Ask CancerCare

April 2008 This Month's Topic: Survivorship Issues Featured Expert: Julie Larson, LMSW

 

Q. I've been trying to get back to normal after treatment for cervical cancer but I'm having some trouble. Everyone is happy that I'm back to work, but I'm not sure I am. Why am I feeling this way and what should I do?

A. What you have described is quite normal. With the end of treatment often comes the expectation that it's time for celebration, and for things to go back to how they used to be. Yet, it's common for many people to feel lost, uncertain and confused about how to move forward. Friends and family usually mean well, but they might not be fully aware of the emotional challenges that can arise after treatment is over.

Often times after treatment has ended, people find themselves reevaluating their lives. This could mean reassessing relationships or professional goals, and discovering new ways of finding meaning and fulfillment. Moreover, you might not be fully ready to be back to work, whether emotionally or physically.

Newly diagnosed patients can be so busy learning about their diagnosis, working with their medical team, and going through treatment, that the emotional impact of the diagnosis is not fully felt until treatment has ended. Understanding what life after cancer means to you can take time. This process may involve reflecting on what you've been through, identifying changes you might want to make in your life and recognizing what you've learned about yourself.

Remember that support groups are not only for people in active treatment. You might find the feelings you're having right now are better understood by people who've "been there" and are currently facing similar issues such as fear of recurrence, living with uncertainty, lingering side effects, and going back to work. You might also find individual counseling helpful.

CancerCare offers several Telephone Education Workshop podcasts that might also be helpful:

• Finding Hope and Meaning After Treatment
• My Treatment is Over: Why Do I Feel So Alone and Sad?

If you have concerns about how your feelings, both emotional and physical, are affecting your daily life, speak with your doctor or a counselor for support and additional guidance.

 

Q. I've finished my treatment (radiation and chemotherapy) and now I feel like I'm on my own and everything just stopped. Are there other things I should be doing now?

A. Finishing cancer treatment often brings mixed feelings. A sense of relief and feelings of accomplishment are normal; so, too, is uncertainty about the future. Your instinct to prepare in some way for your survivorship is a good one. Here are some steps you can take to keep both your mind and your body healthy as you continue to work with your medical team, now and into the future.

1. Ask your doctor for a Treatment Summary. This should include:
   • Your type(s) of cancer with the date and stage at diagnosis
   • Types of treatment received (surgery, chemotherapy drugs, radiation doses and tests performed)
   • Complications experienced (side effects, transfusions, hospitalizations)
   • Other services used (physical therapy, acupuncture, herbal)
2. Discuss with your doctor what your Follow-Up Plan will be. This should include:
   • Future schedule of visits (time and date)
   • Who will deliver follow-up care (and where)
   • Tests that will be done and why (surveillance and preventative)
   • Assessment and treatment for long- or late-term effects (e.g., lymphedema, depression, pain)
   • Evaluation of current health behaviors and promotion of healthy life style

You mentioned feeling "on your own" now that your treatment is complete. This is a common feeling when treatment ends, and it's good to know about the different types of support available to you that might help you feel connected:

• Professional support provides you with information, resources and counseling
• Peer-to-Peer support reduces your sense of isolation and helps you connect with others who share similar concerns

To tap into these types of support, speak with an oncology social worker or join a support group at CancerCare. A social worker can also help you identify local support services. You might find it useful to listen to the upcoming Telephone Education Workshop, The Importance of Communicating with Your Doctor About Follow-Up Care. This is the first part of a three part Survivorship Series.

There are great resources available that can help you "organize" all of the above information. The Lance Armstrong Foundation (LAF) has developed worksheets and a Survivorship Notebook. The National Coalition for Cancer Survivorship (NCCS) provides information about Living Beyond Cancer and Survivorship Care Planning. And for childhood cancer survivors, the National Children's Cancer Society offers a wealth of information in managing long-term effects from treatment.

 

Julie Larson, LMSW is the Program Coordinator for Young Adult Services at CancerCare. She provides support to young adult clients and their loved ones face-to-face, over the telephone, and online. She has presented extensively on young adult cancer issues and represents CancerCare as part of the LiveStrong Young Adult Cancer Alliance.

 

The questions and answers listed above are from the April 2008 Ask CancerCare feature.  New Ask CancerCare topics are introduced every month. 

If you have additional questions about coping with survivorship issues, please contact CancerCare directly for information and guidance. CancerCare provides free professional support services, including counseling, education, financial assistance and practical help. These services are provided by professional oncology social workers. If you have a specific concern or question and would like to speak with an oncology social worker, please contact us at info@cancercare.org or 1-800-813-HOPE (4673).

For questions about medical issues, please visit Cancer.net, the patient information website of the American Society of Clinical Oncology (ASCO).