Cancer Survivorship

Coping with Cancer

You may have just learned that you have cancer. Or you may be in treatment, finishing treatment, or have a friend or family member with cancer. Having cancer changes your life and the lives of those around you. The symptoms and side effects ofthe disease and its treatment may cause certain physical changes, but they can also affect the way you feel and how you live.

Feeling and Cancer

Just as cancer affects your physical health, it can bring up a wide range of feelings you’re not used to dealing with. It can also make existing feelings seem more intense. They may change daily, hourly, or even minute to minute. This is true whether you’re currently in treatment, done with treatment, or a friend or family member. These feelings are all normal. Often the values you grew up with affect how you think about and deal with cancer.

When you first learn that you have cancer, you may feel as if your life is out of control and overwhelmed.Even if you feel out of control, there are ways you can take charge. Try to learn as much as you can about your cancer. Ask your doctor questions and don’t be afraid to say when you don’t understand. Also, many people feel better if they stay busy. You can take part in activities such as music, crafts, reading, or learning something new.

Trouble believing or accepting the fact that you have cancer is called Denial. It can be helpful as allow time for adjusting to your diagnosis asl well as gives you itme to feel hopeful and better about the future. However, it can be a serious problem as if lasting too long, it will prevent you from getting the treatment you need. Most people work through this with time, albeit patient or those who care for them.

It is normal to feel angry and ask “Why me?” as well as anger against health care providers, your friends and your loved ones. You may even feel angry with God if you’re religious. Anger often comes from feelings that are hard to show, such as fear, panic, frustration, anxiety, or helplessness. If you feel angry, you don’t have to pretend that everything is okay. Anger can be helpful in that it may motivate you to take action. Talk with your family and friends about your anger. Or, ask your doctor to refer you to a counselor.

It’s scary to hear that you have cancer. You may be afraid or worried about:

  • Being in pain, either from the cancer or the treatment
  • Feeling sick or looking different as a result of your treatment
  • Taking care of your family
  • Paying your bills
  • Keeping your job
  • Dying

Some fears about cancer are based on stories, rumors, or wrong information. To cope with fears and worries, it often helps to be informed. Most people feel better when they learn the facts. They feel less afraid and know what to expect. Learn about your cancer and understand what you can do to be an active partner in your care. 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.

Once people accept that they have cancer, they often feel a sense of hope. There are many reasons to feel hopeful. Millions of people who have had cancer are alive today. Your chances of living with cancer—and living beyond it—are better now than they have ever been before. And people with cancer can lead active lives, even during treatment.

Some doctors think that hope may help your body deal with cancer. So, scientists are studying whether a hopeful outlook and positive attitude helps people feel better. Here are some ways you can build your sense of hope:

  • Plan your days as you’ve always done.
  • Don’t limit the things you like to do just because you have cancer.
  • Look for reasons to have hope. If it helps, write them down or talk to others about them.
  • Spend time in nature.
  • Reflect on your religious or spiritual beliefs.
  • Listen to stories about people with cancer who are leading active lives.
  • Stress/Anxiety

Both during and after treatment, it’s normal to have stress over all the life changes you are going through. Anxiety means you have extra worry, can’t relax, and feel tense.

If you have any of these feelings, talk to your doctor. Though they are common signs of stress, you will want to make sure they aren’t due to medicines or treatment. Stress can keep your body from healing as well as it should. Talk to a counselor, or take classes that helps in coping stress. The key is to find ways to control your stress and not to let it control you.

Many people with cancer feel sad. They feel a sense of loss of their health, and the life they had before they learned they had the disease. This is a normal response to any serious illness, even after treatment has completed. It may take time to work through and accept all the changes that are taking place.

When you’re sad, you may have very little energy, feel tired, or not want to eat. For some, these feelings go away or lessen over time. But for others, these emotions can become stronger. The painful feelings don’t get any better, and they get in the way of daily life. This may be a medical condition called depression. For some, cancer treatment may have added to this problem by changing the way the brain works.

Getting help for Depression

Depression can be treated. Below are common signs of depression. If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment. Be aware that some of these symptoms could be due to physical problems, so it’s important to talk about them with your doctor.

Emotional signs:

  • Feelings of sadness that don’t go away
  • Feeling emotionally numb
  • Feeling nervous or shaky
  • Having a sense of guilt or feeling unworthy
  • Feeling helpless or hopeless, as if life has no meaning
  • Feeling short-tempered, moody
  • Having a hard time concentrating, feeling scatterbrained
  • Crying for long periods of time or many times each day
  • Focusing on worries and problems
  • No interest in the hobbies and activities you used to enjoy
  • Finding it hard to enjoy everyday things, such as food or being with family and friends
  • Thinking about hurting yourself
  • Thoughts about 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
  • Changes in energy level
  • Fatigue that doesn’t go away
  • Headaches, other aches and pains

If your doctor thinks that you suffer from depression, he or she may give you medicine to help you feel less tense. Or, he or she may refer you to other experts. 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.

It may be hard at first, but you can find joy in your life if you have cancer. Pay attention to the things you do each day that make you smile. They can be as simple as drinking a good cup of coffee or talking to a friend.

You can also do things that are more special to you, like being in nature or praying in a place that has meaning for you. Or, it could be playing a sport you love or cooking a good meal. Whatever you choose, embrace the things that bring you joy when you can.

Ways to Cope with Your Emotions

Express Your Feelings

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, a support group, 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.

Don’t Try to Be Upbeat If You’re Not

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.”

You Choose When to Talk about Your Cancer

It can be hard for people to know how to talk to you about your cancer. Often loved ones mean well, but they don’t know what to say or how to act. You can make them feel more at ease by asking them what they think or how they feel.

Find Ways to Help Yourself Relax

Whatever activity helps you unwind, you should take some time to do it. Meditationguided imagery, and relaxation exercises are just a few ways that have been shown to help others; these 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. Exercise or gentle yoga and stretching can help too.

Look for Things You Enjoy/strong>

You may like hobbies such as woodworking, photography, reading, or crafts. Or find creative outlets such as art, music, or dance.

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, but instead do what they can to enjoy the positive parts of life.

Self-image and sexuality

Each of us has a mental picture of how we look, our “self-image.” Although we may not always like how we look, we’re used to our self-image and accept it. But cancer and its treatment can change how you look and feel about yourself.

Some body changes are short-term while others will last forever. Either way, your looks may be a big concern during or after treatment. For example, people with ostomies after colon or rectal surgery are sometimes afraid to go out. They worry about carrying equipment around or fear that it may leak. Some may feel ashamed or afraid that others will reject them.

Every person changes in different ways. Some will be noticeable to other people, but some changes only you will notice. For some of these you may need time to adjust. Issues you may face include:

  • Hair loss or skin changes
  • Scars or changes in the way you look caused by surgery
  • Weight changes
  • Loss of limbs
  • Loss of fertility, which means it can be hard to get pregnant or father a child

Even if others can’t see them, your body changes may trouble you. Feelings of anger and grief about changes in your body are natural. Feeling bad about your body can also lower your sex drive. This loss may make you feel even worse about yourself.

How do you cope with body changes?

  • Mourn your losses and know it’s okay to feel sad, angry, and frustrated. Your feelings are real, and you have a right to grieve.
  • Try to focus on the ways that coping with cancer has made you stronger, wiser, and more realistic.
  • If your skin has changed from radiation, ask your doctor about ways you can care for it.
  • Look for new ways to enhance your appearance. A new haircut, hair color, makeup, or clothing may give you a lift. If you’re wearing a wig, you can take it to a hairdresser to shape and style.
  • If you choose to wear a breast form (prosthesis), make sure it fits you well. Don’t be afraid to ask the clerk or someone close to you for help. And check your health insurance plan to see if it will pay for it.

Coping with these changes can be hard. But, over time, most people learn to adjust to them and move forward. If you need to, ask your doctor to suggest a counselor who you can talk with about your feelings.

Many people find that staying active can help their self-image. Some things you can try are:

  • Walking or running
  • Swimming
  • Playing a sport
  • Taking an exercise class
  • Weight training
  • Stretching or yoga

You may find that being active helps you cope with changes. It can reduce your stress and help you relax. It may also help you to feel stronger and more in control of your body. Start slowly if you need to and take your time.

Hobbies and volunteer work can also help improve your self-image and self-esteem. You may like to read, listen to music, do crossword or other kinds of puzzles, garden or landscape, or write a blog, just to name a few. Or you could volunteer at a church or a local agency, or become a mentor or tutor, for example. You may find that you feel better about yourself when you get involved in helping others and doing things you enjoy.

It’s common for people to have problems with sex because of cancer and its treatment. When your treatment is over, you may feel like having sex again, but it may take some time. Sexual problems can last longer than other side effects of cancer treatment. It’s important to seek help in learning how to adapt to these changes.

Until then, you and your spouse or partner may need to find new ways to show that you care about each other, e.g. touching, holding, hugging, and cuddling.

Cancer Survivorship

Survivorship is a unique and ongoing experience, which is different for each person and those close to them. A key to survivorship is to regain, as far as possible, the important aspects of your life before cancer, and to find new pathways to a satisfactory life going forward.

Survivorship focuses on health and the physical, psychological, social and economic issues affecting people after the end of the primary treatment for cancer. Post treatment cancer survivors range from people having no disease after finishing treatment, people who continue to receive treatment to reduce the risk of the cancer coming back and people with well controlled disease and few symptoms, who receive treatment to manage cancer as a chronic disease. Survivorship care includes issues related to follow-up care, the management of late side-effects of treatment, the improvement of quality of life and psychological and emotional health. Survivorship care includes also future anticancer treatment where applicable. Family members, friends and caregivers should also be considered as part of the survivorship experience.

Facing Forward: Life after cancer treatment :
www.cancer.gov/publications/patient-education/facing-forward

Facing Forward: Making a difference in Cancer:
www.cancer.gov/publications/patient-education/make-a-difference

Esmo Patient Guide on Survivorship :
www.esmo.org/content/download/117593/2061518/file/ESMO-Patient-Guide-Survivorship.pdf

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