Is laughter the best medicine?

After smoking cigarettes for 50 years, Nampan Lura Fellows suffered wracking coughing fits that cut her words off midsentence and left her gasping. She hoped it was bronchitis. Then she felt a lump in her chest and figured she had lung cancer. She was right.

That was in 2004. Against all odds, the rail-thin 69-year-old still is going strong. She temporarily gave in to hopelessness, but then she found a mission: to cheer up other cancer patients and the professionals who care for them at St. Luke’s Mountain States Tumor Institute Nampa.

Her not-so-secret weapons are costumes — a bunny, a chicken, a gorilla and others. She wears the animal suits to MSTI Nampa on most major holidays and any other time she feels like it. She has anonymous admirers who help her to rent her costumes. And the Costume Depot in Nampa gives her a break, too.

Her hope, generous spirit and playful attitude may not cure Fellows, but such traits have huge advantages, said her oncologist, Dr. Jon Swerdloff. "She’s been able to go on and live her life despite this awful disease,’’ Swerdloff said. "And on top of that, she has brightened everyone else’s life."

Fellows continues to hang in there, even as her lung cancer spread to one of its favorite spots — the liver. Treatments had shrunk the spot, but a CT scan in late February showed that while one spot stayed small, the other grew slightly. Another CT scan showed no change, Fellows said in May.

No worries, Fellows said dismissively. "It’s one of those aggressive cancers." She began another round of chemotherapy with a drug that has worked before. Being in a costume takes the edge off her pain and the pain of other patients. Who can cry as a chicken strolls by?

"It is fun for me," Fellows said of dressing up. "My husband kind of hides his face when I am going down the street, (but) he enjoys it," she said over coffee at her kitchen table. "He gets a kick out of it, too."

And so he does. But he doesn’t stay with his wife once she gets in the chair where she receives her cancer drugs. He can’t. He sees the faces of the other patients and knows cancer will kill some of them. After four years, it still is more than he can bear.

"You can only cry so much for everybody," James Fellows, 64, said. "You have to leave and come back a little later." Lura Fellows’ humor helps her hang on, and so does her faith in God. When the good Lord is ready, she figures, he will take her. That’s really all she needs to know.

"I have a strong faith, and without that and my family and my doctor, I’m through," she said tearfully.

Dr. Thomas Beck, director of St. Luke’s MSTI locations, doesn’t know Lura Fellows but admires her fighting spirit against lung cancer, which he described as "a mean disease. The treatments have improved, but the improvements have not been a quantum leap. The improvements have been slow."

Women, he said, generally live longer after a diagnosis than men do. "She seems to have a very healthy attitude," Beck said. "Nobody knows when anybody is going to go, so living day to day is a pretty good strategy, actually."

Do hope and faith help?

The role of humor, hope and prayer in extending patients’ lives has been subjected to some rigorous research, with mixed results. Major scientific organizations, like the National Cancer Institute, say people who believe a good attitude can cure cancer are believing in a myth. Major studies on whether prayers help patients recover faster are inconclusive — some say yes and some say no.

Swerdloff, Fellows’ oncologist, hesitates to say Fellows’ good spirits keep her alive, even though he obviously is very fond of her. "She is just such a wonderful person," he says. "You really do get a charge out of working with her."

But to say she lives because of her attitude places a heavy, unspoken burden on other patients: Be happy or die.

That’s just not the way it is, Swerdloff said. "I have seen people who have the most incredible attitude, and their treatment doesn’t work," he said. Other times, the most pessimistic people, who have to be talked into treatments, do well.

Fellows responds well to treatment, he said. "We’ve been fortunate in that several of the treatments have worked for her that don’t work for other people," Swerdloff said. "And she has done exceptionally well with them." Fellows and her doctor have lots of company when they contemplate the role of humor and religious faith in illness. Some studies show doctors are more likely than their patients to believe in God. Others show they are less religious.

St. Luke’s Health System and Saint Alphonsus Regional Medical Center, among other hospitals in the Valley, hire chaplains and other staff who may use humor, prayer and other ancient, nonmedical ways to help desperately vulnerable patients. Alex Chamberlain is a chaplain at St. Luke’s Meridian Medical Center, where he sees patients who may feel as hurt, shocked and scared as Fellows did when she first heard the word "cancer" applied to her body.

Chamberlain thinks scientists trying to measure whether prayer cures illness might be looking off in the wrong direction. Maybe cure is the wrong word. "While some may legitimately pray for God’s help in curing an illness, that is not always the outcome," Chamberlain said. "To suggest that prayer is going to line you up for a certain prognosis, I think that is setting yourself up for disappointment."

Sometimes the real, immeasurable goal of prayer is to find inner resources or a relationship with our Creator, Chamberlain says. Healing may mean not that symptoms disappear forever, but that they fade long enough to accomplish something no one else could, he said.

Life’s toughest questions

The chaplains’ job is to stand by people like Fellows who have received the scariest news of their lives and to help answer their hardest questions. "I think serious illness raises big questions about life and why do horrible things happen, like receiving a cancer diagnosis," said Kelly Loy, who, like Chamberlain, prays with patients without pushing her own religion. She is Lutheran.

Sometimes, Loy sees patients who make her think of deeply sad times in her own life. "Why do these things happen? Why do people get cancer?"

"There are times we are grieving with the family and wrestling with those same questions," she said. "We try to follow their lead and not push our views on them. We want to find answers that work for them," Loy said.

Laughter is good medicine

Chamberlain is known for his use of humor, but timing is everything, he said. "You don’t just start with a pie in the face." Laughter is therapeutic, he said.

"People get physiological relief from the stress they feel," he said. "Other health-care providers are trying to cure things or fix things. We are fighting against the isolation someone might feel when they are vulnerable."

Humor, done well, can help patients and family members take themselves, their fears and anxieties less seriously, Chamberlain said.

Fellows might not say it that way, but that might be what her costumes do. "There certainly is a lot of evidence that laughter does boost your immune system, and that can only benefit your health," Chamberlain said. Besides, he added, everyone’s days are numbered. "We all have a terminal condition, when it comes down to it."

Chamberlain admits to donning a costume now and then, but, "I prefer to offer a sense of warmth and humor." Warmth and humor no doubt are in demand inside and outside of hospitals. Chaplains provide that, and so does Fellows, in her own way.

"I could feel sorry for myself, but that’s not going to make me feel any better," Fellows said over coffee. Occasionally, she became teary-eyed about her future and her family. "Now that I’ve been through all of this, I am not going to let it take me," she said of the cancer. Fellows looks for reasons to live, not predictions of when she might die.

Half of patients die within a year of their diagnoses. Some hang on for two. Few live much past that. Lung cancer is the No.1 cancer killer in Idaho and nationwide. It has too few effective treatments. But Fellows didn’t read up on the statistics.

Smoking is an addiction that’s very tough to shake, but since her own cancer diagnosis, her husband, James, who works at the landfill in Canyon County, has managed it.

A challenging journey

Fellows never really lectured her husband much about quitting, because if there was one thing she knew, it was how hard it was to quit. "I think maybe three days was my best effort, and that was on the patches. If I hadn’t gotten the cancer, I probably still would be smoking."

She’d still be smoking even though she couldn’t really say she enjoyed it. It relieved stress and went well with coffee. When she began coughing all the time and noticed the lump, she did not go to a doctor immediately. She still was 64, too young for Medicare.

With the health insurance the couple had, Fellows worried an expensive diagnosis would ruin the couple financially. "So, basically, I didn’t say anything to my husband about it, and I wasn’t hurting or anything."

When a new year began and she qualified for Medicare, she still did not seek medical attention immediately. The coughing finally drove her to seek help. Her hope of having nothing more than a bad case of bronchitis was shattered.

Her doctor first used the word "terminal" when her cancer spread to her liver. Even that didn’t appear to faze Fellows once she got over the initial shock. One thing you notice about Fellows when she talks is that hope is woven through her, and she never seems to run short of it for long.

"I am not one to ask too many questions," she confided, "because I’m not one that really wants to know some answers. There’s a lot of patients who go in there and probably want to know everything," she said. "I figure what I don’t know won’t hurt me."

She knows there is no cure for her, not yet anyway. She and her husband are planning a summer vacation, probably to Cascade to go fishing again. "I try to look forward, not back. If I’m here, that’s a blessing. If I’m not, I don’t want to know."