"Why Do I Have Cancer?" Kismet, Chastisement or Coincidence?

Is the reason I got cancer because of fate, punishment...or is it just part of the human experience? Show Notes

How people receive a cancer diagnosis is variable. Their reactions can range from anxiety, fear, and depression to feelings of guilt. They may feel cancer is a punishment for past actions or failure to practice a healthy lifestyle. This week we dive into these emotional reactions.

Our guest Dr. Jeanna Ford shares cultural perspectives on cancer and how people such as veterans may have self-blame. For example, thinking cancer is a punishment for something they did in the Vietnam War. Learn how Dr. Ford helps them through these feelings. 

In this Episode:

• 01:50 - Celebration of our 250th Podcast!
• 02:35 - Recipe of the Week: Cincinnati Chili
• 03:57 - How Did Valentine's Day Start?
• 06:41 - Why Do I Have Cancer? Views
• 07:07 - Is Cancer Just Kismet - or Fate?
• 08:18 - Some View Cancer as a Gift
• 09:23 - Cancer Viewed as Punishment or Bad Karma
• 11:58 - How Shame and Stigma Affect Us
• 15:13 - Dr. Jeanna Ford: Self Blame for Cancer Common in Indigenous Communities and for Veterans
• 29:44 - Outro

Chapters

• 0:00 Intro
• 0:00 Celebration of our 250th Podcast!
• 0:00 Cancer Viewed as Punishment or Bad Karma
• 0:00 How Shame and Stigma Affect Us
• 2:30 Recipe of the Week: Cincinnati Chili
• 3:57 How Did Valentine’s Day Begin?
• 6:41 Why Do I Have Cancer? Views
• 7:07 Is Cancer Just Kismet – or Fate?
• 8:18 Some View Cancer as a Gift
• 9:23 Cancer Viewed as Punishment or Bad Karma
• 11:58 How Shame and Stigma Affect Us
• 15:13 Dr. Jeanna Ford: Self-Blame for Cancer Common in Indigenous Communities and for Veterans
• 29:44 Outro

Transcript

This podcast does not provide medical nor legal advice. Please listen to the complete disclosure at the end of the recording. Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement.

I'm Marianne Matzo. I'm a nurse practitioner and I used my experience from working as a nurse for 46 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City, and here to offer an every-person viewpoint to our podcast.

We are both here because we believe that the more you know, the better prepared you are before an end-of-life crisis hits. So welcome to this week's show. Please relax, get yourself a handful of candy conversation hearts, and thank you for spending the next hour with Charlie and me as we continue with our series titled, Everything You Always Wanted to Know About Cancer, But Didn't Have Anyone to Ask, with a conversation about how a cancer diagnosis is viewed.

Like the BBC, we see our shows offering entertainment, enlightenment, and education and divide that into three halves to address each of these goals. Our main topic is in the second half, so feel free to fast forward to that yak-free zone. In the first half, Charlie has our recipe of the week and a little valentine for all of you.

In the second half, I'm going to continue our series about cancer and how a cancer diagnosis is viewed in terms of karma or punishment. In the third half, we welcome back Dr. Gina Ford, a clinical nurse specialist who will be talking about a Native American view of being diagnosed with cancer. Hey, Charlie.

Yeah, I don't owe you money, right? Probably. Do you know what podcast this is? I'm sorry, what? This is our 250th show. You can never have too much cowbell, Charlie.

Yes, cowbell. We need more cowbell. 250, Marianne? Yeah.

Geez. Yeah. One a week for the last almost five years.

That's nuts. Yeah. It seems like it was only yesterday.

So, in our first half, the Everyone Dies Road Trip has us in Ohio this week. Ohio gets its name from the Iroquois word, Oy Ho, meaning Great River. Additionally, Ohio was a crucial state for the Underground Railroad, providing escape routes for thousands of slaves seeking freedom, and Ohio was home to the world's largest collection of trolls.

Let that sink in, ladies and gentlemen. But when it comes to food, Cincinnati chili wins the prize. In the 1920s, two Macedonian brothers opened the Empress Chili Parlor in the corner of a theater.

Patrons could order chili on hot dogs or spaghetti, but it was a chili that was outstanding, saucy and seasoned with the familiar cinnamon of the brother's homeland. The dish spread across the city as other entrepreneurs tweaked the recipe. Over time, the elements of a legend emerged.

Grated cheddar on top, a three-, four-, and five-way ordering shorthand, and the addition of cocoa powder to the pot. Well, now you, our loyal listeners, can be a part of this legend by making Cincinnati chili for your next funeral lunch. Bon Appetit! To complete our second half, as we are releasing this episode for the first time on St. Valentine's Day, we decided to review the death and myth of St. Valentine.

Variations abound. Around 265 AD, the Roman Emperor Claudius created a law that young men are not to marry. He believed that they would fight more with abandon in war if they didn't have a wife and family to worry about.

What was a young person who wants to tie the knot to do? So, that crazy romantic St. Valentine secretly married couples. Of course, Emperor Claudius found out, otherwise what's the point of the story, and put him to death. National Public Radio tells us that Emperor Claudius executed two men, both named Valentine, on February 14th of different years in the third century.

Their martyrdom was honored by the Catholic Church with the celebration of St. Valentine's Day. We also have the Normans, Rockwell and Bates, who celebrated Gallatin's Day, which was defined as lover of women. Chaucer and Shakespeare, ask your high school English teacher, romanticized it, which popularized the story.

We also have the story that St. Valentine wrote the first Valentine greeting to a young girl he tutored and fell in love with, while he was imprisoned for the crime of officiating soldiers' weddings. According to the History Channel, he wrote her a letter signed, from your Valentine, before dying. Eventually, the tradition made its way to the New World.

In 1913, we get Hallmark cards, which began mass-producing Valentines, and we have been paying for it ever since. Ask your parents. Please go to our webpage for this week's recipe and additional resources for this program.

Everyone Dies is offered at no cost, but is not free to produce. Please contribute what you can. Your tax-deductible gift will go directly to supporting our non-profit journalism, so that we can remain accessible to everyone.

You can also donate at www.everyonedies.org. That's every, the number one, dies.org. Or, at our website on Patreon, www.patreon.com, and search for Everyone Dies. Marianne? Thanks, Charlie. We talked last week about how cancer develops, that it's a mistake that happens in cell division.

How people view the cell error when receiving cancer diagnosis is variable. These reactions range from anxiety, fear, and depression to feelings of guilt related to thinking cancer is a punishment for past actions or failure to practice a healthy lifestyle. Cancer can be viewed as kismet, which is our lot in life or our fate.

When we encounter something by chance, then it could be kismet or our destiny. For example, Dr. Peter Goldsworthy wrote about his cancer diagnosis in 2024 and said, quote, karma is to blame. No use complaining, I tell myself.

I've led an undeservably lucky life, and my luck has finally run out. Getting cancer is just some sort of overdue rebalancing of the cosmic equilibrium. Apart from that stint in intensive care in my late teens, my life has been blessed beginning from the first luck any of us can have, the big birthright lottery, the biggest we will ever win or lose.

A big lotto win doesn't come close to genetic luck, geographical luck, familial luck. I hit the jackpot in all of them through no efforts or virtues of my own, end quote. Some people may see the cancer diagnosis as a coincidence having to do with the probability of anyone being diagnosed with cancer.

Any event or object in our life has the power to generate coincidences because it involves a random, independent variable, like needing a chest x-ray for a job and then finding out that there's lung cancer. If there's something linking the variables, the chances of coincidences increase. Alongside this thought is that a diagnosis may be a gift in some way.

I've had patients say this to me after the treatment's over and they have no evidence of disease. One woman told me, I think the cancer was a gift, not in a way that I would want to give this gift to anyone, but more in that it was a gift in helping me learn new things and grow as a person. Dr. Goldsworthy said one of his thoughts after his diagnosis was that, quote, cancer might be good for me, not in the priceless raw material it's given me, but in the lessons it might teach.

Lessons perhaps born of a necessary grounding, a long overdue humbling, end quote. There is also a large group of people that view the cancer as punishment for past misdeeds. Dr. Goldsworthy went down this hole as well by saying, quote, it's a quick jump to a completely weird idea.

I deserve my cancer, not because I was born lucky and can't complain, but because of what I've done with my dumb luck since. I mean, simply, I've got away with enough over the years to deserve some sort of punishment, even if its delivery is pure happenstance and the penalty a tad severe, end quote. Esther Zhu is Chinese and writes about how her, quote, immediate community practice aversion of Buddhism where karmic superstitions and respect for ancestors makes a family's reputation way more important than that of the individual.

Essentially, my parents believe that the immoral behavior of a person in a past life is the reason they get cancer, or an ancestor's misconduct causes incurable illness or bad luck to their descendants. This accumulates as bad karma and the cancer is the punishment, end quote. We don't need religion to tell us we're being punished.

McCarty reported in The Independent that during a round of press interviews outside Congress, Democratic Maryland Congressman Jamie Raskin was approached by a man who allegedly described himself as a, quote, mega-American and told Raskin, who has lymphoma, that God had punished him by giving him cancer. The man also allegedly told Raskin that he was on the, quote, wrong side of history and should repent, end quote. Spirituality and religious beliefs are ways that people may use to overcome their fears of anxiety, to endure treatment, and to find meaning and purpose in the cancer experience.

One religious belief may positively influence cancer treatment is that God is in control of life, death, and illness. Believing that, quote, God is in control and will heal me does not automatically imply that treatment is not warranted or needed, but rather that the prescribed cancer treatment is believed to heal through the power of God, that God gave people to enable healing. Around the world, cancer continues to carry a significant amount of stigma, myths, and taboos that can result in feelings of guilt, shame, or embarrassment.

These feelings may result in people not accessing health care when they develop symptoms, getting support, or even treatment once diagnosed. Feelings of shame can especially come up in cancers that they might be linked to specific behaviors, whether or not those behaviors actually played a role in the diagnosis. For example, people might ask a person with lung cancer, did you smoke? This question is not helpful, you know, whether or not the person smoked.

Another example is a person with an HPV-related cancer, which is sexually transmitted, who feels ashamed about their diagnosis. It's important to recognize that shame differs from guilt. Shame can be defined as a painful emotion caused by the belief that one is, or is perceived to be, inferior or unworthy of affection or respect because of one's actions, thoughts, circumstances, or experiences.

Shame focuses on the self, while guilt focuses on the behavior. It's the difference between saying I'm a bad person because of a behavior and I feel badly about a behavior. Adding feelings of guilt, shame, or embarrassment on top of other painful emotions like sadness and anxiety only intensifies feelings that come with receiving a cancer diagnosis.

Sickness and death are part of the human experience and humans want to find a meaning in life. We want to understand how something happens so we feel as though we have some control. Please remember that cancer can happen to anyone.

It's an illness, not a failing. Questions, Charlie? You know, I am shocked to hear this that, you know, people would, I really, I've never heard of anyone, I can't even put the words together, you know, what you're describing that, you know, that somehow an individual is responsible for their cancer because of, you know, some thing like, you know, a religious belief or you didn't believe enough in, you know, fill in the blank. I've never encountered that.

That's... You've never known somebody who's smoked and then got lung cancer and people would say, well, he deserves it. He was smoking his whole life. Never heard that? No, no.

That, well, I mean, the first part, oh, he, you know, he got, you know, he got cancer because, you know, he's a smoker. Yeah. But then what you were talking about, you know, shaming someone because of it.

I don't know. How thoughtless, you know? Exactly. Exactly.

In our third half, we welcome back Dr. Gina Ford, a clinical nurse specialist for the Department of Internal Medicine at the University of New Mexico Health System in Albuquerque. Gina. Thanks, Charlie, for that nice introduction of Gina.

Gina, it's so nice to have you back again. Thanks for having me. So I was just talking about guilt, shame, embarrassment, sadness, anxiety, all the things that people can experience when they receive a cancer diagnosis.

And I know that you work primarily with Native American and Hispanic population. What have you seen or what you take care of? Yeah. You know, I think, unfortunately, this is something that comes up so often, you know, when we get any type of serious illness diagnosis, but even more specifically with cancer, it's just human instinct, almost like a knee-jerk reaction to ask, why me? What happened? And, you know, even more so in some cultures, I think we start looking inward and looking for blame.

You know, I'm really, I think, being raised in the culture of my family, you know, being Native, I am comfortable speaking to that. A lot of my research is done in that. And what I have seen is there's really this concept of health and wellness, where your health and your well-being are really strongly interrelated.

And that goes with your physical health, your spirituality, and this just kind of permeates every aspect of your life. And it really comes down to living in balance and harmony, you know, your physical, emotional, mental, spiritual well-being. But if one of those is imbalanced, then you're at risk of disharmony and illness.

And so, a lot of people that are very traditional, you know, when there's any type of illness that comes about, then they start looking at, well, what happened? What went wrong? Was there alcohol involved? Was there tobacco involved? Were they not living their life right? What did I do wrong? Was, you know, were I not eating right? Did I not treat my family right? And so, you kind of start going down this rabbit hole of what happened? What did I do wrong? Am I being punished? And I think it's really, really dangerous, you know, and a lot of Native patients will start looking and saying, okay, well, I'm going to do this chemotherapy, I'm going to do the radiation, you know, whatever it is, but I'm also on the side going to look at, you know, restoring this balance with, you know, whether you're living harmoniously, whether it's my spiritual life, repairing relationships, you know, traditional beliefs, really. And so, that way, they can kind of be in more harmony again. And, you know, they'll see some of their traditional healers, in addition to seeking Western medicine, which I think it's fine.

It's absolutely fine. But again, you know, I always tell them, just be upfront, like the oncologist, let them know what you're doing. But I think it's a lot of deep soul searching is what I'm seeing.

And people just immediately feel guilty, like, you know, I really cut up in college, I wasn't faithful to my significant other, I haven't been there for my kids. And this is what caused it, you know, if I've been home more instead of out partying, then, you know, I wouldn't have gotten this cancer. And it's really, really dangerous, the shoulda, woulda, coulda, you know, and I'm sure you've spoken about that.

I mean, there's so many factors that go into a cancer diagnosis, we, you know, for the most part, we have no way of identifying what caused it, you know, unless, you know, with the exception of a few cancers, you know, and I just think it's really dangerous to go down that rabbit hole and saying, well, if I'd only done this, then this wouldn't happen. If I'd only done this, and I've even seen, you know, it goes so far as saying, well, I'm not going to take my pain medicine, because this pain is part of, you know, the illness, and this is what I deserve. You know, this is my lifestyle choice, therefore, I got this cancer, and this is, you know, my penance almost.

And so, it really, it really is, it's difficult to watch people navigate this and really struggle with this and view this as their lifestyle choices, behavior, even just a personal failing, rather than considering the broader societal or even systemic factors that have contributed to these health issues. So, are there traditions or rituals within the Native American population that are done to restore balance? Yeah, there are, and, you know, here in New Mexico, you know, there's many, many different Pueblos and tribes, and even in Oklahoma, you know, originally, there's many tribes there, and with each tribe, they have their own traditional beliefs and different things that they can do to help restore their balance, their faith. And, you know, each tribe has their own religion, their own life ways, their own culture, their own language.

And so, there's going to be some similarities, but it will vary from each person. And then also, the degree of acculturation. So, what some people may subscribe to their beliefs may not be as much as the next person, even within the same tribe.

And so, you know, it really, you know, it's not a one-size-fits-all, you know, for each person, even if they come from the same tribe, you know, and just kind of asking them, you know, where their beliefs are on this and what we can do to help them with this. I think that that's really important. And, you know, even shifting gears a bit with some of our Hispanic patients, you know, I see this a lot, and there's a really strong religious undertone with some of the Hispanic patients that I see, primary Catholicism.

And there's a lot of, I think, you know, questioning on that, you know, wondering, you know, is God punishing me? What did I do wrong to, you know, why is God allowing this to happen to me? You know, I've even taken care of veterans before, wondering, is this something that happened, you know, that I'm being punished for that I did in the war in Vietnam? You know, and so, it's really, really kind of, it almost launches them into existential distress or spiritual distress. And, you know, I'm comfortable helping to a certain point that I feel like that's really when we need to pull in our chaplains or, you know, spiritual experts or, you know, religious, you know, if they belong to a parish, you know, talking to the priest, because, you know, that is something that's very, very deep rooted in their faith. But, you know, again, I think, you know, really kind of trying to talk to them about this again and saying, you know, that this is, you know, unfortunately, very, very common.

Cancer is very common. And, you know, we don't want to spend our precious energy and time on what caused this. What did I do wrong? Because most of the time, you know, we didn't do anything wrong.

These things, you know, it's just really shitty and it just happens. And so, let's focus on what we know. What do we have? What are the facts? And, you know, what do we have at hand? And let's focus on that and what's coming up.

Let's talk about what we can do about this. You know, what about our treatment? What can we do about that? Let's focus on that. And, you know, the social stigmas that go along with that, because that really, you know, that adds more stress on top of stress and depression.

And it doesn't help with this whole, the whole journey, because this road is hard enough as it is without adding that type of pressure on it and just reminding them, you know, getting cancer is not your fault. It's not anybody's fault. You know, I'm sure you've spoken about it.

There's just random mutations that happen. And, you know, I think people inherently blame themselves because they're trying to make sense or get control out of something that we have no control over. And so, it's really important that we talk about that and just kind of normalize saying, this is not your fault and you're not being punished.

And, you know, and really kind of normalizing that and saying, it's okay. And, you know, I don't know why these things happen, but I'm here with you during this. Do you think people, is it your experience that people believe you when you say it's not your fault? It's just something that happens? Are they able to kind of get past sort of the indoctrination that we, that we feel, you know, that we had from the church or whatever? Yeah.

You know, it really is kind of 50-50. I've had, you know, some people come in, some couples come in and you can just see the release wash over their face and they're like, thank you. We needed to hear that.

I needed that permission to let this go. I've had others where I've had multiple conversations about this, you know, and I think it really just, there's so much that goes into this. You know, I am one that I would probably, you know, I don't practice what I preach.

I would probably feel guilty. You know, I think like any good Southerner, you know, I'm going to feel guilty about it and, you know, chew on it, wear it in my hair and let everybody know that this is my fault. I mean, I don't think, you know, I could practice what I preach.

So, I'm not, you know, judging them for this, but I think some things are easier to let go than others. But I have talked to some people and, you know, I've even seen them just start weeping and saying, thank you. I needed to hear that.

I needed to be able to let this go. And then I've had others where I've multiple conversations about this. And, you know, but I also don't feel like I'm there to change anybody's mind.

I'm not going to change years of religious beliefs and years of cultural beliefs. That's not what I'm there for. I'm there to give them permission to let this go, but I certainly can't undo any type of, you know, deep-rooted teachings, indoctrination, anything like that, you know.

And, you know, I'm really there to listen and be with them on this journey that they go through this. And so, I've had some people, you know, weep and say, thank you. I've had some people like smiling on be like, okay, yeah, no, I know you're wrong.

This is still my fault, you know. And so, I think it goes from one end of the spectrum to the other. And so, you know, I just do what I can to be there for them, but I don't want them to carry that.

And, you know, I always tell all of my patients, you know, this is really tough and there's going to be some days you have to take it day by day and even hour by hour. But one thing, you need to give yourself some grace because this is, this is tough, you know, and I do want them to do that. And one thing we don't need to do is go around blaming ourselves or blaming our spouses saying, well, if you had cooked me better food, I've even heard that and not fried everything, this wouldn't have happened.

Or I'm mad at my parents for smoking and exposing that, you know, me to the second and third hand smoke my whole life. This is why, you know, because that's not going to do anything right now. There's nothing we can do about that.

We need to, you know, deal with the situation we have at hand. And hopefully, you know, each generation, you know, we'll, we'll learn more about, you know, cancer. And we talk, hear a lot about, you know, make good choices, make good choices with the information that you have.

And each generation is going to make, hopefully, I hope, better choices as they go along, as they have more information. You know, we do the best we can with the information that we have, right? Absolutely, absolutely. And you can see how much, you know, things have changed over time.

You know, before they used to tell people, you know, women when they were pregnant, they were stressed out to smoke. I mean, now we think that's completely horrible. But you look at pictures in the 50s, you see pregnant women smoking all the time, and it was okay.

And so, you know, again, we do the best with what we have. But I think we really are trying to get away from the blame culture, because that really is just a serious threat to patients. And, you know, especially, they don't need to carry that around on their shoulders, you know, that there's so many systemic problems that go into that.

And there's so many other things to focus on. And that is one thing they don't need to lug around with them. Well, Gina, I appreciate that.

And, you know, I hope our listeners take what you said and decide to, you know, leave that bag of guilt or the religious blame, or whatever it is that's bearing down on them, just, you know, drop it off, leave it somewhere and put your energy into, you know, managing your cancer and loving your family and, you know, having cancer and treating it is hard work. And we're going to get to that later in our series. But you don't need to lug around all that guilt.

Absolutely, absolutely focus on what we know. And like you said, put your energy into what we know that is good and true and the important people in your life. And it's much better, much better focus on your time and your precious energy and instead of looking backwards.

Well, Gina, thank you for using your precious time to come in and talk with us and give us your perspective. We really appreciate that. Well, thank you for having me.

Thanks, Gina. And that's it for this week's episode. Please stay tuned for the continuing saga of Everyone Dies.

And thank you for listening. This is Charlie Navarrette, and from the playwright Jack Thorne, those we love never truly leave us. They are things that death cannot touch.

And I'm Marianne Matzo, and we'll see you next week. Remember, every day is a gift. This podcast does not provide medical advice.

All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages and any other discussion are for informational purposes only, and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk.