Adding Life to Your Years

by Jane Ashley

You’ve just finished your last chemotherapy session, or you’ve just had your last radiation treatment. Or your pathology report from your surgery showed clean margins, no residual tumor and no positive lymph nodes – so you won’t be needing adjuvant (mop-up) chemotherapy.
They tell you, “We’ll see you in three months.”

Sunset

“WOW,” you think. You’re happy and relieved. You look forward to getting back to normal.
And then that little devil named “DOUBT and FEAR” whispers in your ear, “Yes, but what if it comes back?”

What can we do about our fear of recurrence?

Hopefully, all of our oncologists have told us what we can do to help prevent a recurrence. These suggestions include:
Lose weight, if you are obese.
• Eat healthier foods – more fruits and vegetables, less red meat, more fish.
• Limit alcohol consumption.
• Stop smoking.
• Exercise regularly – 150 minutes weekly is ideal.
• Follow your oncologist's recommendations about vitamins – i.e., breast and colorectal cancer patients are usually advised to take higher doses of Vitamin D3.
• Reduce stress.

These are the behavior modifications that we can make to help prevent a recurrence.

The only additional “thing” that we can do is to keep our appointments for blood work and scans. Every person’s cancer is different – age, overall health, stage, location and number of mets if Stage IV, pathology report, response to treatment, genetic mutations, family history, social history – so we’re all different.

ASCO (American Society of Clinical Oncology) and NCCN (National Comprehensive Cancer Network) have developed surveillance guidelines for each type of cancer, according to each stage, for what our oncologists should do to help detect a recurrence early so that it can be treated effectively.

So the bottom line is that lifestyle changes and surveillance is ALL that any cancer survivor can do to prevent/detect a recurrence.
Obviously, if we have symptoms like we had before, develop new symptoms like shortness of breath, serious fatigue, weight loss, blood in our stools or urine, frequent/severe headaches or persistent pain … then we need to call our oncologist. Reporting any new symptoms is part of our vigilance.

Crystal Ball

What if we can’t stop worrying about our cancer coming back?

Some people, however, experience fear so severe that interferes with their daily life. This fear takes many forms – insomnia, anxiety, fear of every little ache and pain or cough – even worse, some people may find that they can’t enjoy their favorite hobbies or other activities because fear has taken over their life.

All of us are different, and each of us has to find our own peace of mind in our life after cancer. Some of us expect to just pick up where we left off. But we may find that it’s not that easy. Someone at work may have assumed some of our duties. Another family member may be doing what we used to do for family gatherings. There will be a time of adjustment as we find our “new normal.”

Don’t feel that you have to live up to others’ expectations. There is no scientific evidence that keeping a positive attitude helps prevent recurrence. If you need some time to feel sad and reflective about what you’ve experienced, that’s OK.

But there comes a time after our treatment ends when we must learn to live with a degree of uncertainty in our life. None of us will deny that we don’t have some fear of recurrence – we wouldn’t be human if we said that we didn’t have some worry or fear. Usually, this uncertainty is worse in the first year after treatment.

But, for some people, the fear of recurrence becomes crippling. This fear results in sleep deprivation, inability to stay close to family and friends and loss of interest in our favorite things. If you feel anxious every day, if you feel so fearful that you cancel a follow-up visit or cancel a scan or other surveillance procedure (colonoscopy, lab work, bone marrow biopsy) because you are too afraid to learn the results, it’s time to acknowledge that you may be suffering from serious anxiety and/or depression.

Fear

How to find help for your fear of recurrence

There are lots of effective options in addition to seeking professional help. Here are some ideas that may help.

Talk to your healthcare team – ask them for help in accepting that there is a chance of recurrence
• Join a support group – being part of a group of cancer survivors is liberating. You’ll discover that you are not alone in your fears, and you’ll hear how other cancer survivors accept uncertainty while living a full and productive life after cancer.
• Manage the stress in your life – reduce your work hours for a while, begin an exercise program, resume an old hobby or start a new one and learn how to laugh again.
• Learn more about your cancer type – knowledge is power – your oncologist can help you know what symptoms are a concern so that you learn to ignore routine aches and pains.
• Gradually take back control of the work and/or household tasks you used to do. It takes a while to regain your strength but regaining control of your life help you feel empowered and not a victim. Well over half of what you worry about will never happen. If you have a well-founded worry, like not being able to pay some medical bills, be proactive and call to make arrangements.
• Endeavor to live one day at time. Savor your morning coffee. Allow a spectacular sunrise or sunset to send you scurrying for your camera. 

Relish a well-cooked meal. Embrace your pet and let them know you still love them. Live in the now.
If none of these help, seek professional help. There is no shame in needing help. Cancer is a life-threatening illness. Everyone recovers at a different pace.

Remember the day we were diagnosed. One of our first thoughts was, “Am I going to die?”

Keep in mind that we didn’t go through all of the chemo, surgery, radiation and other procedures just so we could sit at home afterward being afraid. We endured what we endured so that we could live.

No one is promised tomorrow. Today is the day we have … live life to the fullest.

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Creating A Survivorship Plan For Life After Cancer

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