Every year, roughly 12 million people get news that they never imagined they would hear: “You have cancer.”

Without a doubt, this diagnosis is shocking, upsetting, and terrifying. As a cancer survivor myself, having had two different primary cancers, I can tell you that I certainly can relate to the whirlwind of emotions that comes from such life-altering news.

However, the purpose of my message today is to tell you this: Once you get over the initial shock, how you conduct yourself next can make a world of difference in how well you respond to treatment and recover.

System 1/System 2 Responses

As many of you know, dual (System 1 and System 2) reasoning is a major concept in my new book, The Rewired Brain.

System 1 thinking originates in the lower (reptilian) and mid (limbic system) brain. It is responsible for unconscious emotions and reactions that center on survival instincts.

System 2 resides in the outer regions of the front brain (neocortex and particularly the frontal cortex). In stark contrast to System 1, System 2 thinking is much more developed, deliberate, and uniquely human.

The capacity to use System 2 to make conscious choices gives us the ability to move beyond our fear-based survival instincts and to carry out higher-level cognitive functions, to have distinct unique personalities, to make complex decisions, and to dream and hope.

The Fear Response

What does this have to do with cancer? Well, when you first get diagnosed with cancer (or any disease, really), you have two ways you can react.

I think it’s perfectly natural to initially react in a very System 1 way. In fact, I know I did, and I spent some time in a state of fear and anxiety wondering what was going to happen to me. Being given a cancer diagnosis can be very isolating because no matter how much you are loved, you still have to go through much of this journey alone.

Facing the possibility that this disease could take your life can make you feel very lonely. So, it’s very important to give yourself grace to feel this way.

However, it’s important not to linger too long in this constant state of System 1 fear and anxiety. If you do, there is a wide range of consequences that lead to the deterioration of both your physical and mental health and weaken you, giving your cancer a better chance of winning. And this is the last thing you want to do if you want to be a cancer survivor.

You see, when you’re stressed, your body releases cortisol (often called the “stress hormone”) and other stress-related messengers. Small bursts of cortisol in stressful situations help to initiate the body’s System 1 fight-or-flight response. This is incredibly helpful if you need to escape a fire or run away from a dangerous situation.

But when stress is chronic, it causes cortisol to pump through your body nonstop. Chronically elevated cortisol raises the risk of systemic inflammation, which increases the severity of cancer.

So higher stress makes it harder to fight cancer and makes metastasis more likely.1

The Mindful Response

Real Female hairless fight against cancer outdoor

The second way you can react puts your System 2 conscious mind in control. With a System 2 mindset, you choose to live courageously.

For me, this also means that I choose to connect with God in a very personal and powerful way. I find it fascinating that the phrases “do not be afraid” and “fear not” appear more than 80 times in the Bible. Do you think God is trying to tell us something? Clearly, the writers of this sacred text anticipated our natural tendency toward fear, especially in very scary times such as cancer. But God does not want us to be afraid.

This does not mean you can’t feel fear, anxiety, or uncertainty. These reactions are absolutely normal. Rather, you acknowledge these fears and then allow your conscious mind to monitor them so they don’t take over. This type of mindfulness is difficult at first, but the more you do it, the more natural it becomes.

You may be asking yourself, “Dr. Ski, What specifically does this mean?”

I’ll tell you what I do. To this day, I undergo routine 6-month checkups with my cancer doctors. About a week before these visits, I typically go for blood work and other types of tests to see if the cancer has come back. The doctor tells me the results of these tests at my visits. I’m not going to lie—they’re very stressful and pretty scary.

Prior to these appointments, I give myself permission to think about the worst-case scenarios for 24 hours. I allow my System 1 fears to come through in full force during that time. But that is all that I will allow cancer to take away from me—24 hours, and that’s it. Once that time is up, I get back to living my full, happy, productive, passionate life.

I don’t have time to waste thinking about what-ifs. No one does. For me, the “great blessing” of cancer is that it reminds me of my own mortality and how important it is to spend my time focusing on things, people, and purposes that matter. None of us live forever, so we all ought to “live like we’re dying,” as the country music artist Tim McGraw sings.

With this type of mindfulness, you are able take conscious control of your thoughts and emotions, and you find the capacity to connect with God in a very powerful and meaningful way. Yes, you still have some fear and anxiety because, after all, you are only human. However, you do not allow yourself to live in them and you are constantly reminded and encouraged to “fear not.”

If you have cancer, I want you to know that I understand how you feel. I know how hard it is to consciously take control of your emotions …to let go of the what-ifs…to choose to live life without constant fear… But if you want to live a beautiful life today and for the rest of your life, you must.

I am here for you and with you, and I am praying that this message might help you or someone you love today.


  1. Moreno-Smith M, et al. Future Oncol. 2010 Dec;6(12):1863-81.

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