A Doctor With Lung Cancer Shares His Top Lessons
Whether you’re dealing with a serious illness or not, Dr. Morhaf Al Achkar’s must-read advice can help you live your truth.
No one is an exception and no one is immune from cancer. Still, we live in a time when there's plenty of hope for people living with lung cancer, says Morhaf Al Achkar, M.D., Ph.D., and he should know. The 37-year-old physician is living with incurable lung cancer, and he's on a mission to help other patients.
And to do that, he’s been busy: In the last two years, he wrote and published the e-books Being Authentic: A Memoir and Roads to Meaning and Resilience with Lung Cancer, and is working on another. He’s also released two music albums on Apple Music, where he plays a Middle Eastern string instrument called an oud, to raise money for his new research initiative called Project Equity. Through this endeavor—perhaps his most important yet—he's working to develop strategies that address the vast lung cancer disparities among Black Americans. "It deeply troubles me to be in my fourth year surviving with stage IV lung cancer while others fail to get an early diagnosis, are denied treatments, and face discrimination because of the color of their skin," he says.
Of course, Dr. Al Achkar never imagined he would get lung cancer. Who does? He vividly recalls the day he was working out with his trainer, and he was so short of breath, panting, that he couldn't finish training. "Well, that's certainly not normal," he thought.
Being a family medicine physician, he asked a colleague to listen to his lungs, which had no breath sounds on the whole left side of the chest—definitely concerning. Next, he got a chest x-ray, which showed half a chest wall with fluid in it. When the fluid was analyzed, it confirmed stage IV cancer. Dr. Al Achkar was soon diagnosed with a type of non-small cell lung cancer that’s caused by a specific genetic mutation called anaplastic lymphoma kinase (ALK) and affects non-smokers.
"Basically, some random genetic change sets off a pathway for cancer cells to grow without control," he says. "Lung cancer occurs mainly in older people, but this type could also affect younger people.”
Many people who are considered at lower risk when they develop cancer present at advanced stages, he says. This is especially true for lung cancer, which has no reliable screening test for moderate to low-risk individuals.
Thankfully, his cancer is currently controlled— although remission is not an appropriate term to use, he says—because he has received treatment and it's succeeding. But, like it is for others, Dr. Achkar’s cancer journey has become about so much more than his diagnosis and treatment plan. He's keenly aware that he's changed for the better since his diagnosis—the way he looks at life and at others—and he wanted to make a real difference by helping other patients reflect on their diagnosis and their lives. And that’s what writing his book, Roads to Resilience, where he shares intimately his own story as well as those of 39 other advanced lung cancer patients, was all about. "I am hoping that by developing the language to explain our struggles as cancer patients, others can understand us better, and with that, also better understand themselves," he says.
Here, he shares five ways cancer patients (or anyone, really) can live a better life:
1. Find Purpose
Dr. Al Achkar found and connected with his subjects using online support groups, and in separate discussions he asked them all about everything from life before the cancer diagnosis to treatment to how they were coping with the disease. Through many exchanges, he learned that patients' needs were fairly simple and understandable. They wanted to be able to work, manage finances, and skillfully navigate their health insurance. But, perhaps most of all, they wanted to lead meaningful lives.
Dr. Al Achkar admits that for him, meaning, as in a sense of purpose, was attached to his labels as a family doctor and university professor. "When I was diagnosed with cancer, one of the hardest things for me was losing those identities," he says. At that point, he knew he couldn't do both of those jobs, and admits that realization was a hard one, but he was determined to keep moving forward.
David, 42, whom Dr. Al Achkar interviewed for his book, said what hasn't changed is finding meaning in helping people. Nancy, 36, affirmed that life is indeed precious, and that she wanted to live a life that makes the world a better place. Mary, 46, concluded, in a very level-headed way, that in the scheme of things, her problems were not any better or any worse than what somebody else might have.
"Life is an unfinished project, and similarly, finding meaning is an uncompleted task," says Dr. Al Achkar. "I want to be mindful and intentional of how I'm spending every moment and I ask myself, 'What are the other ways I could be doing it?'"
The experience of living with cancer has been transformative for Dr. Al Achkar, but he has also had to grapple with how to "reconstruct" who he was as he scaled back at work. Earlier this year, he was working four days a week—he used to work many more hours a week—and he only saw outpatients when he also worked at the hospital. He used work accommodations, or adjustments that allowed him to keep doing his job, which is hugely meaningful to him.
Now with COVID-19, he's working at the clinic, only doing research, and seeing some patients via telemedicine.
He’s adjusted his attitude, too: "Now I can do things for others in ways I was never able to before," Dr. Al Achkar says, and that makes him happy. "To my patients, I can be the doctor who also understands their experience because he is a patient himself. I can serve communities of patients as a researcher who understands their experiences inwardly because he is also a member of and belongs in these communities."
3. Lean Into Your Support System
Friends and family, and their loyalty, rate high for lots of Dr. Al Achkar's fellow patients. Ashley, 68, says "I'm aware and grateful and mindful of all the friends who have stayed with me through this." Staying the course with someone with any health condition is a sign of the real deal.
His interviewee, Michael, 43, shared lightheartedly that, when friends are around, his perennially confident wife jokes that she'll "be the one to kill me, not cancer, in the end." Elizabeth, also 43, said she gets strength from watching her kids, "knowing that I'm their example and that I need to be the best I can be so they see that, regardless of what we are going through."
Many said their pets were also magic for them, giving and receiving affection and companionship. For Dr. Al Achkar, his beloved dog, Leonardo, is a source of pure joy.
4. Take Control of Your Health
You know your health is more than what's done in your doctor's office. You play a huge part, too, and Dr. Al Achkar calls that paying attention to "health actions."
The participants in his book talked about diet and exercise, and everyone had a different opinion about whether changing diet—or not—or starting to exercise if they hadn't, would make a difference for them, either physically or psychologically. He also asked them about complementary and alternative medicine options, like acupuncture or energy therapies like Reiki or qigong. Everyone chose to do what worked to enhance their lives.
For him, certain things are must-dos. Dr. Al Achkar still works out, eats most everything he wants, in moderation, and meditates. It all works for him.
The one action everyone did do was take medication, not surprisingly, and it was targeted chemotherapy, a type of cancer treatment that targets the changes in cancer cells that help them grow, divide, and spread. The goal is to reduce the cancer's size and keep it in check, says Dr. Al Achkar. He currently takes a targeted chemo drug that he says "has been very effective for my type of cancer, compared to traditional chemotherapy."
5. Find Your Best Coping Mechanism
"Cancer shifts many aspects of a person's life," he says, and living with it is "unchartered territory." There's hope to carry on, along with fear of the cancer's progression.
Some, like Stephanie, 37, coped by doing advocacy work like networking with other cancer survivors. Sharon, 42, met with lawmakers to try to bring increased attention and research funding to lung cancer.
Amanda, 75, volunteered at her local cancer hospital, and brought her granddaughter, which was great fun. In a similar vein, 54-year-old Rebecca, mentored others with cancer and said "It helped me—sharing with somebody else and having someone else understand."
A few joined research studies, or support groups, and some turned to therapy for help.
Overall, Dr. Al Achkar says that for him, there's also relief in reconciling that he is vulnerable. "I accepted being what I am." He relishes engaging in reflections and dialogues—in meaningful conversations with other people. Talking and sharing are all good.
His best coping mechanism is this: Writing the book and learning "so much" from each person he interviewed, but still, something else might help, too, he admits. "I could use more good laughs. I could also breathe deeper."