Ask CancerCare

A. A wide range of both physical and emotional responses surface following the completion of treatment. Reaching out for support around your unique needs is a very healthy way of taking care of yourself. Additionally, engaging in certain activities can help you to regain some sense of control and be an active participant in your recovery.

Take a moment to think about the people who have been helpful to you. Your "team" includes the doctors, nurses, social workers, alternative health practitioners, other survivors and the family and friends who surround you. Defining and understanding the distinct role that each person plays is beneficial so you know where to turn when you need help. Who can answer medically related questions? What programs exist to help financially? Who do you approach when you need a good listener?

Keep in mind the following services as you evaluate your current needs:

• Peer support, through support groups or survivor matching programs, allows you the opportunity to learn from others and find emotional support.
• Individual counseling provides a space to process the many complex feelings that come with cancer survivorship.
• Financial assistance programs are available to help with some medically related expenses such as co-pays for medication, as well as out of pocket costs associated with transportation.
• Alternative therapies such as Reiki, acupuncture or massage can help you alleviate side effects such as fatigue and pain. Relaxation techniques may also help you manage feelings of anxiety.

Taking inventory of available supportive services is an important first step to take. Think about what services would be a good fit for you given your current needs. If it's not clear or you are having trouble finding local services, speak with an oncology social worker who can help guide you.

A. Experiencing lingering side effects after active cancer treatment has completed is common. These side effects can be especially frustrating when you expect to feel better as soon as treatment is over. Most side effects gradually lessen with time as your body heals and recovers from these treatments. Yet, people experience these changes at varying rates and in unique and individual ways. It's important to share your concerns and questions about continued side effects with your medical team and explore resources to help you manage. I'd recommend keeping a detailed daily log of the side effects you are experiencing—this makes it easier to share details with your doctor.

Connecting with other cancer survivors in a support group for those who are post-treatment can be helpful. A support group is a place to share tips and ways of coping with other survivors who might be experiencing similar lingering effects. CancerCare offers groups over the telephone, online and in person (New York City area). We can also help you locate groups in your area.

Our Connect^® Education Workshops provide practical tips and more comprehensive information on managing side effects after cancer treatment.

• Neuropathy and Joint Aches: New Post Treatment Challenges
• Chemotherapy Related Memory and Thinking Changes
• Care and Well-Being After Treatment

Finally, these publications offer useful information in coping with certain treatment side effects:

• Understanding Peripheral Neuropathy
• "Cognitive Problems After Chemotherapy"
• "Ways to Improve Concentration"
• "Keeping Your Memory Sharp"

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 these Connect^® Education Workshops:

• The Importance of Communicating with Your Doctor About Follow-Up Care
• The Importance of Nutrition and Physical Activity
• Managing the Stress of Survivorship

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 for childhood cancer survivors, the National Children's Cancer Society offers a wealth of information in managing long-term effects from treatment.

 

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 Connect 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.