Can someone diagnosed with terminal cancer actually be in denial that they have cancer?

My phone was on my desk as I was working at my job in employee benefits on the morning of March 20, 2018 when it started buzzing with the “you have a text alert”. As I grabbed my phone to open the text message, I realized it was one of those texts you hope you never receive. It was a text from one of my golfing buddies who was letting me know that a joint friend of ours, who I will call Vinny, passed away that morning from his 3-year battle with colon cancer. I was in shock as I read the text in disbelief that Vinny was gone. My hands started to shake, and my eyes moistened as I was on the verge of crying at my desk. I thought to myself, wow, I knew Vinny was battling cancer, and I heard he was not doing well, but I did not think it was this bad. You see, Vinny was just a few years older than me (56), he had the same type of cancer which I had (colorectal cancer) and we worked together in the energy business for many years. It was one of those jobs where everyone was pretty close with each other. His wife and my wife work in the same school system. Hearing that Vinny had died was just hitting a little too close to home for me, and I started to think of all the things I meant to reach out to talk about with Vinny.

I was sad that I would not have any more chances to follow-up with Vinny about the spiritual conversation which we had the previous summer. Let me explain what happened the last time we saw each other…. After not seeing each other for a few years, Vinny and I got together during the summer of 2017 to re-connect and discuss all things cancer. He knew I was a survivor and we both knew it would be comforting to get together and talk about our shared colorectal cancer experiences. As we caught up over some hot chocolate at Panera Bread, Vinny provided me with a more detailed history of his cancer experiences to date. Vinny went on to tell me that after he had been diagnosed with colorectal cancer, he went through some initial chemotherapy treatments and then he had the big surgery (laparoscopic) to remove part of his colon and was eventually given the news that every cancer patient wants to hear that “he was in remission”. Unfortunately, Vinny explained that less than a year went by until he heard the news from his oncologist that his cancer was back. He went on to tell me that he had recently begun chemo treatments to battle his cancer this second time around. I knew that Vinny had a real battle ahead of him. I work with so many people with cancer in my role as Ministry Coordinator for the Cancer Support Group (CSG) at my church and I have come to realize that when cancer comes back a second time (after receiving the remission news) the chances of beating it go down significantly. This is why I can still remember my colorectal surgeon saying to me, “Jim, when dealing with cancer, your first action is your most important action”. My surgeon told me that statement in his office on January 12, 2007, the day after he called me to tell me I had cancer. As you can see, I have never forgotten what he said.

After Vinny updated me on his cancer history, I asked him how he was dealing with the news that his cancer was back, and he responded in a way which I was not expecting. I was expecting him to say something like he was slowing down, taking a medical leave of absence from his job to battle his cancer a 2nd time, and that he was also going to focus on the relationships in life which were the most important. Rather than hearing those types of statements, I heard something like, “Jim I am trying to stay positive, and I am excited about the new job which I (Vinny) recently started”. He told me it was a dream job, and that he was going to be traveling a lot, but he was confident he could manage the new job and his treatments. He was really convinced that he was going to make a significant impact at his new employer. He was obviously concerned about his family and his adult children, but he also said that his new job would be a nice distraction given all that he was going through in his cancer trial. In other words, Vinny felt this new career opportunity, which he was uniquely qualified for, would help him keep his mind off of his cancer trial while he was going through his latest round of chemo treatments. I shared with him some Christian support materials, including some books and CD’s from CSG but he was not really interested in discussing them so I did not push it. We had not seen each other in a while so I was just trying to be his friend and I figured I would see him again. As we were ending our time together that day at Panera Bread, I had no idea that this would be the last time I would ever see Vinny. We talked about getting together again a few months later but it never happened. As his treatments got more intense and as his disease progressed over the coming months, he stopped returning my texts as I am sure he just did not have the energy to do so. Truthfully, I did reach out to him a number of times but looking back I could have and should have been even more intentional about getting together with him again. Because so many things were left unsaid with Vinny, I was very sad when I learned of his passing. As a way to deal with my grief, I wanted to document in this blog post some of the things I should have said to Vinny so that others might benefit and learn from his life and the decisions he made. God has taught me so much in my role as Ministry Coordinator with CSG. It is such a shame when I see friends like Vinny struggling with cancer and I do not take more time share this CSG wisdom in a way which will bring them hope and help them better cope with their own cancer trial.

I remember driving home from our meeting at Panera Bread thinking that Vinny was in denial that he had terminal cancer. As hard as this is to believe, I have seen someone being in denial about their cancer diagnosis happen more times than you can imagine. James 4:14 tell us: “yet you do not know what tomorrow will bring. What is your life? For you are a mist that appears for a little time and then vanishes”. Vinny had not come to grips with the fact that his medical prognosis was less than optimistic and that he needed to at least start thinking about what would happen to his soul should he pass away from his cancer. Matthew 16:26 tells us: For what will it profit a man if he gains the whole world and forfeits his soul? Or what shall a man give in return for his soul? I will come back to this point at the end of this blog post, but I have observed that one of the major stumbling blocks to people coming to faith in Christ is the fact that they have not come to grips with their own mortality.

At Vinny’s funeral calling hours on March 22, 2018, I spoke to one of his closest friends. Both the friend and the wife said that Vinny was in complete denial that death was even a possible outcome of his cancer trial. I learned that Vinny was still working only a few days before he passed away from his cancer. In fact, Vinny spoke at three sessions at a conference the week of March 12, 2018 IN CALIFORNIA! His job was important to him and he was trying to use is as a distraction during his cancer trial. Since he had a home office job, I was told that many of his coworkers thought when they saw him in California that it might be the last time they ever saw Vinny. Everyone, except for Vinny, seemed to know the end of his life was near. Yes, even though he had lost a ton of weight in the months leading up to this trip out west and even though the cancer was everywhere in his body, he still flew five hours to the west coast from Ohio the week before he died! I was told Vinny wasn't prepared at all for his funeral as there were so many decisions left undone like which charity friends could send their funeral home donations to (Vinny had a lot of different causes he was passionate about) and so many other end-of-life decisions. The day before he passed away, Vinny found out that the cancer was in his bone marrow, yet I was told even then he was still unwilling to admit he was terminal. It is ok to be optimistic about your chances of surviving a cancer trial as such celebrations do happen all the time. However, if you are diagnosed to be terminal like Vinny was diagnosed, to be in complete denial that there is any chance you might not make it is what I'm referring to here when I said Vinny was in denial that he had terminal cancer. Vinny could not consider any possibility other than beating his cancer and his actions all the way to the very end of his life proved he was unwilling to come to grips with his own mortality. He was in denial that he had terminal cancer and he also had an unrealistic perspective of the disease.

In ministering to 100’s of people via the cancer support ministry I help lead, I have seen over and over again how a cancer diagnosis, particularly a terminal cancer diagnosis, will cause people to inventory their life and consider their own mortality more than they ever have before. In my last blog post, I mentioned that one of the blessings of a cancer diagnosis for most cancer patients is the element of time to ponder their future and consider the claims of the Gospel and what is of the upmost importance given their limited time left. I also discussed in that first blog post that one of the amazing blessings of cancer is when someone is so graciously humbled by their cancer experiences, realizing their own sinfulness and need for a savior, and then commits their life to Christ so that they might have hope and find rest for their soul no matter the outcome of their cancer trial. It is amazing to me how some people come to faith in Christ because of their trial but many unfortunately do not. Only God knows where Vinny’s heart was when he left this earth, but he never expressed to me that he turned his heart over to Jesus. John 3:5 tell us: “Truly, truly, I say to you, unless one is born again he cannot see the kingdom of God.” This verse tells us unless you are born again and have a personal relationship with Jesus Christ, you will not get into Heaven. Christianity is an exclusive club but it is not exclusive in a way that many might think it is. No matter your nationality, race, income level, creed or past, all are welcomed and encouraged to put their faith in Christ. In other words, there is unlimited and unrestricted access to all who believe in Christ. 1 John 2:2 tells us: “He (Jesus) is the propitiation for our sins, and not for ours only but also for the sins of the whole world.” Yes, the bible says Jesus is available for everyone in this world. The exclusive part of Christianity, which many in our society find to be extremely offensive, is that you can only get to heaven by having put your faith in Jesus. Matthew 7:13-14 tells us: 13"Enter through the narrow gate. For wide is the gate and broad is the road that leads to destruction, and many enter through it. 14But small is the gate and narrow the road that leads to life, and only a few find it. In other words, the exclusive part of Christianity is the narrow gate which can only be opened by having a personal relationship with Jesus.

There was a man, who I will call Jeremy, who came to our Cancer Support Group (CSG) meetings the past few years and he was battling stage 4 male breast cancer. Yes, males can get breast cancer, but it is just not as common in males’ as it is in females. Jeremy reminded me a lot of myself in that he was always looking for humor in everything he talked about. He would cause our group to roar with laughter when talking about something as frightful as cancer. Jeremy had a unique gift to make people laugh, and he knew it, and he used his unique gift in encouraging and creative ways. I also learned that Jeremy used laughter as a distraction and as a way to avoid talking about important subjects like his own mortality and the fate of his own soul. He would go on and on about a lot of things and you always enjoyed when he spoke but he never spoke about the things which God says are the most important, including someone like him who had terminal cancer.

As his health slowly declined, I do not believe Jeremy ever made it to CSG in 2018. In late January, he fell and ended up in the hospital. Two of our CSG members visited him while he was in the hospital and they said Jeremy went on and on for over two hours about all the things which he had accomplished in his life. I heard he told some great stories about his past jobs, family moments and worldly experiences. Since he attended our group so many times, Jeremy knew that our mission at CSG is to see those impacted by cancer become committed followers of Christ and he knew those two visitors in his hospital room that day wanted to talk to him about his faith, but he chose to talk about other things which were more important to him. Another one of our members visited him in the hospital a few days later, and, after the visit was over, the second visitor told me in a phone call afterwards that Jeremy had not yet committed his life to Christ. After trying to schedule a time to visit him for weeks, I was finally able to schedule a visit with Jeremy at his home on March 4, 2018. Jeremy and I always had a good relationship and it was a humbling privilege to visit him and his wife in their home that day. Jeremy explained that he had lived all over the world and had been exposed to many different religions. As a result of all the different religious perspectives he had been exposed to, Jeremy said he did not believe in the exclusivity of the Gospel message and that he found merit in the beliefs of all the religions which he had been exposed to. In other words, he never made a decision on which religion he wanted to put his faith in. I am not sure if it was because he never took the time to investigate each of these religions so he could better comprehend them or if it was because of some other reason but he was essentially making up his own religion by not making a choice on which religion he ultimately believed in. By what they believe and stand for, the various religions of the world are in conflict with each other. As we talked about earlier in this blog post, Christianity is an exclusive club so pieces of Christianity cannot be shared with or put together with pieces from the other religions of the world to create your own unique religious belief system. I do not think he purposefully was trying to create his own religion. Rather, I believe he was unable to come to grips with his terminal condition so the different pieces of the worldly religions perspective he suggested to me was just an avoidance tactic which he used to avoid talking about the true fate of his own soul. While I was visiting with him in his house, I respectfully reasoned with him for over an hour about the truths in the Bible and the hope which Christ can bring to someone with terminal cancer. More than once while I was there, Jeremy said he was still unwilling to commit his life to Christ. Because hospice had been called in a few days earlier, I was sad about his perspective as I knew the time he had left might be limited. However, I also realized that it is only God who can save a soul so there was nothing that I could do other than to pray to God for Jeremy to turn to Him in repentance and faith and to put his faith in Christ. While I was visiting Jeremy, I needed to serve God and do my best to respectfully relay the message of the Gospel, but the rest was up to God.

One of the things which I have thought about many times since I visited Jeremey that day is the fact that he said he was hopeful to return to CSG in a month or two. He was also looking forward to seeing his family later that week but there was no talk about the fact that he might not make it. He was in the care of hospice and was unable to move from his bed and he could barely speak but his focus was still on beating his cancer and returning to his life and his plans. Since the cancer had started to interfere with his voice box, his wife had to translate for me many of the things which he said that day – Jeremy would just nod in agreement so it was obvious to me they were in agreement on these topics which we were discussing. He was not willing to talk about the fact that he might die – he just wanted to avoid the topic of his eternal destiny altogether. Similar to how I had seen him act during his whole cancer trial, Jeremy was in complete denial that he had terminal cancer and that it might kill him. This is hard for me to write as I do not want to come off as judgmental as it is only God who can open someone’s eyes to His truths and it is only God who can save souls. 1 Corinthians 1:18 tell us: “For the message of the cross is foolishness to those who are perishing, but to us who are being saved it is the power of God.” Jeremy had heard the message of the cross and, based on what he said to me the last time I visited him, it was still foolishness to him. I do not believe this foolishness perspective was an intentional response by Jeremy but an unintentional one. There are three potential responses to the Gospel: 1. Belief, 2. Undecided or still thinking it through, 3. Denial/Rejection. The latter two responses unfortunately result in the same outcome – rejection of the Gospel. As the Bible says so many times, belief is the only way you can have a relationship with Jesus. Acts 16:31 tells us: They replied, "Believe in the LORD Jesus, and you will be saved-you and your household." Only God knows if Jeremy’s heart and his beliefs changed after I left him that day. However, if he remained in the undecided court or in the all religions offer something good perspective which he shared with me that day, then he was unintentionally rejecting the Gospel as foolishness.

The humbling reality is that we are all terminal but most of us do not think about this and do not have to deal with our own mortality until we get a diagnosis like cancer. We are all one day closer to our own death today than we were yesterday. As I was leaving his house that Sunday, I promised to mail Jeremy a hardcopy of my first blog post and he agreed to read it. Unfortunately, Jeremy died three days later and was never able to read it, his wife told me at his funeral. I visit a lot of folks in hospice and, although Jeremy was not in good shape, I thought he probably had weeks or months to live. There was no morphine pump hooked up to him, and he was still able to interact with visitors like me. Many cancer patients lie lifeless in the hospice bed for weeks. God obviously had other plans for Jeremy’s life. I heard he played sudoku the morning he died, before going downhill from there and passed away in the mid-afternoon, five hours before his daughter arrived from Europe. It is amazing to me how quickly someone can pass away when it is their time to go.

Wow, in two weeks, two stories about two friends (Vinny & Jeremy) who were both in denial that they had terminal cancer and the realities which accompany such a diagnosis. Why do the circumstances of cancer cause some cancer patients to turn their lives over to Christ yet others either deny that they have cancer or they fail to have a realistic perspective of the disease and the fact that it could kill them? Only God knows the answer to that complicated question. However, in order to turn their lives over to Christ, everyone, including unbelieving cancer patients, must first admit that they are not in control of their own life and their own eternal destiny but God is in control. This is very hard for most people, including myself, to acknowledge the first time. Cancer patients must also come to grips with the fact their cancer disease might actually end their life as it exists here on earth. If a cancer patient comes to this sort of realization, they must then wrestle with questions like “what happens to me if I die” and “do I have a soul” and “what the eternal destiny of my soul is”. I realize that talking about these types of life and death scenarios and associated questions is easier for me to discuss than it is for others because I have been around cancer and the CSG ministry for over 10 years. I get it – familiarity brings comfort. Just because it is easier for me to discuss doesn’t mean that other people have an excuse to avoid discussing these eternal destiny questions. As described in the John 3:5 verse (“Truly, truly, I say to you, unless one is born again he cannot see the kingdom of God.”) I quoted earlier, denying that you have cancer or avoiding discussions about your eternal destiny altogether is the biggest mistake we can make in our lives. In order to come to faith in Christ, we must all first come to grips with the fact that we are all terminal and that we are all going to die. Once we come to grips with our terminal diagnosis, the bigger question becomes where can we find hope? Jesus provides hope and eternal life to all those who believe in Him, including those stricken with cancer. Terminal cancer may destroy your earthly body but cancer can’t touch your soul. John 3:16 tells us "For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.”

I have visited with Cancer patients on both sides of this belief continuum. Believe me, I have yet to meet anyone who wanted to die at the point that they were initially diagnosed with cancer. However, it is amazing to me how someone who is a Christian can have a perspective of “no matter what happens to me in this cancer trial, I am ready to accept whatever your will for my life is. If God takes my life as a result of my cancer trial, I am ready to meet Him in heaven, just as you promise me you will do for me in the Bible.” Colossians 1:3-4 says that Our hope is laid up for us in heaven. I have met many Christians who believe what I just typed in the first part of this paragraph and the peace they have as they approach their potential homecoming moment is just incredible. Those who don’t know Christ are always looking for the next clinical trial, the next miracle, the next new treatment so they can be cured of their trial and return to their old life. These types of individuals won’t accept anything less than being cured of their cancer and are therefore denying that there is any chance that they may pass way from their cancer. In other words, they are either denying the fact that they have cancer or they have come up with their own view of cancer which is just not realistic. By denying that they have cancer and that it could kill them, these individuals are avoiding the eternal destiny questions which tug at all of our hearts. They would prefer to focus on obtaining a cure for their disease rather than grapple with these tough questions about the destiny of their souls. If you believe that the Bible is the word of God, then it clearly states that these individuals are either willingly or unwillingly denying Christ. For example, Matthew 10:32-33 tells us: 32"Whoever acknowledges me before others, I will also acknowledge before my Father in heaven. 33But whoever disowns me before others, I will disown before my Father in heaven.” These verses in Matthew 10 tell us that anyone with cancer who denies Jesus before they die, He (Jesus) will deny them after they die; However, these verses also say that Jesus will acknowledge cancer patients after they die if they acknowledge Him (Jesus) before they die and this is incredibly good news. If you have cancer and if your ultimate goal is to get into heaven if you die from your disease, then the Bible says Jesus is the truth and the life and He is the only way into Heaven. I would argue that questions about eternal destiny are the most important questions anyone with cancer will ever have to answer in their life.

If you are not a believer in Christ and you are battling cancer, I would encourage you to figure out what will happen to your soul after you die. What is your plan or what is it that you understand will happen to someone after death occurs? In what or in whom are you ultimately putting your confidence and trust? We are all going to die so please don’t be like Vinny and Jeremy and deny you have cancer in order to avoid these tough and thought-provoking questions we all have to wrestle with. Both of them denied the fact they had terminal cancer so they never truly came to grips with the question of what will happen to their souls after they die. Hebrews 9:27 tells us: “And just as it is appointed for man to die once, and after that comes judgment.” If you are struggling with the answers to these questions about the eternal destiny of your soul or if you feel God tugging at your heart, please read the Bible, talk to a believer or reach out to a pastor, and consider the claims of Jesus and perhaps He will change your heart so you will begin a personal relationship with Him. Acts 4:12 tells us (referring to Jesus): “And there is salvation in no one else, for there is no other name under heaven given among men by which we must be saved.” For all those who are battling cancer, I hope the medical professionals can cure you of your cancer but there is no guarantee that this gracious outcome will happen. However, anyone battling cancer needs to be prepared for either surviving or dying from it. Avoiding the later question is like denying you have cancer. Individuals who fail to acknowledge they have cancer, particularly those diagnosed with terminal cancer, have come up with a convenient coping mechanism to avoid coming up with an answer to questions about what will happen to them after they die and the eternal destiny of their souls. If you would like to come to grips with your own mortality and if you would like to have the hope which Jesus provides to those who trust in Him, you can begin a personal relationship with Him today. In order to begin a relationship with Christ, you need to accept your own mortality and you need to also understand that you are not in control of your life but God is in control. He is sovereign but He is also calling you to begin a relationship with Him. Like all of us here on earth, you must also acknowledge that you are a sinner and that you are in need of a savior. If you repent of your sins and ask Jesus into your heart, you can begin a relationship with Him which will change your life and eternal destiny forever.

If you are a Christian and if you are battling cancer, please continue to fight and continue to be a good steward of the amazing medical resources available to those of us who live in this world. However, please don’t let finding a cure for your cancer totally consume your thinking and your desires. There is no reason to fret about when you will pass as God already knows the exact day each of us will leave this earth. Job 4:5 tells us: “You (God) have decided the length of our lives. You know how many months we will live, and we are not given a minute longer.” We all enter and leave this earth with nothing. If you have terminal cancer, the way you can really make an impact on your friends and family is for them to see you living your faith when your life is on the line and the medical professionals say you have no hope. People will be watching you very carefully when the “chips are down and the end is near”. It is how you respond during these difficult times which will make people wonder “what is it that you believe” and “how can these beliefs provide you with so much peace in the midst of a terminal cancer trial”. If you continue to point people to the cross and the hope you have in Jesus, no matter the outcome of your cancer trial, these are the opportunities for you to use your platform of cancer to show people what you truly believe. Perhaps God will use your actions to help change the hearts of your friends and family and those are the types of investments which will pay dividends forever. Only God saves but He can use his servants to help Him do mighty things.

If you are not a Christian and have been diagnosed with terminal cancer and fail to accept the reality of your terminal diagnosis, then your avoidance mentality will likely cause you to avoid seeking answers to questions about what happens to your soul after you die, regardless if your terminal cancer diagnosis ends up being accurate or not. If you are a Christian and if you do end up passing away from your terminal cancer, then you are not truly terminal because Jesus offers eternal life to all those who believe. In John 11:25 Jesus says to Martha, “I am the resurrection and the life. Anyone who believes in me will live, even after dying. Everyone who lives in me and believes in me will never ever die. Do you believe this, Martha?” What an interesting dichotomy this is: if you avoid facing your own mortality head-on when you have a terminal condition like cancer then you truly are terminal. However, if you have terminal cancer and if you are willing to acknowledge your terminal condition and this realization causes you to start seeking answers from God which ultimately causes you put your faith in Christ, then you truly are not terminal anymore.

As we approach Easter (April 1, 2018) please remember that it is not about eggs, candy and the Easter Bunny. Even though my Mother-in-law gives me a chocolate Easter bunny every year, and I look forward to devouring it each time I receive it, the story of Easter is the message of the cross and how Jesus died and then rose from the dead to sit at the right hand of the Father to offer hope to everyone who believes including those stricken with Cancer.

Jim Risk, a two-time cancer survivor, is the volunteer Ministry Coordinator for the Cancer Support Group at a non-denominational church in NE Ohio. Jim and his wife, Kristina, have participated and served in CSG, a Christian ministry, since 2007. They have had the humbling privilege to minister to hundreds of people with cancer as well as many of their caregivers since 2007.