Asking people with cancer to change their beliefs, to understand that they can recover and live a full and rewarding life—despite their own fears about the disease and the negative expectations of the people around them—is asking for a great many acts of courage and personal strength. Yet all of our experience has shown us that many cancer patients have been capable of achieving this courage and strength. To help them in the effort we first attempt to counterbalance society's negative beliefs about cancer with positive counterparts.

The beliefs listed in the "positive expectancy" columns are, as we have been showing, justified by modern scientific research—more justified than the "negative expectancy" beliefs. However, the difficulty in persuading people to change their beliefs from negative to positive is that they generally have had negative experiences that "prove" the validity of their beliefs. In effect, then, we seem to be asking that they deny their own experiences and take on beliefs inconsistent with what they "know." Our point is that the negative experiences these people have had were not necessarily inevitable; the experiences have been shaped in part by original negative expectancy.

The same power that allows us to create negative experiences can be used to create positive experiences. And while there may be limits to the role that expectancy plays, no one really know what these limits are. Unquestionably, then, it is desirable to have expectancy working for, not against, the cancer patient..

Some readers may feel that since their own. expectancy is negative, they are necessarily going to have a negative outcome.

This is not the case. We have had many patients who started with a negative expectancy and learned a positive one. The essential first step in changing an expectancy is to become aware of what you believe and its potential effect. Just reading this chapter should do that for you. Later in the book, we will describe step-by-step the methods that we use to help our patients work toward a positive expectancy.

The Question of "False Hope"

We are sometimes asked, "Aren't you giving your patients false hope?" Our answer is "No," we are giving our patients reasonable hope. Our approach does not guarantee recovery. But the question of "false hope" suggests that people should never have hope if there is a good chance they will be disappointed. Such a belief provides no basis for living a full life or for dealing with a threat of life.

We enter marriage with no guarantee that it will be a happy and fulfilling experience. If we approach marriage with the expectation that it is bound to fail, it certainly increases the probability that it will fail. A positive expectancy does not guarantee a successful marriage, but it increases the likelihood of a good marriage and improves the quality of the relationship.

Since the first pages of this book, we have discussed how significant we believe a patient's view of his or her own prospects for recovery to be in the process of getting well again. Patients who have worked hard using our approach have still died, although in many cases they have significantly outlived their prognoses—and lived a more rewarding life than they would have had they not actively participated in their treatment. Yet death appears inevitable for us all. And our program includes activities designed to help the patient confront the possibility of death openly—an attitude that frees energy for living.

People who are concerned about "false hope" often see themselves as realists, people who see life "as it really is." But a life view that does not include hope is not realism but pessimism. This stance may avoid disappointment, but it does so by actively shaping negative outcomes.

Hope is an important element in survival for the cancer patient. Indeed, hopelessness and helplessness are frequent precursors of cancer. The hope we try to impart is essentially a stance toward life. It is not just a matter of philosophy, but of survival. For each patient, the process of getting well includes redefining his or her own stance toward the experience of a life-threatening disease so that there is hope.

Another concern expressed by people who talk of false hope is that this approach to illness is some form of quackery. It is true there are a number of nontraditional approaches to cancer treatment that do not appear to have a scientific basis. Still, it is not always easy to make definitive judgments about their worth, for supporters of such approaches are occasionally able to point to recoveries reportedly occurring as a result of their treatments.

The case of Laetrile is probably the most notorious recent example of "miracle cures" for cancer. Although there are no studies in reputable medical journals documenting Laetrile's effectiveness, there are numerous cases of cancer patients who attribute their recovery to the use of the drug. The placebo effect may well be the explanation for these cures, although this, too, is still unproven. Yet, even if it is proven that Laetrile, or other nontraditional approaches to cancer treatment, work because of the placebo effect, this is still a significant finding, for it will further demonstrate the extraordinary degree to which belief can materially affect the outcome of treatment. Then, rather than focus solely on the form of medical treatment, medicine may begin to focus on the psychological power of belief itself.

By openly focusing on belief and using it to reinforce and support both the body's natural defenses and the best medical treatment available, we are in the process of developing a medical approach that is supported by scientific research.

Continuing to ignore the role that the mind and emotions play in recovery—in spite of the medical evidence that now exists— may be considered a form of quackery because it disregards other proven techniques. The real issue is no longer whether the mind and emotions affect the course of treatment; the question is rather how to direct them most effectively in support of it.

Changing Your Beliefs

Some readers may still be having difficulties accepting the ideas we have proposed. This is not surprising. It has taken us years, not just a few hours of reading, to come to understand and accept these concepts. It could not be otherwise— and it should not be otherwise. Beliefs too quickly gained can be as quickly lost, while those arrived at over a period of time, are more likely to be retained. Our experience has shown that patients who have slowly, sometimes even grudgingly, altered their beliefs have done particularly well in our program. The time taken in consideration and internal argument has allowed them to integrate their new beliefs into all aspects of their personality and behavior.

The starting point for changing negative beliefs, then, is simply to become aware of the manner in which beliefs affect outcomes in many areas of your daily life. Once you begin to see how the process of creating experiences through beliefs works for you, you may find it easier to apply that concept to illness and to use it to gain health.

It is also essential for you to understand that you can influence your own attitudes. When you are convinced it is desirable to do so, you are capable of changing them. All our patients, and we ourselves, continue to have doubts at times or become aware of vestiges of old beliefs. But it is the effort to acquire positive beliefs and the recognition that we can change that are the important elements.

Many of the techniques and processes we will describe are means of reinforcing beliefs or of assisting people to identify how a new belief applies to their lives. We welcome you to explore them with whatever degree of openness is comfortable for you. Simply by exposing yourself to these processes and ideas you will become sensitive to alternative ways of viewing life, and ultimately your beliefs may begin to change.