Life After Cancer
The end of cancer treatment is often a time to rejoice. You are probably relieved to be finished with the demands of treatment and are ready to put the experience behind you. Yet at the same time, you may feel sad and worried. It's common to be concerned about whether the cancer will come back and what you should do after treatment.
When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. Or you may even have emotional scars from going through so much. You may find that others think of you differently now - or you may view yourself in a different way.
One of the hardest things after treatment is not knowing what happens next.
What Is "Normal" After Cancer Treatment?
Those who have gone through cancer treatment describe the first few months as a time of change. It's not so much "getting back to normal" as it is finding out what's normal for you now. People often say that life has new meaning or that they look at things differently now. You can also expect things to keep changing as you begin your recovery.
All cancer survivors should have follow-up care. Knowing what to expect after cancer treatment can help you and your family make plans, lifestyle changes, and important decisions.
Some common questions you may have are:
- Should I tell the doctor about symptoms that worry me?
- Which doctors should I see after treatment?
- How often should I see my doctor?
- What tests do I need?
- What can be done to relieve pain, fatigue, or other problems after treatment?
- How long will it take for me to recover and feel more like myself?
- Is there anything I can or should be doing to keep cancer from coming back?
Coping with these issues can be a challenge. Yet many say that getting involved in decisions about their medical care and lifestyle was a good way for them to regain some of the control they felt they lost during cancer treatment. Research has shown that people who feel more in control feel and function better than those who do not. Being an active partner with your doctor and getting help from other members of your health care team is the first step.
In general, survivors usually return to the doctor every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that. At these visits, your doctor will look for side effects from treatment and check if your cancer has returned (recurred) or spread (metastasized) to another part of your body.
At these visits, your doctor will review your medical history, give you a physical exam, and may run follow-up tests such as: Blood tests, MRI or CT scans and/or Endoscopy. This test uses a thin, lighted tube to examine the inside of the body.
At your first follow-up visit, talk with your doctor about your follow-up schedule.
Some have described survivorship as being "disease-free, but not free of your disease." What you experience with your body may be related to the type of cancer you had and the treatment you received. It's important to remember that no two people are alike, so you may experience changes that are very different from someone else's, even if that person had the same type of cancer and treatment.
You may find that you are still coping with the effects of treatment on your body. It can take time to get over these effects. You may wonder how your body should feel during this time and what are signs that cancer is coming back. This section describes some of the problems that can occur when treatment is over. Some of the most common problems that people report are:
- Memory and concentration changes
- Nervous system changes (neuropathy)
- Lymphedema, or swelling
- Mouth or teeth problems
- Changes in weight and eating habits
- Trouble swallowing
- Bladder or bowel control problems
- Menopause symptoms
Each person's experience with cancer is different, and the feelings, emotions, and fears that you have are unique. The values you grew up with may affect how you think about and deal with cancer. Some people may feel they have to be strong and protect their friends and families. Others seek support from loved ones or other cancer survivors or turn to their faith to help them cope. Some seek help from counselors and others outside the family, while others don't feel comfortable with this approach.
Whatever you decide, it's important to do what's right for you and try not to compare yourself with others.
Worrying About Your Health
Worrying about the cancer coming back is normal, especially during the first year after treatment. This is one of the most common fears people have after cancer treatment. For some, the fear is so strong that they no longer enjoy life, sleep well, eat well, or even go to follow-up visits. "If I get it again, what am I going to do?" one woman said. "I never thought I'd make it through the first time." Others may react in a more positive way. As one survivor put it, "Cancer is just part of life, and we always have hope."
As time goes by, many survivors report that they think about their cancer less often. However, even years after treatment, some events may cause you to become worried. Follow-up visits, symptoms similar to the ones you had before, the illness of a family member, or the anniversary of the date you were diagnosed can trigger concern.
Coping With Fear of Cancer Returning
- Be informed. Learning about your cancer, understanding what you can do for your health now, and finding out about the services available to you can give you a greater sense of control. Some studies even suggest that people who are well-informed about their illness and treatment are more likely to follow their treatment plans and recover from cancer more quickly than those who are not.
- Express your feelings of fear, anger, or sadness. People have found that when they express strong feelings like anger or sadness, they're more able to let go of them. Some sort out their feelings by talking to friends or family, other cancer survivors, or a counselor. But even if you prefer not to discuss your cancer with others, you can still sort out your feelings by thinking about them or writing them down.
- Look for the positive. Sometimes this means looking for the good even in a bad time or trying to be hopeful instead of thinking the worst. Try to use your energy to focus on wellness and what you can do now to stay as healthy as possible.
Don't blame yourself for your cancer. Some people believe that they got cancer because of something they did or did not do. Remember, cancer can happen to anyone.
- You don't have to be upbeat all the time. Many people say they want to have the freedom to give in to their feelings sometimes. As one woman said, "When it gets really bad, I just tell my family I'm having a bad cancer day and go upstairs and crawl into bed."
- Find ways to help yourself relax. The exercises in Learning to Relax have been proven to help others and may help you relax when you feel worried.
- Be as active as you can. Getting out of the house and doing something can help you focus on other things besides cancer and the worries it brings.
Look at what you can control. Some people say that putting their lives in order helps. Being involved in your health care, keeping your appointments, and making changes in your lifestyle are among the things you can control. Even setting a daily schedule can give you a sense of control. And while no one can control every thought, some say that they try not to dwell on the fearful ones.
When you were diagnosed, you may have put concerns such as family, work, or finances aside. Now that treatment is over, these issues may begin to resurface.
Many cancer survivors also worry that stress may have played a role in their illness. It's important to remember that the exact cause of many cancers is still unknown. No research shows that stress causes cancer, but we do know that stress can cause other health problems. Finding ways to reduce or control the stress in your life may help you feel better. Devoting time to any activities that make you feel calm or relaxed may help.
Many survivors have found activities like the ones below useful in dealing with their worries after treatment ends. Ask your doctor, nurse, social worker, or local cancer organization about taking part in activities like these.
- Exercise. Exercise is a known way to reduce stress and feel less tense - whether you've had cancer or not. As one man put it, "I can feel down a little bit, and it is a fine line with depression, but when I walk 30 or 45 minutes in the fresh air, I feel like I can take on the world sometimes." See your doctor before making an exercise plan, and be careful not to overdo it. If you can't walk, ask about other types of movement that may be helpful, such as chair exercises or stretching.
- Mind-body methods. Things like meditation or relaxation may help you lower stress by quieting your mind. Try focusing on your breathing or repeating words or phrases to yourself. Other methods include hypnosis, yoga, or imagery.
- Creative outlets. Art, music, or dance gives people the chance to express themselves in different ways. Even people who have never danced, painted, or drawn before have found these activities helpful and fun.
- Sharing personal stories. Telling and hearing stories about living with cancer can help people air their concerns, solve problems, and find meaning in what they've been through.
- Finding Humor and Laughing: Ask people to send you funny cards. Enjoy the funny things children and pets do. Watch funny movies or TV shows. Listen to comedy tapes or CDs. Buy a funny desk calendar. Read joke books or check out jokes on the Internet.If you don't own a computer, use one at your local library. You may even find that you can laugh at yourself. "I went by to help a friend this summer, and it was really hot, so I took my wig off," one woman said. "I got ready to go and I couldn't find it. After searching high and low, I found it hanging from her dog's mouth. But I just stuck it on my head and went home. My husband said, 'What happened?' Needless to say that wig has never been the same."
Depression and Anxiety
After treatment, you may still feel angry, tense, or sad. For most people, these feelings go away or lessen over time. For some people though, these emotions can become more severe. The painful feelings do not get any better, and they get in the way of daily life. These people may have a medical condition called depression. For some, cancer treatment may have added to this problem by changing the way the brain works.
Talk with your doctor. If your doctor thinks that you suffer from depression, he or she may treat it or refer you to other experts. Many survivors get help from therapists who are experts in both depression and helping people recovering from cancer. Your doctor may also give you medicine to help you feel less tense.
If you find it hard to talk about your feelings, you may want to show your doctor this booklet. It can help you explain what you're going through. Don't feel that you should have to control these feelings on your own. Getting the help you need is important for your life and your health.
Many people find themselves feeling angry about having cancer or about things that happened to them during their diagnosis or treatment. They may have had a bad experience with a health care provider or with an unsupportive friend or relative.
Feeling angry is normal. And sometimes it can motivate you to take action. But hanging on to it can get in the way of taking care of yourself or moving on. If you can, look at what's causing your anger and what you can do to lessen it.
After treatment, you may miss the support you got from your health care team. You may feel as if your safety net has been pulled away and that you get less attention and support from health care providers now that treatment is over. Feelings like these are normal any time your regular contact with people who mean a lot to you comes to an end.
It's also normal to feel somewhat cut off from other people - even family and friends - after cancer treatment. Often, friends and family want to help, but they don't know how. Others may be scared of the disease. You may also feel that only others who have had cancer can understand your feelings.
Support groups can have many benefits. Even though a lot of people receive support from friends and family, the number one reason they join a support group is to be with others who have had similar cancer experiences. Some research shows that joining a support group improves quality of life and enhances survival.
Support groups can:
- Give you a chance to talk about your feelings and work through them
- Help you deal with practical problems, such as problems at work or school
- Help you cope with side effects of treatment
Finding Meaning After Cancer Treatment
Survivors often express the need to understand what having had cancer means to their lives now. In fact, many find that cancer causes them to look at life in new ways. They may reflect on spirituality, the purpose of life, and what they value most.
These changes can be very positive. Many report feeling lucky or blessed to have survived treatment and take new joy in each day. For some, the meaning of their illness becomes clear only after they have been living with cancer for a long time; for others, the meaning changes over time. It's also common to view the cancer experience both negatively and positively at the same time.
Often, people make changes in their lives to reflect what matters most to them now. You might spend more time with your loved ones, place less focus on your job, or enjoy the pleasures of nature. You might also find that going through a crisis like cancer gives you renewed strength.
Faith, Religion, or Spirituality
Having a serious illness can affect your spiritual outlook, regardless of whether you feel connected to traditional religious beliefs. After treatment, you and your loved ones may struggle to understand why cancer has entered your lives. You may wonder why you had to endure such a trial in your life.
Cancer survivors often report that they look at their faith or spirituality in a new way. For some, their faith may get stronger or seem more vital. Others may question their faith and wonder about the meaning of life or their purpose in it. Many say they have a new focus on the present and try to live each day to the fullest.
Many survivors have found that their faith, religion, or sense of spirituality is a source of strength. They say that through their faith, they have been able to find meaning in their lives and make sense of their cancer experience. Faith or religion can also be a way for survivors to connect with others in their community who may share similar experiences or outlooks or who can provide support. Studies have also shown that for some, religion can be an important part of both coping with and recovering from cancer.
The way cancer affects faith or spirituality is different for everyone. It's common to question your beliefs after cancer. These questions can be difficult, but for some, seeking answers and searching for personal meaning in spirituality helps them cope.
Source: National Cancer Institute