Blending Stories and Science of Psychedelics in Cancer

There's a moment in every cancer journey when language fails. When the experience becomes so overwhelming, so foreign to normal life, that words break under the weight of trying to describe it.

For me, that moment came during chemotherapy. Not the nausea itself—there are plenty of words for nausea. But the totality of it. The way chemotherapy strips away everything that makes you feel human. The weird liminal space between living and dying, between treatment and torture, between medicine and poison.

How do you describe that to someone who hasn't lived it?

You tell stories.

I recently sat down for a podcast conversation with Manish Agrawal, founder and CEO of Sunstone Therapies, one of the most active psychedelic research sites globally. Before building Sunstone, Manish spent nearly two decades as a practicing oncologist. We explored how storytelling functions in psychedelic research—not as a replacement for clinical trials, but as an essential complement to quantitative data. Because some of the most important aspects of healing resist measurement.

Stories create the language we need before science can measure what that language describes.

The Stories That Started the Research

Manish's path into psychedelic research didn't begin with clinical trials or peer-reviewed papers. It began with stories from patients and researchers.

"Just down the street was Roland Griffiths," Manish told me. "So I called him up and said, I want to talk to you about this. And so I went and visited him and Mary [Cosimano]. And they said, yeah, we see these really powerful stories."

Stories. Not data. Powerful stories captured Manish’s attention.

But here's the crucial part: those stories weren't sufficient. Manish remained deeply skeptical despite hearing compelling patient accounts. His training as both physician and philosopher made him wary of anecdotes that might not replicate at scale.

"Most things in life usually disappoint, right?" he reflected. "They never quite match up to the hype. Especially in medicine. You know, there's this promising drug and it moves the ball a little bit, but it doesn't change things."

The stories catalyzed his curiosity. They couldn't override his need for rigorous evidence. He had to see the research. He had to conduct trials himself. He had to witness outcomes firsthand.

This is the philosophy we embrace at Healing Cancer Journeys: stories are a critical complement to science, but absolutely cannot replace it.

What Measurement Tools Miss

Here's the problem with relying solely on quantitative measures: they often miss what matters most to patients.

Manish and I discussed how cancer patients may not meet diagnostic criteria for mood disorders even when experiencing profound distress. The explanation reveals the limitation of measurement tools themselves.

"[Patients] learn to wall off feelings or the symptoms in order to get through the day," Manish explained. "In order to show up, get your chemotherapy, go home, make dinner, be with your family, and then go to your job."

Cancer patients learn to perform wellness. We manage other people's emotions when we disclose our diagnosis. We tell the intake nurse we're "fine" because we literally don't have the space—temporal, emotional, or relational—to fully inhabit our distress during a brief clinical encounter. 

And when someone gives us a questionnaire to measure our psychological symptoms, we continue the emotional repression that enables us to cope with our condition. Our self-reported symptoms are biased. Not because we’re doing anything wrong. But because we’re continuing the coping strategies that we’ve developed to exist with a cancer diagnosis. And so those psychological measurement tools can undercount the frequency and severity of depression, anxiety and distress among people living with cancer.   

"There's some under-reporting," Manish continued. "It's not a denial of reality...but just not being there. So it's much more complicated why those numbers are low."

The DSM diagnoses flatten lived experience into billable categories. The self-report scales measure what they're designed to detect, which isn't necessarily what patients are experiencing. The fifteen-minute appointment slots don't leave room for the kind of disclosure that would reveal the depth of suffering.

This is where patient narratives become essential. Not to contradict the data. But to fill in what standardized measurements systematically miss.

Creating Language for the Unmeasurable

One of Manish's most striking observations concerned language itself: "We sort of have a default materialistic worldview in medicine and in science. And so when you go to the doctor, you never think about talking about love or about death or God or these esoteric concepts that don't necessarily have material measures."

Love. Meaning. Awe. Connection. Acceptance of mortality. These experiences profoundly affect quality of life. But they don't show up in lab values or imaging studies. And they’re rarely discussed during appointments. 

Psychedelic experiences, Manish noted, catalyze these unmeasurable dimensions: "These medicines bring those things to the forefront. And so of course we don't have a language for them because it's not been part of medicine's recent history. We weren't taught those things in medical school."

The challenge ahead, he suggested, is developing language for experiences that medical training systematically excluded: "I think one of the challenges these medicines are gonna bring to the practice of medicine is we're gonna have to start developing language for these things we excluded."

This is where storytelling becomes not just therapeutic, but epistemological. We need patient narratives to create the language. We need that language to eventually build more sophisticated measurement tools. We need those tools to conduct the science that validates what the stories first revealed.

The progression isn't: story or science. It's: story, then language, then measurement, then science. Each stage builds on the previous. Each stage is essential. We need science and stories. 

When Patients Become Teachers

Manish's initial skepticism about psychedelics persisted through reading research papers and conversations with leading researchers. What finally shifted his understanding wasn't abstract data or clinical research—it was witnessing patients' transformations and hearing how they described their experiences with psychedelic medicines. 

"I can say there was healing and there's overcoming of fear," he told me. "But the way they would describe their stories and the words they used - that was transformative for me. It was like they were coming in for help, but the stuff they would say...they were helping us."

The therapeutic relationship reversed. Patients who arrived seeking treatment left offering wisdom for the healthcare team. 

"The insights were really powerful," Manish continued. "I could see a person and say maybe they should think about this or work on this and they might agree with that. But then the [psychedelic] experience they had would take them in a different direction and no amount of human intelligence or left brain thinking could concoct that experience."

This observation matters because it illustrates what storytelling reveals: dimensions of healing that emerge from patients' own psyches rather than from therapeutic intervention. The stories capture internal journeys that external observers—no matter how skilled—cannot predict or control.

Science can measure outcomes. Stories reveal processes. Both forms of knowledge are essential.

What HCJ Is Building

At Healing Cancer Journeys, we're creating space for patient narratives to exist alongside clinical research. Not to replace trials with testimonials. Not to suggest isolated anecdotes should override population-level data.

But to preserve the wisdom that emerges from lived experience navigating both cancer and psychedelics.

Because stories accomplish what quantitative data alone cannot:

Stories reduce isolation by revealing shared experience. Stories create language for powerful experiences that resist standard measurement. Stories generate hypotheses that scientists can investigate rigorously. Stories transform suffering from absurd randomness into meaningful human experience.

The science will eventually tell us which compounds work best for which patients under what conditions. The stories will tell us what "working" actually means from inside the experience. What transformation feels like. What it means to change your relationship with cancer and mortality.

We need both. Always both. Stories to create language and community. Science to validate safety and efficacy.

Medical research has historically privileged quantitative data over qualitative narrative. That made sense when studying interventions with clear biological endpoints—tumor shrinkage, side effects, survival rates.

But psychedelics work differently. They catalyze internal psychological processes that can't be fully captured by standardized scales. They produce insights that patients struggle to articulate even after the experience ends.

Understanding these medicines—really understanding them—requires attending to patient stories with the same rigor we apply to clinical data.

Not stories instead of science. Stories that precede science, inform science, and complement science.

Both together. Always both.

Let's journey together.