Life beyond cancer treatment – you are your own expert

Often after cancer treatment patients are told that they are in ‘remission’ or have been given ‘the all clear’. Understandably, there is great relief all around. Treatment side effects may reduce or disappear altogether; physical energy starts to rebuild, body hair returns, some people return to work, cancer becomes a less frequent topic of conversation. Often people try and continue with their lives where they left off, in the hope those weeks and months of trauma, panic, chaos and fear turn into vague memories of a distant past.

However, it is not always as simple and straightforward as that. Cancer is a life-changing disease, and this includes life post-treatment. Anxiety, depression and even panic attacks are common. What is going on?

While every person with cancer will have a different experience and different way of coping with the emotional impact of treatment and having (had) the condition, there are common post-treatment realities:

• Delayed reaction to the trauma of diagnosis and treatment: often everything happens so fast that you do not have time to digest the enormity of what is happening to you. Post-treatment is often an anti-climax, when the emotional built-up is felt more strongly.

• The ending of regular medical care and appointments: many people will only have check-up appointments and are left feeling vulnerable without regular medical attention.

• Life around continues ‘as normal’ in the world, at home, at work, with your friends, while you have undergone one of the most life-changing experiences. You cannot go back to ‘normal’ and pretend your cancer never happened.

• Perhaps the most potent issue of all is that of uncertainty over whether the cancer is coming back. Most people will have been told the symptoms of secondary cancer, which depend on the nature of the initial cancer. Many react with a heightened sensitivity and alertness to any sign of discomfort.

• Side effects of drugs: many people will decide to continue orthodox cancer treatment with drugs for many years, some of which may have side effects which are a constant reminder of the cancer.

• Some people will have experienced financial hardship during their cancer treatment due to their inability to work and pay bills, rent or a mortgage. Others are still not well enough to return to work, may never be able to return or proactively decide against returning to their previous work schedule.

• Others will have had less supportive experiences during their treatment from family and friends. It is not uncommon for some (for reasons of their own) to find it difficult to be around people with serious and terminal diseases.

This, all taken together, makes for a potent emotional mix of fear, uncertainty, anger, anxiety, depression, often leading to emotional exhaustion. This is why the emotional impact of cancer does not disappear post-treatment.

THE GOOD NEWS is that this is a common occurrence, and does not mean that the person finding themselves in this position has done anything wrong or failed, or has not done other things well enough. It is to be expected that, sooner or later, you will fall into the proverbial black hole - probably several times. That is normal. The key issue is what are you going to do about it and how long it is before you can climb back up. In some this requires a mental shift, a slightly different way of looking at things.

1. What you are experiencing is normal, which does not make it less easy - but you are not alone in feeling this way.

2. You are entitled to your anger and outrage about having (had) cancer - the pain, loss and uncertainty you are facing.

3. You have options and choices of how to manage your life and relationships. Often a cancer diagnosis and treatment becomes a powerful incentive to live life to the full on your terms – because life is precious and can be short.

4. You will find yourself emotional and more fragile than you may have been before – more irritable and easily stressed. Looking after yourself and avoiding stressful situations is essential. This can range from small things like avoiding a packed bus or going shopping at less busy times, or reviewing your work and domestic arrangements.

5. Take regular (even small) breaks throughout the day, where you focus on yourself.

6. A healthy diet, regular (not necessarily energetic) exercise and fresh air help reduce stress and assist your physical and emotional well-being.

7. Be aware of what triggers your anxiety and stress (e.g. an up-coming check up, or arguments at home). 

8. Follow your intuition.

9. Remind yourself how much you have endured and how well you have done to come so far.

10. Dealing with cancer is more complex than a ’10 point to-do list’ could ever attempt to tackle. Your cancer experience is as individual as you. Design your own ’10 point list’ and update it from time to time as you continue to change and move through your life as best as you can.

Counselling can assist in digesting and working through the emotional impact of a cancer diagnosis, treatment, life with and beyond cancer. Talking to someone who is independent can help release difficult emotions, free up space for renewed thinking and making positive choices.