[Linda]

It's hard to imagine in this day and age, when people talk openly about almost anything, that there still exists a stigma around people who are diagnosed with cancer. A stigma, which literally means "a mark on the body of disgrace or reproach," is as old as the disease itself. Many people may think of a diagnosis of heart disease or diabetes as "bad news." But, many people with cancer feel "marked" by the disease. This may be because cancer or cancer treatment can change the appearance of your body. You may feel "marked" by surgical scars, the loss of hair from chemotherapy, or the loss of body parts. The notion that cancer could, in some way, represent a defect or lessening of your identity and abilities does not go away easily. We live in a society that celebrates health and beauty. Those of us with scars or other signs of illness can feel like they're on the outside looking in. We must realize that many people still regard cancer as a death sentence, and may in some way feel that people diagnosed with the disease are "victims" rather than "survivors." Returning to the workplace presents another set of stigma issues to deal with. Many cancer survivors report being treated differently by employers and colleagues as well after their diagnosis and treatment.

[Narrator]

To lose the stigma of cancer, survivors have to make themselves visible to others who may be afraid to confront their own fears about cancer. At a time in your life when you want to be treated like everyone else, or more importantly, the same way as you were treated before you were diagnosed, the reality is that your life after cancer is different. Allowing other people to impose a stigma on you could confirm your own worst fears about having cancer. Keeping a positive attitude in the face of any such stigma is a challenge that survivors must confront head on.

With all this discussion about living with fear and uncertainty, the good news is that studies show that cancer survivors are among the most resilient people when it comes to their ability to recover emotionally and regain their optimism. And they can learn to be hopeful about the future. The distinction between optimism and hopefulness is an important one for survivors who are living with uncertainty and fear. Optimism emphasizes the positive aspects of any given situation. Hope, on the other hand, can be defined in many ways and is an essential experience of the human condition. It functions in different ways in families and across cultures, but universally it is a way of feeling, a way of thinking, a way of behaving, and a way of relating to the people in your world. Hope is a necessary element for healthy coping that can help you avoid despair. Hope is also a reflection of the desire to make life under stress bearable. It is important to think about the ways in which you hope, and to be direct with family, friends, and professional caregivers about what is most helpful to you. Never let anyone tell you that there is nothing further to hope for, or that there is no hope. There is always something to hope for. You, as an individual, have the right to determine what you hope for and when and how you hope.

Over many decades, cancer survivors have discussed their fears and their hopes, their feelings of anxiety and uncertainty. Cancer survivors have shared these emotions with each other in support groups, in waiting rooms, and over the telephone. With few exceptions, they report that the act of openly acknowledging their fears is, in itself, a way of gaining a sense of control and maintaining a sense of hopefulness.

Cancer survivor, Ellen Stovall, sees that the path to dealing with uncertainty begins with good communication between you and all the people from whom you seek support. 172. Ellen Stovall: With communication comes understanding and clarity; with understanding, fear diminishes; in the absence of fear, hope emerges; and in the presence of hope, anything is possible.

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