For much of his career, Dr. Anil Abraham Joy has watched patients and clinicians deal with cancer diagnoses. “It’s amazing to see how people deal with all of this,” he says, from his office at the Cross Cancer Institute. Since the beginning of his training, Joy has been quietly considering the life-altering implications of cancer diagnoses, and wondering what sets apart those patients and clinicians who cope well with a diagnosis from those who don’t.
So he got to work with colleagues across the country and considered some of the elements that oncologists and their patients need to consider for a healthy life. “It’s not just from the cancer perspective, but also from a life perspective,” he says. “As I started to think about all this stuff, and reflecting on what I’ve seen time and time again, I realized this is not just specific to oncologists or cancer patients, it’s applicable to everybody.” The researchers expect to publish their findings this winter.
Joy, along with Dr. Mark Clemons and Dr. Carmel Jacobs, set out to consider a philosophical question: how can we live a healthy life? The idea came in the early part of 2015, with drafts of their paper being revised over a couple of months. It has turned, slowly, into a kind of op-ed for medical professionals. “Looking after cancer patients is highly rewarding, but can become emotionally draining,” says Clemons. “It was evident to Dr. Joy and me that, given the high rates of physician burnout, we needed to warn doctors to look at themselves and ensure that they are adopting healthy lifestyle choices. Failure to do so is bad for the physician, their families and their patients.”
At first, the article set out to try and consider self-care from an oncologist’s perspective. Joy later intended their work to take two forms – a paper that addressed patients and another that looked specifically at oncologists. “The more we started digging into all this, the more we realized it was applicable to all,” he says. The paper directed to oncologists is titled “Hallmarks of Happiness,” a nod to the famous Hallmarks of Cancer papers and framework. “We propose the ‘Hallmarks of Happiness’ that we feel should be of equal importance to know, understand and practice for anyone involved in cancer care,” they write in the paper.
The list of key hallmarks are what Joy calls “common sense-type items. There’s nothing that’s really magical or that stands out, but we believe that people who consistently follow these essential elements had a better chance to live a good, balanced and flourishing life.”
The paper outlines the elements, which are: taking the time to reflect, considering a deeper purpose in your work, striving for growth, prioritizing nutrition and exercise, remembering to rest, expressing gratitude, being of service, striving to remain connected to others and embracing uncertainty.
“It is the constant demands of the job and trying to do your best for your patients which means that we often forget to look after ourselves,” says Clemons.
“That’s what struck me,” adds Joy. “I’m trying to implement some of these things in my own life on a regular and consistent basis, and this has helped balance me out.”
In an oncologist’s busy life, and even for the rest of us, this can seem hard to achieve. “It’s not meant to be prescriptive,” says Joy. “But as we look at the various elements of well-being, I think somebody can find something in each of these areas to focus on. If we try to improve in these areas, we’ll have a better life.”
Clemons says that, busy schedules aside, oncologists should be aware of these markers: “Sometimes, during a busy clinic visit, it is important to remember this and spend a few moments not talking about the cancer and its treatment, but more ‘normal’ topics – like asking how a patient’s children are.”
Joy is quick to add that we should all be experimenting with these aspects of our lives – and if something doesn’t work, don’t sweat it. “This is not just about happiness, but really more about a sense of fulfillment and value of life,” he says. “I hope that people will make the time to think about these areas of their lives and see if they can optimize them. If they test it out and it works, keep on doing more of the same.”