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Coming to Terms With Your Diagnosis

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When Nina Beaty had a low-dose CT scan to check for lung cancer in 2014, she didn’t expect the radiologist to find anything. Although she smoked as a young adult for about 13 years, she’d kicked the habit more than 30 years ago and prided herself on living a healthy life. But since her mom was a lung cancer survivor, she decided to get screened.

She was completely shocked when her radiologist called her a few days later and told her she had small-cell lung cancer. “I wasn’t surprised when my mom was diagnosed: She’d smoked four packs a day for decades,” Beaty, a 68-year New York City art therapist, recalls. “But I’d been the picture of health for decades. I just couldn’t wrap my head around it.”

Initially, her cancer was only in one spot, on the top of her left lung. Beaty underwent chemoradiation and preventative whole brain radiation. Then, in early 2015, she got the devastating news that her cancer was metastatic. Normally, that would mean she had only months to live. But she was able to enroll in a clinical trial at Memorial Sloan Kettering, where she was given a new immunotherapy drug.

“Within weeks, my tumor shrunk by leaps and bounds. My oncologist said he’d never seen anything like it,” she recalls.  Thankfully, Beaty is now in remission. But she had plenty of terrifying moments when she assumed that she wouldn’t make it.

Managing Your Emotions With MSCLC

It’s normal for a diagnosis of metastatic small-cell lung cancer (MSCLC) to lead to an overwhelming number of emotions ranging from sadness to guilt to fear, notes Daniel Huvard, a social work counselor at MD Anderson Cancer Center in Houston. Here are some ways to help you manage:

Have hope. A diagnosis of metastatic small-cell lung cancer is not necessarily a death sentence. Some people with advanced lung cancer, like Beaty, can live many years after diagnosis. Some doctors even think that hope may help your body better deal with cancer.

“Since I’d spent most of my career working with patients who had AIDS or terminal cancer, I didn’t have the traditional reaction,” says Beaty. “I’d seen enough death that it didn’t necessarily frighten me. I kept telling myself not to view my cancer recurring as a relapse, but as a natural progression. The drugs my doctors had originally given me weren’t working, so it was time for next steps. If those didn’t work, we’d try again. And again.”

Find ways to express your emotions. You may not feel comfortable yet talking to friends or family about your diagnosis, and that’s OK, Huvert says. But it’s important to find other ways to process your feelings, whether it’s through journaling, meditation, or even art.

“My first year of cancer was rough: I had moments where I felt completely worthless and didn’t want the struggle of having to ‘keep up the good fight,’” Beaty says. What did help: picking up a pen and paper to process the dark thoughts that invaded her mind. “I would work through thoughts such as ‘Where will I go when I die?’ while drawing an image of a bridge going somewhere, although I wasn’t sure exactly where,” she explains.

Embrace your spirit.  Embracing faith or spirituality can help you get through your diagnosis of metastatic small-cell lung cancer. It doesn’t have to mean attending a religious service: it can be something as simple as practicing mindfulness or spending time in nature, Huvert says. Lee credits her faith with helping her deal with her initial diagnosis. “Normally, I was a pessimist, but anytime I felt overwhelmed I would read the Bible and find it soothing,” she recalls. “It gave me something to focus on, so I wouldn’t keep drifting into emotions like anger and fear.”

Think about your legacy. A diagnosis of metastatic cancer can serve as a “wake-up” call for you to stop and think about how you want to experience the rest of your life. You may want to visit somewhere you’ve never been, or finish projects you’ve put aside, or mend broken relationships. “When I was first diagnosed, I was in despair. I thought, ‘I’m twice divorced, I don’t have kids, and I haven’t done that much with my art therapy career,’” Beaty says. “I asked myself: ‘What legacy am I leaving behind?’”

Then, one afternoon while she went through a 6-hour cancer treatment, Beaty scrolled through the emojis on her cell phone and realized that none of them were relevant to her life right now. A year later, she created the EmPat Project, a website filled with animated emojis for cancer patients to text to friends and family when they felt too tired, sick, or sad to explain how they were doing. “The EmPat emojis became the legacy project I was so afraid I’d never get to create,” Beaty says proudly. 

Getting Support When You Have MSCLC

Surround yourself with a medical team you can trust. Alexis Daniuk, 76, was diagnosed with metastatic small-cell lung cancer in January 2021 after being hospitalized for a persistent cough. Almost as soon as she got the news, she received a telephone call from her primary care doctor. “He was there from day one, cheering me on and telling me I’d conquer my cancer,” she says. “He was always after me to make sure I ate enough, and to remind me to get off the couch every single day and walk, even if it was just 2 feet. He really kept me going through my darkest times.”

Lean on others. “When I was diagnosed with small-cell lung cancer 15 years ago, I had to swallow my pride and ask for help,” recalls Montessa Lee, 43. “But I needed assistance — was being treated at two different hospitals with radiation and chemotherapy, and the therapies made me so woozy I couldn’t drive.”

It can be particularly hard if you have adult children, since it may involve a fairly sharp role reversal. “As a parent, you don’t want your kids, no matter how old they are, to see you sick and taking care of you,” Daniuk says. But she quickly learned that she had no other choice. “My daughter Shannon is a nurse, so she knew exactly what to ask the doctors when I was first diagnosed,” Daniuk explains. “I’ve also realized that it makes her feel better to help me.”

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