Caring4Cancer

Interview with Jeremy Geffen, MD

(The following interview appears in the Fall 2006 issue of Caring4Cancer magazine.)

Medical oncologist Jeremy Geffen, author of the highly acclaimed book The Journey Through Cancer: Healing and Transforming the Whole Person (Three Rivers Press, 2006), is one of nation's pioneers in blending state-of-the-art conventional medicine with safe and effective complementary and alternative therapies in the treatment of cancer. In his groundbreaking book, based on his experience in treating thousands of cancer patients and their loved ones, Dr. Geffen outlines The Seven Levels of Healing®—revolutionary model of healing based on the best treatments available from every paradigm of medicine.

Dr. Geffen's professional credentials are formidable. He received his undergraduate degree summa cum laude from Columbia University and is an honors graduate of NYU school of medicine. He completed residency training in internal medicine at the University of California at San Diego Medical Center, followed by 3 years of subspecialty training in hematology and oncology at the University of California at San Francisco Medical Center. After completing his training, he practiced hematology and oncology for 11 years. During that time he was also elected a Fellow of the American College of Physicians.

What makes Dr. Geffen unique, however, is not the level of his education and training; other outstanding physicians have these as well. Rather, it is his extraordinary medical training and years of clinical experience, combined with his long-standing interest in the deeper dimensions of healing and exploration of the world's great spiritual and healing traditions.

C4C: Until fairly recently, you worked full-time as an oncologist. Now you're focused full-time on writing, speaking, consulting with doctors, cancer patients, and their families. Tell us more about your new focus.

GEFFEN :It does seem like a big change, doesn't it? (smiles) Up until 3 years ago, I was director of the Geffen Cancer Center and Research Institute in Vero Beach, Fla. I opened the center in 1994, about 8 years after my father's untimely death from cancer. My father passed away when I was a senior in medical school.

The center was the culmination of a long-held dream that emerged out of what my family experienced during my father's illness. I wanted to be able to offer what wasn't available for my father when he was diagnosed with cancer—truly integrative, comprehensive, whole-person cancer care.

At the center, we practiced state-of-the-art, meticulous, mainstream medicine. That was the foundation from which we never wavered. But we also offered a variety of wonderfully supportive, complementary approaches to healing.

We created an environment that addressed the emotional and spiritual needs of our patients and their families in ways that were responsible, meaningful, and deeply inspiring. Our center was one of the first cancer centers of its kind in the United States, and it grew rapidly.

There was tremendous interest in our program, from many quarters, including the medical community. The many patients and their loved ones who came to our facility validated the importance of what we were offering by their overwhelmingly positive feedback. We could also directly see the profound effects of the care we offered on their quality of life.

Although we lacked the resources to scientifically document it, I firmly believe that patients' outcomes and survival times were improved. Eventually, I decided that in order to share what we had learned and bring the program to a larger audience, I would need to focus on doing that full-time. It was an extremely difficult decision, but it was the right one.

C4C: Can you describe your program briefly?

GEFFEN: Sure. It's called The Seven Levels of Healing, and what it is, in essence, is a whole new approach to helping patients and their loved ones navigate the journey through cancer as successfully as possible. It guides them through the initial diagnosis and the panic and confusion that often come with that, and it helps them organize themselves, clarify their priorities, and get a handle on what they need to do.

But that's just one piece of it. What it does in the larger sense is give them a framework, a kind of map, for working through all the dimensions of cancer—just the physical ones, but the mental, the emotional, and the spiritual aspects as well. These other dimensions of who we all are so often get overlooked in the rush to fix or cure the disease.

This is very unfortunate because overlooking these other important aspects of what people are going through often causes patients and their loved ones so much unnecessary pain and suffering. What The Seven Levels of Healing program does, quite successfully, is give patients and their loved ones a comprehensive way to fight cancer with mind, body, heart, and soul.

C4C: Why do you think your program has been so well received by cancer patients and medical professionals?

GEFFEN: A big part of the program's success according to patients and health care providers who have experienced it is that it greatly improves quality of life. So much of medicine today is focused on bringing care and attention to the physical body. No one, least of all me, is arguing for a millisecond that this isn't vitally important and a major part of what we should be doing.

But at the same time, while we're doing that, we can also be helping patients and their loved ones find meaning and fulfillment, even happiness and joy, in the face of illness. This is what The Seven Levels of Healing is all about. We've seen again and again how it helps people live and work with less fear and stress, and enjoy greater vitality, energy, and purpose. That's what we mean by improving the quality of life.

C4C: How did you come to create The Seven Levels of Healing?

GEFFEN: I wouldn't say I created The Seven Levels of Healing so much as I discovered them. As a young man, before going to medical school, and throughout my residency and fellowship training as well, I studied a wide variety of the world's great spiritual and healing traditions, including on numerous trips to India, Nepal, and Tibet. After my father died, I set out in earnest to learn everything I could from these ancient traditions and cultures.

I also spent a lot of time talking with my patients about what it means to be human and how to heal and transform at the deepest levels of our being—body, mind, heart, and spirit. I spent years asking my patients to share what mattered most to them, and what made the biggest difference for them on their healing journey. Very often, these conversations took place in the hospital late at night, or even in the middle of the night, after I had finished my rounds.

C4C: What did you discover?

GEFFEN: One night I awoke in a classic "eureka" moment in which I recognized a  profound, universal pattern. I saw that all questions and concerns that patients and loved ones encounter on their cancer journeys inevitably fall into one of seven distinct, but deeply interrelated domains of inquiry and exploration, which I call The Seven Levels of Healing. I wrote down the levels then and there, and took them into my office the next day and showed them to my staff. I also started sharing them with my patients and their loved ones. Almost everyone said, in one way or another, " You know, this is a mirror of my own experience; it describes exactly what I've been going through."

For many people, the experience of being diagnosed with cancer is similar to being dropped into a jungle and trying to find their way home. Patients and family members described The Seven Levels of Healing as like being given a crystal clear map of the whole terrain. It helped them to know exactly what issues they were going to encounter and where to put their focus and attention.

C4C: It appears that you place a lot of emphasis on the emotional aspects of cancer? Why is that?

GEFFEN: Oh, you mean the elephant in the room? (smiles) I often refer to the emotional aspects of cancer as the elephant in the room. Some people face the elephant—all the emotions head-on, and don't run away from them. Others shun the emotional issues, or ignore them completely, and then are often haunted by them in different ways. Still others become overwhelmed by the rollercoaster of emotions they may be experiencing.

Right now, the typical medical response is to prescribe antianxiety medicines or antidepressants. Don't get me wrong, these medications have an important role to play. But they don't get to the core of what's really going on. Part of what our program is about is shifting some of our focus from the outer world of chemotherapy, surgery, and radiation to the inner world of our thoughts, feelings, and emotions.

C4C: What about complementary or alternative therapies? Where do you see those fitting in?

GEFFEN: The role of complementary and alternative therapies is fully addressed in Level Three of The Seven Levels of Healing. Almost inevitably, there comes a point when a patient asks the doctor, "In addition to my mainstream, conventional care, what else can I do to help myself?"

They may be in a support group, they may have their family and friends, but they're still worried, they're not sleeping well, or they're confused about what to eat, what supplements to take, or what kind of exercise to do. This is the point in the program where we emphasize thinking about the body less as a machine and more as a garden. It's here that the whole universe of complementary and alternative therapies finds its home—including modalities such as yoga, meditation, nutritional support, acupuncture, massage, and guided imagery, to name just a few.

Most people don't want to abandon conventional medicine, but they do want to explore complementary and alternative therapies, and learn how to use them safely and wisely to augment their treatment. Our program encourages them to do this, but a key point is that it must be done safely and wisely, and ideally, with the full knowledge and support of the physician. This is very important.

C4C: You also place a lot of emphasis on the importance of connection with others in healing. Why do you think that's so important?

GEFFEN: As the poet John Donne said, "No man is an island." No one can get through life alone, and no one can get through cancer alone. I believe that connection with others lies at the heart of healing.

If you want to see evidence of this, just recognize the instinctive human need and desire for touch. When we're sick, or scared, or in pain, on some level we all want to be held and feel connected. This need for connection is natural and deep.

Meeting this basic human need is the extremely valuable role that support groups, educational programs, religious organizations, and other groups can play in helping people on their journey through cancer. Mainstream medicine, thankfully, is beginning to recognize that this is an important component of healing that is worthy of our time and attention.

C4C: I know that in The Seven Levels of Healing there's a Life Assessment process that you encourage patients as well as their loved ones to complete. This seems like a very difficult task.

GEFFEN: Actually, it's quite simple. There are three questions in the Life Assessment process we've developed. One of the questions is, "What is the meaning and purpose of your life?"

When you or a loved one is diagnosed with cancer, the illusion of immortality is shattered. You realize, You know what? I am mortal. Even if this cancer is cured, I'm still not going to live forever. So it becomes valuable to start saying, OK, I might even be cured, but let me use this experience as an opportunity to grow and connect with what my deepest purpose in life is because none of us knows how long we're going to live.

C4C: What if someone already has a religious faith? Is The Seven Levels of Healing still relevant?

GEFFEN: Yes, it is. Absolutely. The beauty of The Seven Levels of Healing is that it's designed to provide empowering skills and insights for all people—regardless of their background or religious faith. The program has nothing to do with any particular religious tradition, spiritual orientation, or philosophy. It is more about how we are wired as human beings to seek wholeness, fulfillment, and health in the face of a crisis.

C4C: What do you say to someone who has cancer and is very angry about it? Or to someone who in the back of his or her mind feels like he or she did this to himself or herself, or caused their cancer?

GEFFEN: For me, this is always heartbreaking to hear, but I understand how it can happen. Every human being has a mind that includes an inner monologue that is going on all the time. It says, " This is good, this is bad; I like this, I don't like that; I'm responsible for this, but not for that; and so on." I call this the tyranny of the mind, and it can drive people crazy, especially when dealing with cancer.

But it doesn't have to be this way. It's possible to completely transform our experience of cancer, and our relationships with others and ourselves, by coming to terms with these thoughts. In my book, The Journey Through Cancer, I write about real people, actual patients who I cared for, who have done this, and I describe how they did it. Their stories are beacons of light that demonstrate what's possible, what we can accomplish in medicine, and what we can all aspire to as human beings.

C4C: Can someone guide themselves through The Seven Levels of Healing program on their own, or does it need to be done in a hospital or clinical setting with supervision?

GEFFEN: The program doesn't need to be done under formal supervision, although it can easily be adopted in hospitals and cancer centers, and it works beautifully when integrated into a patient's entire treatment program. And yes, it is definitely possible for someone to read the book The Journey Through Cancer and get a tremendous amount out of it on their own, or even more when they share it with their loved ones. It guides them clearly through the entire process, step-by-step. They can also learn more about it by visiting www.Caring4Cancer.com.

C4C: What's next for you?

GEFFEN: My deepest desire professionally is that this model of healing and care will be implemented throughout the health care system and be available to whoever wants it. Part of my work now is traveling around the country working with health care professionals and conducting workshops and retreats for cancer patients, family members, and caregivers.

Not only do I want to train medical staff to offer this program to their patients, I also want to offer the program to physicians, nurses, and medical teams so that they can experience it for themselves, and in doing so reconnect with their own deepest purpose, clarify their most important goals, and be rejuvenated personally as well as professionally.

The next phase of my work will also be, hopefully, to implement the program for patients with heart disease, diabetes, and a host of other chronic conditions because it has so much to offer them as well. In fact, as we've said, The Seven Levels of Healing are universal: they can help anyone who is undergoing a crisis or challenge of any kind that impacts their health. So, there's a lot to do, and I'm looking forward to doing it and getting as many people involved as possible.