Coping With the Pressure of Looking Fine

There is a certain difficulty involved with not dying right away from lung cancer. After all, the popular expectation is that the disease is a death sentence, especially in advanced stages. So what is a patient to do when treatments appear to work? Looking good and doing well are a day-to-day phenomenon for many lung cancer patients; the disease still lurks within, treatment still takes a silent toll.

Patients still want to look their best. The reflection they want to see in the mirror is one of health, hope, and strength.

Assumptions about how a cancer patient should look may be in opposition to how a patient feels; assumptions about how a patient behaves may go counter to how taxing that behavior might actually be. It may not be easy for a patient in active treatment to appear healthy and appearances may be deceiving. Imagine the stress associated with heightened expectations based upon successfully looking good when those expectations are difficult to meet. These could come from work or home, or they could be purely social in nature, but without a T-shirt emblazoned with "Undergoing Cancer Treatment" or a sign stamped on the patient's head, how is anyone else to know that all is not perfect within?

Stresses are piled on through otherwise "normal" expectations. Work longer hours. Get more accomplished around the house. Come out for drinks.

Looking good does not always mean feeling good

There may be a distinct difference between how a patient feels and how a patient looks or acts. Some patients strive to put their best face on, no matter what. Some patients bask in the glow of energy bursts or pockets of time when they truly feel good, even if just for a few hours here and there. However, not many people are around for a patient's full range of feeling during any given day. The way others experience and interact with the patient will define their understanding of how the patient is doing and their expectations for the patient's future. In this way, even close friends and family members may have wildly divergent impressions of how the patient is doing. And there is the possibility that none of those impressions are accurate.

People base a lot on what they see with limited exposure or context.

It becomes all too easy to write off the patient's treatment as being complete, the cancer a thing to be forgotten. Of course, this is convenient for those around the patient, and they all have the built-in belief that because they want the best for the patient, it is important to embrace the patient's success. There is a psychological predisposition, then, for people to want to see the patient as having "beaten" the disease. Part of this is rooted in their own fear of cancer, perhaps; part of it may be rooted in the inconvenience of having to acknowledge the disease while feeling otherwise helpless to do anything about it. But it is hard to fault someone for assuming that when a patient looks good, that patient probably feels good, too.

A full head of hair doesn't mean that chemo and radiation were easy

Of course, it is unlikely that anyone would intentionally pressure a cancer patient to outwardly suffer. Many patients follow the "fake it till you make it" mantra, hoping that their outward display of optimism and strength will lead toward an inward reflection of the same. And there may be something to that. But there is no easy solution to the patient's dilemma of looking and acting healthy while struggling inside. The best we seem able to do now is try to teach the public more about both the disease and the treatment -- or, more accurately, the multiple diseases under the umbrella of lung cancer and the ever-growing array of treatment options that patients may try.

The more openly we dialogue about our experiences, the less alone we are in our struggles. And at some point, perhaps there is a balance between what we show and how we feel, and an understanding that it is okay to set our own limits and speak frankly about them without being stigmatized.

Have you felt similar pressures to Jeffrey? Share your story here.

We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.