1. A Tragic Opera - Can it be a Source of inspiration? Cancer and its decisive impact on human existence

2. A Tragic Opera with 6 Acts 1.Suffering losses that bring grief 2.Threatened by isolation from life and relationship networks 3.Attacked by the hounds of fear 4.Struggling with questions about guilt 5.Thrown around by emotional struggles 6.Battling with various types of pain All acts are performed simultaneously!

3. Act 1: Suffering losses that bring grief 1. Wellbeing / mobility / physical self-control 2. Loss of dignity: physical / mental / emotional 3. Bodily strength 4. Identity / control / decision making 5. Relationships 6. Work / security / social status / possessions 7. Future 8. Opportunities to make peace with God 9. Ultimately, loss of own body

4. Act 2: Threatened by isolation from life and relationship networks 1.Dying is an individual process 2.Social factors can contribute 3.Nature of the disease can contribute 4.Can experience isolation even when not so

5. Act 3: Attacked by the hounds of fear 1.The nature and seriousness of the disease 2.The future / re family / re finances 3.Suffering and pain 4.Dependence on others / Helplessness 5.Being a burden 6.Being alone / being abandoned 7.Humiliation 8.Not being able to cope emotionally 9.Separation from loved ones / from God 10.The unknown 11.Punishment / judgment 12.Losing mental capacities

6. Act 4: Struggling with questions about guilt 1. Guilt is the consequence of breaking a law; it is a judicial state, not a feeling 2. Four types of guilt 1. Personal 2. Social 3. Legal 4. Theological 3. Guilt about: 1. Bad things done 2. Good things not done

7. Act 5: Thrown around by emotional struggles Denial  Rebellion  Negotiation  Restlessness  Anger  Distrust  Despair  Disappointment  Doubt  Criticism  Depression  Bitterness  InsightSurrenderAcceptance Peace, clear conscience Meekness Trust in relationships Courage, hope Satisfaction Certainty, security Appreciation, gratitude Comforted, joy Reconciliation, forgiveness

8. 6. Battling with various types of pain Transcendent

9. The main aria - the song of the cancer sufferer 1. Please draw a cancer history timeline from five years before you first noticed something was wrong right up to today 1. Either from the patient perspective 2. Or from the relative / friend perspective 2. In this timeline show highs and lows where the cancer sufferer was facing various aspects of the six acts: losses, isolation, fear, guilt, emotional struggles and pain 3. Share this with one another in the discussion time asking: What can we learn from this history?

10. 19942000 1989 Example: Cancer History Timeline

11. Possible extra activities: You might want to expand a section of the timeline on another sheet of paper to show more details Write a poem about your time line Make a drawing / painting about your time line Write an essay about your time line What about a daily journal where you examine all six acts of the opera?

12. Discussion Time 1. Share your Cancer History Timeline in the group 2. Group members are not allowed to give comments or advice, only to ask clarifying questions. 3. You might want to add some extra elements to your timeline 1. Questions remind you of something 2. Other stories remind you of something 4. When the person has finished their own story, discuss: What can we learn from this history?

13. Facing Death in the Tragic Opera Spiritual needs of those with cancer Spiritual needs of those with cancer What about life after death? What about life after death? The second aria – the experience of the survivors The second aria – the experience of the survivors Group Discussions Group Discussions Plenary Feedback: what we have learnt from one another’s experiences Plenary Feedback: what we have learnt from one another’s experiences

14. 7 basic spiritual needs of those with cancer 1. Good relationship with God 2. Good relationships with relatives 3. Hope 4. Meaning 5. Purpose 6. Life concluded with no loose ends 7. Prepared for the transition

15. What about life after death? a Christian perspective Conception Birth Death Second coming of Christ Paradise Hades New heaven and new earth Gehenna / Hell

16. How can we make sure our life after death is good? From a model developed by Dr Walt Larimore

17. The wages of sin is death but the gift of God is eternal life in Jesus Christ our Lord (Romans 6: 23) wages sin death but God eternal life gift Jesus Christ Lord

18. The second aria - the song of the relative 1. Please draw a close relative/friend history timeline from five years before you first noticed something was wrong up to today 1.Either from the patient perspective 2.Or from the relative / friend perspective 2. In this timeline show highs and lows where the relative / friend of the cancer sufferer was facing various aspects of the six scenes: losses, isolation, fear, guilt, emotional struggles and pain

19. Discussion Time 1. Share your Cancer History Timeline in the group 2. Group members are not allowed to give comments or advice, only to ask clarifying questions. 3. When the person has finished his / her own story, discuss: What can we learn from this history? How can we sing better?

20. Plenary Feedback: What have we learnt? Not allow work to ruin your life Not allow work to ruin your life Doctors should learn to share the news about cancer in a better way Doctors should learn to share the news about cancer in a better way Relatives are very important to cancer patients Relatives are very important to cancer patients Give special attention to how the children experience the cancer of relatives Give special attention to how the children experience the cancer of relatives Power of the Word of God if used in a good way Power of the Word of God if used in a good way People also go through the six acts in other traumatic situations: divorce, sudden death of a loved one People also go through the six acts in other traumatic situations: divorce, sudden death of a loved one Sometimes cancer patients experience other situations (divorce / sudden death of a loved one) as more traumatic than their cancer Sometimes cancer patients experience other situations (divorce / sudden death of a loved one) as more traumatic than their cancer Even if we do not have cancer, we need to prepare ourselves for death Even if we do not have cancer, we need to prepare ourselves for death Live life to the full in any case Live life to the full in any case All of us are going to die at some stage; as we realize this it gives such a different perspective to life All of us are going to die at some stage; as we realize this it gives such a different perspective to life

21. Sing your aria to inspire others in the tragic opera of cancer

22. Make a whole person diagnosis Transcendent Make a strengths / weaknesses evaluation of all relationships in the diagram

23. Work towards whole person wholeness Transcendent Relating rightly to –inner human, –outer human, –relationship network, –environment –transcendent Biblical concept that covers all these aspects: Shalom

24. Paint a life of SHALOM Shalom touches all areas of life What it is: –The presence, blessing and peace of God –Jesus Christ Himself Shalom continues all the way right through death, so it can always be our goal

25. What needs to be done about my spiritual needs? 1.Good relationship with God 2.Good relationships with relatives 3.Hope 4.Meaning 5.Purpose 6.Life concluded with no loose ends 7.Prepared for the transition