Participant: Is aggressive treatment recommended for senior citizens? From your experiences in treatments, do you think a dramatic surgical procedure could make life more painful than living with the possibility that a removed tumor would come back?
Joel Nathan: Often not. Cancers in older patients tend to be more slow-growing. It depends on the cancer and the age of the patient. Everyone who has surgery lives with the fear of recurrence. Older people don't always do well from surgery. It depends on their age and their physical health. Also, you need to weigh this up against the type of cancer and the prognosis.
Chat Participant: I'm in a new love relationship, and her lung cancer just came back. I don't want to add to her stress but want to support her. Any suggestions?
Joel Nathan: Do you want to pursue the relationship?
Chat Participant: Yes!!!
Joel Nathan: It all depends on how you feel. Why not ask her what she wants? You will only add to her stress if you hold back and are not honest about your feelings. The greatest gift of cancer is that it forces you to be honest. It should, unless you don't accept that life is finite. It also forces you to rearrange your priorities. In this case, you will have to prioritize what you want out of this relationship.
Chat Participant: If people stopped eating meat and ate only raw food, they wouldn't get cancer.
Joel Nathan: I know many people who get cancer and are vegetarians. People who also eat only raw food also get cancer.
Chat Participant: That describes me! I am a vegetarian with cancer.
Joel Nathan: People who exercise regularly and eat all the right foods also get cancer. Food is not the answer.
Chat Moderator: Finally, tell us about your book, please.
Joel Nathan: The message of cancer is what I try to cover in my book. Cancer is the wake-up call we all need to remind us that life is finite and that now, more than ever, we had better get on with living.
Chat Moderator: Thank you, Joel Nathan, for joining us today to discuss people who have life-threatening diseases.
Chat Participant: Thank you so much ... this has been very helpful to me; I needed the added perspective. And I plan to buy the book.
Joel Nathan: Thanks for having me. I hope the answers I gave have helped in some way in dealing with the problems presented. Never give up!
Chat Host: Thanks, everyone, for joining us. Joel is an inspiration!
Joel Nathan: Thanks, and goodbye!
July 16, 1999
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