Is it possible to be healthy and have incurable cancer?

Jonny Wilkinson was undeniably fit when he played rugby for England, but I recently heard him say[i] that despite being very fit at this time he wasn’t healthy. Jonny was talking about health from a holistic viewpoint. He recognised that fitness is about physical ability but health is a much broader picture. I agree with Jonny’s view that it’s possible to be both very fit and unhealthy. But, I wonder, if one applies the same principle of health from a holistic view, does it mean that I’m not healthy just because I’ve got cancer. Sure, I’m not as strong as I used to be, I get fatigued, I’m susceptible to infection and my feet hurt most of the time but I see these as the parameters I work in rather than signs that I’m unhealthy.

I often find myself discussing the interrelationship between health and fitness with my osteopathic clients. It is not uncommon for me to treat injuries in patients who describe themselves as dependent on their exercise for their mental health. As an osteopath I always start with the caveat that I’m not qualified to assess mental health, but it is well understood that physical and mental health are positively interlinked. If you improve one the other will benefit.

Like many of my patients Jonny described a fear-based need to keep training. These people often present with high susceptibility to/and chronic overuse injuries. These sorts of injuries ultimately lead to Jonny’s career on the field being cut shorter than he might have liked. With my clients a large part of my task is to get them to include something that isn’t their usual ‘tonic’ in their routines, usually rest and often strength training. To illustrate the point, I use the example of elite athletes in high-money sports like football. Premier League football teams operate with a purpose of making money. It is serious business. Yet, if you look behind the scenes you will often find a very holistic programme of care for their players. They take rest, sleep and emotional stress and very seriously. They will reduce the training load on their assets (players) if their sleep or emotional stress levels ‘blip’ because they know that pushing an ‘asset’ too hard at the wrong time will compromise his performance and reduce his value! (Side note: NB I don’t think making money is a great purpose in life but I do believe you can often learn a lot by watching what the money does!)

In these circumstances I will suggest to my clients that overtraining is an indication of not taking exercise seriously. I will then suggest that if they want to take their exercise seriously, they will operate with the purpose of being the best they can be at their chosen activity and to do this they will benefit by taking in a more holistic approach including rest and possibly some cross-training. This is often followed by a discussion of mental health, initiated by the client, where I hope to help them see that taking the required rest will develop mental resources, they didn’t previously believe they had. It is a purely physical route to developing improved mental health and importantly my insurance cover is valid for exercise prescription! Viewed like this it is impossible to see health as anything other than a relationship between mind and body. And operating with purpose is much more powerful in the long term than being motivated by fear of being second best.

But what about a poor immune system or fatigue due to cancer? Do these things indicate poor general health even in a person like me who is exercising as much as he can, living each day with as much purpose as he can muster?

In 1948 the World Health Organization (WHO) defined health as:

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

It would seem from this definition that WHO don’t think it’s possible to be healthy and have cancer but in 1986 they made further clarifications to define health as:

“A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”

I prefer this revised definition. They have removed the requirement for ‘absence of disease’ and replaced it with a much more individual idea of ‘social and personal resources as well as physical capacities.’

WHO then see good health as that which is exemplified by an individual making the most of their personal resources and physical capacities and not an ‘objective of living.’ One can’t create more resources by being healthier. Fitness is the business of creating more resources. The ability to do more of something, do it faster or do it better is increased by increasing specific fitness. Jonny was fit but his career was short. Being healthy is about being more resilient, better able to make the most out of one’s resources. It is achieved when operating with a constructive purpose not out of fear.

The ability to focus one’s resources outwardly is often lacking in people with chronic disease or pain. I have noticed this in my specialist osteopathy work with chronic pain patients and I have also observed it in myself. In my example I struggled with a fear of infection[ii] which limited my ability to do things with my family. This fear burnt my personal resources meaning I was compromised in my ability to achieve my purpose of being the best father I can be. I was unhealthy!

But I am getting better. I am finding tools which I can use to reduce the fear. Chiefly the experience of having fought off a few infections and knowing what to look for. But there are parameters on what I can do. I have been hospitalised twice in recent times due to simple infections so trekking through the Amazonian jungle is probably off the table. The crucial difference is that my parameters are being defined by common sense and have flexibility rather than being resolute and motivated by fear. I believe the absence of fear, facilitating a clearer view on one’s purpose, is the crucial detail in what defines health.

Jonny Wilkinson was undeniably a great rugby player. Many have him down as the greatest of all time. You don’t get there without putting in hours of hard work. I would suggest that putting in those hours is probably not a bad thing. The question though is what motivates the decision to put the hours in. Is it fear or is it a purpose? Jonny has said he was motivated by fear. But, these days, despite being less fit, he has more purpose. He sees himself as a healthier person.

I too know what it is like to be motivated by fear but I’m getting better. My purpose in life is to be the best father that I can be. I am lucky. I have been able to address my fears so they don’t burn so much of my personal resources.

My cancer is incurable and barring a leap in medical science one day it will beat me but, currently, I have plenty to give within the parameters I can operate in.

I am less motivated by fear. I am living with more purpose. I am getting healthier.

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[i] E131: Jonny Wilkinson: Winning The World Cup Led To My Darkest Days. The Diary Of A CEO with Steven Bartlett · 2022-05-02

[ii] Multiple Myeloma is cancer of the Plasma cells in the blood. The plasma cells play a key function in the blood immune response. Myeloma patients are therefore at risk of sepsis from relatively minor infections. This can be fatal without the urgent administration of antibiotics.