"Doctor, there are hydroma on my ovaries, sometimes large, sometimes small. Is my number up? Do I have cancer?" "In your situation, these are mostly benign. However, if the hydroma are brown, there is a greater chance of their being malignant. . . ." If the setting is a hospital emergency room, there would be nothing strange about such a conversation. But in fact this scene was played out at a seminar sponsored by a citizens' group, the Anti-Cancer Association of the ROC (ACA).

The ACA invited Dr. Hsu Wen-lin, chairman of the Department of Radiation Oncology at the Tri Service General Hospital, to speak on the subject, "A Woman's Concern--Uterine and Ovarian Cancer." Most of the participants were people currently fighting cancer, and their families. Discussion was lively, and people asked questions ranging from specific case problems to universal health insurance.

Besides weekly seminars, the association also publishes information and has a telephone help line. The volunteer workers, all cancer patients, attend meetings regularly, talking about their own experiences and sharing their accounts of their treatment and how they have adjusted psychologically.

One woman who had breast cancer relates that she attends the weekly seminars without fail. She smiles, "It feels as warm and welcoming as going home to mother."

This association which feels like home was launched in December of 1991 by Annie Hsu, director of the Cancer Crusade Angel organization of the American Family Life Assurance Company. It was the first legally registered national cancer fighting organization.

Only about 5% of victims survive cancer of the pancreas, but Yang Chung-fa is already entering his fifth year beyond his prognosis. He gets up early every day and exercises, and is in far better shape than most people.

Beating cancer through diet

When the ACA was founded, Dr. Tung Ta-cheng, professor emeritus of National Taiwan University, who spent half a century researching a cure for cancer and who himself was a victim, became the first chairman. This venerable scholar, now 80, says that the purpose of the association is to disseminate accurate information about cancer prevention to educate people to adopt better habits and to prevent cancer from even getting started.

Cancer develops in stages. The process takes anywhere from 5 to 20 years. If one is able to catch it at an appropriate time, it is very likely one can avoid the worst.

Normal cells in a healthy body usually mutate into cancer cells due to environmental factors such as chemical toxins or radiation. Dr. Tung encourages everyone to eat more mushrooms, bananas, and apples. That is because these contain lectine, which can improve the body's immunity. Moreover, the Institute of Public Health in the US has determined that genistein, which is found in unpolished rice and in beans, has a cancer resistant effect. Furthermore, exercise and the consequent increases in the volume of oxygen absorbed can also help prevent the formation of cancer cells.

Even if cancer cells do form into the stage called "microcancer," there is much one can do to prevent the cancer from worsening. Cut down on fat and meat, which stimulate the growth of cancer cells. Adopt a more balanced diet, including anti-oxidants such as vitamins B2, C, and E.

But the onset of cancer is always unexpected, and can happen no matter what you do to try to prevent it.

And when it does come, it is invariably traumatic, because most people believe that "cancer is a sentence of death."

Su Tsai Tsai-chiu, a former secretary-general of the ACA Association, is often called Mama Su. Starting at age 45 she had a complete physical check-up every five years. However, after the first two were normal, she put off the third for seven years. When she had it done, cancer cells were discovered in her stomach. Su, who had always considered her diet and lifestyle to be quite normal, reacted to the news by asking:"Why me? I've never done anything wrong."

Since being diagnosed with intestinal cancer, Huang Kuan-jen often eats fresh, unpolluted, low-fat foods. He even grows many of his own vegetables.

To tell or not to tell

Lung cancer victim Su Cheng-hsiung kept a diary of his feelings at that time:"At that time I realized that the problems of work and daily life were so meaningless, and that life is really very beautiful. I used to really be annoyed by car exhausts, but now even a line of vehicles pouring out black smoke looks good to me. You don't dare tell your family about this kind of disease, you just have to quietly accept it."

If a person goes to the hospital accompanied by family members, the hospital ordinarily first tells the family if the patient has cancer, leaving the family with the dilemma of whether or not to tell the affected individual. Yang Chung-fa, a volunteer at the ACA, went to the hospital five years ago suffering from a fever that wouldn't go away. He thought he just had the flu, but, after getting ultrasound and endoscope tests, it was discovered that his pancreas and bile duct were swollen. The doctor lied to him and told him it was benign. But the doctor wanted him to be examined at Veterans' General Hospital, and so he told Mrs. Yang the truth: That Yang had cancer of the pancreas, and only a 5% chance to live.

From this point on Mrs. Yang became depressed and began weeping secretly. Mr. Yang noticed something was wrong and began to wonder. After thinking it over, she finally decided to tell her husband so that he could prepare for the worst. In fact, Yang had long before seen the words "cancer of the pancreas" written on his hospital records.

Wang Chien-ju, who was afflicted with lung cancer, speaks as one who has been there: He says that even if the doctors and family members try to conceal the patient's condition, the victim cannot help but feel something, and it's always better to tell the truth straight out than to let the victim be tortured by doubt and ignorance.

However, a study done in the United States showed that about a third of patients wished that they did not know the truth. Thus in deciding whether or not to tell the patient, the individual's own character and ability to deal with the news must be evaluated in order to avoid impairing the effectiveness of the treatment.

Immediately thereafter, most cancer sufferers then face the major decision as to whether or not they will have surgery. Many people lose their only chance for a cure because they make the wrong choice at the key moment.

Yang Chung-fa was referred to the Veterans' General Hospital. Doctors immediately decided to operate. But when doctors presented Mrs. Yang with permission forms for four separate types of operations to be conducted, she was frightened by how serious her husband's condition was, so she went to a temple to cast lots that would indicate to her whether or not she should sign the forms. The result she got from casting the lots was that the surgery would almost certainly prove fatal to Mr. Yang. Therefore, she strongly urged him to leave the hospital and consult a practitioner of traditional Chinese medicine for treatment. At that time Yang knew of no one else on whose prior experience he could draw, while the doctors did not discuss with him the advantages and disadvantages of each choice. He felt very confused and bitter.

In the end he left the hospital, but within ten days was again running a very high fever. While being rushed to the hospital, he continually drank cold water, but his body temperature was still above 40 degrees Celsius. They went to Chang Gung Memorial Hospital in Linkou for surgery. Doctors removed his bile duct and gall bladder, and parts of his stomach and intestines were also cut away. He thought that taking pain-killers would slow down healing (an erroneous belief many people have), so he resisted getting the shot. As a result, he tossed and turned in bed for 24 hours, in such agony that he cried until he could cry no more. Yang says, shaking his head, "if I had been able to get information from the association then, and knew that I should have listened to what the doctor was telling me, I could have avoided a lot of pain."

Struggling to survive

The vast majority of patients accept chemotherapy, radiation therapy, or electrotherapy, depending upon their situation. Because these treatments not only kill cancer cells, but also kill normal cells, they have powerful side-effects, and even can lead to entirely new health problems.

Miss Lin is only in her early 30s. Because the doctor initially made a misdiagnosis, when it was finally discovered that she was suffering from breast cancer, she was already in the third stage before any treatment could begin. She underwent surgery to remove her left breast and the lymph nodes under her arm. Two weeks later she began chemotherapy, from nine in the morning until 12 noon. At that time she felt that her eyes were burning and her hands were cold, but she didn't think that side-effects would occur so quickly.

"I was in a car on the freeway going home, and I suddenly began to throw up and suffer convulsions. Moreover, the attacks increased in frequency over time. It felt like I had been poisoned, like something was running around inside my body. Or it was like being electrocuted. My whole body was numb and shaking," she recalls. Because she feared damaging her digestive tract, she drank a lot of water. But in the end she was vomiting so much she couldn't even hold water down. They took her to the hospital, but the injection they gave her to relieve her nausea wasn't much use. Her hair fell out all at once, and she lost seven or eight kilograms very rapidly.

Chemotherapy does not only seriously damage the body and require the patient to endure enormous pain, it can also cause permanent damage to ovaries, the womb, and other organs. In serious cases it can affect reproductive ability. For a woman, the loss of a breast is already hard enough to deal with physically and emotionally. The loss of the ability to have a child could very well be the straw that breaks the back of even the strongest camel.

Faced with these risks, Miss Lin decided to grit her teeth and go on with her treatment, because continued therapy was her only lifeline.

The support of her sister and her family was a very important source of strength for Miss Lin. Her sister was very dismayed at having to watch Miss Lin suffer physical harm from her chemotherapy. Her sister also worried that because Miss Lin was still unmarried, if she lost the ability to have a child she might lose the courage to ever get involved with anyone. Yet, despite these concerns, Miss Lin's sister still encouraged her to continue with her treatment.

After her treatment, when she was in the most pain, her sister and brother-in-law would stay up all night to rub her back to try to ease her discomfort. This kind of spiritual and practical help greatly multiplied her courage and determination.

Her family made her understand that she would have to eat well and keep her strength up to endure the rigors of chemotherapy. Every time she finished a session of chemotherapy, she was down to about 45 kilos. But during the periods between treatment, she inflated again like a balloon. When the time to go to the hospital to start again would roll around after three weeks off, she had returned to well over 55 kilos. Even the medical personnel were amazed. The good news is that she has already completed her chemotherapy.

Unfortunately, chemotherapy did damage her ovaries. Within half a year, she began to bleed internally. A check-up showed that the pathological change in her ovaries had led to endometrial problems. It was bad enough when the doctor once told her that it was never advisable for people who had gotten breast cancer to ever have children (to lower the risk of relapse). Now it was a terrible blow to be even unable to keep her womb. Yet her determination to fight the cancer remained steadfast.

Cancer victims take the chance to return "home" （to the association） for seminars. Here they can exchange experiences and information.

A victim like yourself

Even for those patients who pass the first test, the sense of indecision and the shadow of a relapse after leaving the hospital are things that normal people cannot comprehend. Also, there are many traditional "cures" running rampant on the market, with countless examples of people being cheated and even harmed. Thus, many cancer patients share the desire to get accurate information in order to ease their psychological burdens.

In March, 1994, Mama Su was in the hospital for 17 days while having surgery for stomach cancer. When she was about to leave the hospital, she felt an indefinable sense of anxiety, because whereas in the ward she had doctors and nurses to look after her, she was on her own outside the hospital. "I even especially asked the doctor if there was some organization I could turn to for help, but the answer he gave was negative. So later, when someone told me about the ACA, I immediately joined," says Mama Su, remembering her situation in those days.

ACA volunteer Huang Kuan-jen was diagnosed as having cancer of the large intestine in December of 1975. After surgery, he felt aches and pains all the time. Though Mrs. Huang was very supportive during his treatment, seeing that Huang still looked strong and healthy after surgery, she didn't pay much attention to his complaints. It was only 16 years later, when Huang entered the ACA and was talking about this situation with fellow victims, that he sensed that he had finally found someone who could empathize with him.

"In those days, the less my wife paid attention, the more anxious I became. But given her healthy condition, there was no way for me to really communicate to her what I was feeling," says Huang with a sour smile.

Various larger hospitals do have friendship associations for cancer patients, such as the Carnation Society at the Tri Service General Hospital, or the Breast Cancer Work Station at the Veterans General Hospital, as well as National Taiwan University's Liver Disease Prevention Center. But these units belong to these medical centers. After leaving the hospital, many patients are unwilling to again cross that threshold unless they absolutely have to.

The ACA, with its own space, is there to fill the void.

Nevertheless, fighting cancer is an extremely arduous and long process. Some patients suffer repeated relapses or the spread of the cancer to other parts of their body (metastasis). For example, Wang Yi-ting, the former Vice-Minister of Economic Affairs, was struggling against cancer for the last 13 years of his life. The cancer cells in his body spread from his kidneys to his lungs, liver and spine. Altogether he underwent surgery three times for lung cancer and once for spinal cancer. The anguish of such an ordeal is something that outsiders cannot understand.

But there are also success stories. Peng Li-hua, a former board member of the ACA, one day happened to run into a Mr. Wong, who was nearly 70 at the time. As they were chatting, she was deeply moved by his cancer-fighting spirit.

The earliest symptom the old gent showed was blood in his stools. At the time it was misdiagnosed as hemorrhoids. Only later was it discovered to be cancer of the rectum. Three years after surgery to remove the cancer, cancer cells in nearby organs started growing out of control. The cancer was again removed, but three years after that a tumor about ten centimeters large was discovered on his liver. A year later, there was a tumor on his foot. From the first outbreak through the metastasis and to his surgery and trips back and forth to the hospital, the entire process lasted seven and a half years. Although one can see swelling on his belly even from the outside, nevertheless, he doesn't look at all like he's discouraged.

Open yourself, look at the world

Mr. Wong is not an isolated case. Most of the cancer fighters met by the ACA can still find lots to smile about. They make friends to climb mountains, practice qigong, go to lectures, do gardening, go singing, or even do volunteer work at other cancer organizations. They live more active and positive lives than most healthy people. The moroseness one might expect is virtually invisible among these people. What is their secret?

"If we always hide in our own little corners, then all we can see are our own tragedies. But if we don't call ourselves in, if we go out and make friends with other victims [by participating in ACA activities], we will discover that we are not the only ones suffering, and so naturally we can put things more in perspective and feel less discouraged," says Peng, quoting Mr. Wong.

Miss Lin, who lives alone in Taipei, does not feel the least bit lonely. This is because she has many other "friends in need" and they comfort and support one another. She emphasizes that what cancer patients most need is long-term caring from others. It is hard for healthy people to give cancer victims any kind of meaningful comfort, but it can be found in the ACA.

Tung Ta-cheng also believes that the key factor in fighting cancer is "not to lose hope." This is because, as studies of psychological immunity have shown, a person's state of mind can influence their body's physical immunity through the secretion of hormones in the brain.

Momma Su works as a volunteer in a hospital, encouraging cancer patients from the perspective of one who has been there.

A new understanding of life

In his book Life Changes of Chinese People, National Taiwan University psychology professor Yu Te-hui wrote that many people only understand the limits of a materialistic life when they face the threat of imminent death. Only then do they change and come to truly understand the meaning of life. This is a very accurate description of the feelings of so many cancer fighters who have won their battles and survived, and who have even gone on to help others like themselves.

Yang Chung-fa each month rides his motorcycle to more than ten large hospitals in Taipei to hand out information from the ACA. He calls himself "a bit of a fool," because not only is he not paid any salary, he pays all his expenses himself and even makes regular contributions. This kind of behavior, which a normal person might see as "money down the drain," is his secret recipe for helping achieve self-realization. "Anyway, the doctor said I would only have six months to live, and that was four years ago, so I'm already ahead of the game!" says Yang with a smile lighting up his face.

Besides going to the ACA regularly to share experiences with others, Yang also goes to hospitals from time to time to visit cancer patients. At these times he is able to bring to bear his own experiences, helping to encourage and lift the spirits of the patients.

"I've got cancer of the pancreas. The doctor told me I only had six months to live, but I've been living well for more than four years now. The survival rate for the cancer you've got is higher than for mine. If you let the doctor take care of the therapy, while you put your confidence in yourself, then there's a great deal of hope."

His deepest impression is of a patient in the last stages of bone cancer. After a long period in agony, this person pushed himself and his family to the limits with arguing and refusals to eat. When Yang heard about him, he went to the hospital to see this man. Yang sat chatting away happily as the patient ate an apple. Later the man's wife was showing Yang to the elevator, when she broke into tears and cried, "Today is the happiest day for my husband in a long time." They even agreed that Yang should come again to see the man. But when he next got in touch with the family, the patient had already passed away. Yet, they said, he died in a peaceful state of mind.

The work of the volunteers at the ACA is focused on its own members, at the ACA site. Unless they are specifically asked to do so, they will not go to hospitals to see patients. Anyway, even if they wanted to, the hospitals have adopted a cautious attitude. Few hospitals have any corresponding unit to liaise with, and the hospitals also are uncertain about the knowledge possessed by ACA volunteers and are concerned the volunteers will pass erroneous information on to patients.

Cancer fighters themselves have their own psychological barriers to going to hospitals. "It takes a great deal of courage to be a volunteer in a hospital, because we ourselves greatly fear death, and we cannot stay with these patients all the way to the end," says Miss Lin, who reveals the emotions that have kept her from putting into practice her desire to help as a volunteer.

Thus, the only ACA member also formally serving as a hospital volunteer is Mama Su.

Though the bodies of cancer victims are under siege, many acquire a greater depth of understanding of the meaning of life. They have the clear view of one looking far into the distance from a position above the crowd.

Affirm yourself, repay society

Mama Su relates that when she was young, her philosophy of life was to "put gain at the center." Even when she wanted to do something for society, she didn't know how to begin. It was only when she was being wheeled into the operating room that the idea came into her head:"What can I do if I survive?" Of course she did not die, and, thinking back on the tribulations of her own journey, she decided to volunteer for hospital work.

The first place she went to was the Veterans' General Hospital of Taichung, because that is the hospital where her stomach cancer was diagnosed. Tan Chien-sheng, the head of the Department of Oncology at the hospital, posed two puzzlers to her: How would she help those who are facing imminent death? What would she say to young patients who still have hope? Mama Su, unflustered, gave her responses. To the former she would affirm their achievements in life, so that they could leave this world with peace of mind. To the latter she would emphasize how much their families need them, and she would tell them "70% of the difficulty comes from inside your own heads, only 30% is real," with the aim of increasing their will to live. With answers like these, she has smoothly been able to realize her desire to be of service to others.

Because the work of the ACA is mainly focused in the Taipei area, Mama Su has extended herself not only to the Taichung Veterans' Hospital, but also to the Chang Gung hospitals in Keelung and Kaohsiung. She has also established new anti-cancer societies in Taichung and Kaohsiung. The work of these societies is handled completely by cancer patients, to allow those afflicted with cancer to gain the sense of accomplishment and self-affirmation that comes from serving society.

Those in the associations not only make contributions to fellow-sufferers. Their outlook on life can also be very enlightening to healthy people racing around busily every day. Miss Lin's friends all say that she is much nicer since her illness than she was before, and that one always is rewarded by giving her a call, because she can always help them solve their problems by teaching them what is really important in life. "Probably it's because they see someone worse off than themselves," jokes Miss Lin.

Mama Su is an even better example of the way people turn the tables on cancer. You might think her stomach cancer would have struck her as a fateful blow, but she acts in such a way that it seems as if it might have been a blessing. "The bright spot about getting ill is that I have become an example to others. Otherwise I would just muddle through life, and what would make me any different than anyone else?"

Since the future is unknowable, and death will have to be faced in the end, Su Cheng-hsiung simply hopes to avoid pain before going. "Just let us go normally, not in an ugly or degrading way."

Whatever the outcome will be, this group of cancer victims can affirm one thing: They are not alone in their fight against the disease. By coalescing the strength within themselves, in their families, and in other victims, the struggle against cancer need not be quite such an uphill battle.

[Picture Caption]

p.120

In the long days battling cancer, what sufferers need most is the long-term support of their families.

p.122

Only about 5% of victims survive cancer of the pancreas, but Yang Chung-fa is already entering his fifth year beyond his prognosis. He gets up early every day and exercises, and is in far better shape than most people.

p.123

Since being diagnosed with intestinal cancer, Huang Kuan-jen often eats fresh, unpolluted, low-fat foods. He even grows many of his own vegetables.

p.124

Cancer victims take the chance to return "home" (to the association) for seminars. Here they can exchange experiences and information.

p.125

Momma Su works as a volunteer in a hospital, encouraging cancer patients from the perspective of one who has been there.

p.126

Though the bodies of cancer victims are under siege, many acquire a greater depth of understanding of the meaning of life. They have the clear view of one looking far into the distance from a position above the crowd.