Your Feelings
Worrying About Your Health
Feeling Stress
Coping With Depression and Anxiety
Feeling Angry
Feeling Alone
Joining a Support Group
Finding Meaning After Cancer Treatment
"I don't think you ever forget the fact that
it could come back."
- Emily
Just as cancer treatment affects your physical health, it can affect the way you
feel, think, and do the things you like to do. It's normal to have many different
feelings after treatment ends. Just as you need to take care of your body after
treatment, you need to take care of your emotions.
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 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
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- 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
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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.
Reducing Stress
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. See Joining a Support Group for support
group information.
Finding Humor and Laughing
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"Is cancer life-threatening? Yes, but why die mad?
So I joked about it all the way through,
and I think it helped me."
- Ari
Laughter can help you relax. When you laugh, your brain releases chemicals that
produce pleasure and relax your muscles. Even a smile can fight off stressful
thoughts. Of course, you may not always feel like laughing, but other people
have found that these ideas can help:
- 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."
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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.
Getting Help
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.
Do I Need Help?
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If you have any of the following signs for more than 2 weeks, talk to your
doctor about treatment. Some symptoms could be due to physical problems,
so it's important to be willing to talk about them with your doctor.
- Emotional signs:
- Feelings of worry, anxiety, or sadness that don't go away
- Feeling emotionally numb
- Feeling overwhelmed, out of control, or shaky
- Having a sense of guilt or feeling unworthy
- Feeling helpless or hopeless
- Feeling short-tempered or moody
- Having a hard time concentrating, or feeling scatterbrained
- Crying for long periods of time or many times each day
- Focusing on worries or problems
- Having a hard time getting certain thoughts out of your mind
- Finding it hard to enjoy everyday things, such as food or being with friends
- Finding yourself avoiding situations or things that you know are really harmless
- Thinking about hurting or killing yourself
Body changes:
- Unintended weight gain or loss not due to illness or treatment
- Sleep problems, such as not being able to sleep, having nightmares, or sleeping too much
- Racing heart, dry mouth, increased perspiration, upset stomach, diarrhea
- Physically slowing down
- Fatigue that doesn't go away, headaches, or other aches and pains
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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.
"I went to radiation treatment every day, and
the staff became like part of my family. And then
when I finished, there was this instant separation,
and I really felt a loss."
- Tom
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.
Getting Help
What can you do to make yourself feel better? Try to think about how you could
replace the emotional support you used to receive from your health care team,
such as:
- Asking one of your nurses or doctors if you could call
sometimes. This could help you stay connected and help you feel less
alone. Even just knowing you can call them may help.
- Finding support services offered over the phone or Internet.
- Finding new sources of support for your recovery. Friends, family,
other cancer survivors, and clergy members are a few ideas.
- Joining a cancer support group. People who have had cancer meet in
groups to talk about their feelings and concerns. Besides sharing their own
stories, they hear what others have gone through and how other people
have dealt with the same problems they are facing. A support group may
also help members of your family cope with their concerns.
"I could feel myself getting down, and I joined
this group and we have a great time. We cry, we
laugh, we carry on."
- Elia
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
Types of Support Groups and Where To Find Them
There are many different types of support groups. Some may be for one type of
cancer only, while others may be open to those with any cancer. Some may be
for women or for men only. Support groups may be led by health professionals
or fellow cancer survivors.
Support groups aren't just for people who have had cancer. Support groups can
be helpful for children or family members of survivors. These groups focus on
family concerns such as role changes, relationship changes, financial worries,
and how to support the person who had cancer. Some groups include both
cancer survivors and family members.
Not only do support groups meet in person, they also meet online. Internet
support groups can be a big help to people with computers who live in rural areas
or who have trouble getting to meetings. Some Internet groups are sponsored by
cancer organizations, while others are not monitored. With informal chat groups,
you can seek support at any time of the day or night. While these online groups
can provide valuable emotional support, they may not always offer correct
medical information. Be careful about any cancer information you get from the
Internet, and check with your doctor before making any changes that are based
on what you read.
Is a Support Group Right for Me?
A support group may not be right for everyone. For some people, hearing about
others' problems can make them feel worse. Or you may find that your need for
a support group changes over time.
If you are thinking about joining a support group, here are some questions you
may want to ask the group's contact person:
- How large is the group?
- Who attends (survivors, family members, types of cancer, age range)?
- How long are the meetings?
- How often does the group meet?
- How long has the group been together?
- Who leads the meetings - a professional or a survivor?
- What is the format of the meetings?
- Is the main purpose to share feelings, or do people also offer tips to solve common problems?
- If I go, can I just sit and listen?
Before joining a group, here are questions you may want to ask yourself:
- Am I comfortable talking about personal issues?
- Do I have something to offer to the group?
- What do I hope to gain by joining a group?
Support groups vary greatly, and if you have one bad experience, it doesn't mean
support groups are not a good option for you. You may also want to find
another cancer survivor with whom you can discuss your cancer experience.
Many organizations can pair you with someone who had your type of cancer
and is close to your age and background.
The Association of Cancer Online Resources (ACOR) offers access to mailing lists that
provide support and information to those affected by cancer and related disorders. The
ACOR mailing lists are a group of free, unmoderated discussion lists for patients, family,
friends, researchers, and physicians to discuss clinical and other issues and advances
pertaining to all forms of cancer. Learn more online at www.acor.org.
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"After treatment for breast cancer, I knew
my life had changed forever. Nothing could ever
be the same. I was very sad at my losses, but I felt
I had been given the gift of a new life."
- Linda
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.
"I feel good that I've found ways to cope," one colon cancer survivor said. "I also
feel better able to handle any future problems that might come up. I have
strength that I didn't know I had."
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.
Finding Comfort and Meaning
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- Read uplifting stories about the human spirit.
- Pray or meditate to help you gain perspective.
- Take part in community or social gatherings for your own support and to support others.
- Talk with others who have had similar experiences.
- Find resources at a place of worship for people dealing with chronic illnesses like cancer.
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Finding Support
How can you find faith-based support in your community? Here are some ideas
that have helped other cancer survivors:
- Contact a religious or spiritual leader in your community. Most
have been trained in counseling people with major illnesses.
- Contact the chaplain at your local hospital or treatment
facility. Most hospitals have a staff chaplain who can provide support to
people of different faiths and religions, as well as people who do not
consider themselves religious at all. These chaplains have also been trained
to provide spiritual support to patients and families in crisis.
- Talk with your hospital, health care team, or social worker.
They may know about faith-based organizations in your community that
provide specialized services for cancer survivors.
How Can You Find New Meaning in Your Life After Cancer?
- Assess your life. Some survivors say their cancer gave them a wake-up
call and a second chance to make life what they want it to be. Ask
yourself: do your roles in your family fulfill you, or are you doing what
people expect of you? What are things you've always wanted to try? Are
you happy in your job, or are you just used to it?
- Seek spiritual support. A trusted clergy member or professional
counselor may be able to help you with life questions.
- Keep a journal. Write down your thoughts about what gives meaning to
your life now.
- Think about helping others who have had cancer. For some,
reaching out and helping others helps them find meaning. Others want to
get cancer out of their minds and prefer to focus their energy in other
ways. If you want to help, many local and national cancer groups need
volunteers. Or you may prefer to reach out to people you know and spread
the word through family and friends. (The NCI booklet Facing Forward:
Ways You Can Make a Difference in Cancer gives more information. See the
Resources section for how to order it.)
- Think about taking part in a research study. Research studies are
trying to identify the effects of cancer and its treatment on survivors. Joining
a research study is always voluntary, and it could benefit both you and
others. If you want to learn more about studies that involve cancer survivors,
talk with your doctor or see the Resources section.
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