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Recovery, Reappraisal, and Renewal

After Cancer Treatment

by Tish Knobf, PhD, RN, FAAN, AOCN

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Cancer survivors frequently say that family and friends want them to return to “normal” after their treatment is over. And much has been written about cancer survivors needing to adjust to a “new normal.” But what is normal?

Average, routine, regular, orderly, constant, and rational are synonyms for normal. There is little that is average or routine after cancer treatment. Physical and psychological recovery after treatment is a dynamic process – ups and downs, some steps forward, maybe a few back, more forward. Everyone’s experience is unique. After treatment, congratulate yourself and any supportive friends and family for getting through it. But expect challenges. Give yourself time to recover, reappraise yourself (physically, psychologically, and socially), and consider ways to renew yourself moving forward as a cancer survivor.

Recovery
There are some general side effects of cancer therapy, such as fatigue and sleeping problems, that may last up to a year or longer. However, physical activity has been proven to improve energy levels, cardiovascular fitness, and muscle strength. Walking is great physical activity. Get a pedometer to count your steps, find a partner to walk with, or join a local fitness program. Start wherever you are and work up to 30 minutes of walking on five or more days of the week. Identify what might get in the way of your goal to exercise every day and write down ideas to overcome these barriers.

Finishing treatment is a cherished goal, but it is a change, and change can be stressful.

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Dr. Tish Knobf

Cancer therapy is associated with many side effects: some continue after treatment, some get better, some stay the same, and some new symptoms may occur over time. It is different for every survivor. Physical recovery may be easier or more difficult for one survivor than it is for another. Young women with breast cancer may experience symptoms of menopause, men with prostate cancer may have serious changes in their bowel patterns, some chemotherapy drugs may cause numbness and discomfort in the hands and feet, and surgery or radiation for tumors of the head and neck region may cause a lack of saliva.

Be proactive in helping your body recover. Contact your healthcare provider and ask for suggestions to help manage symptoms. Go back if the first approach is not working. You may even need to get a second opinion.

Expect some emotional turbulence in that first year. Finishing treatment is a cherished goal, but it is a change, and change can be stressful. You have gotten used to seeing the oncology nurses, therapists, and doctors, and now you are on your own. This can be an unsettling time for many survivors. Increases in emotional distress and anxiety are common. The vulnerability of the cancer experience is still quite fresh, and it takes the body and mind time to heal. Some cancer survivors have ways to work though this on their own, and some may need support from other survivors or professional counseling. Don’t be afraid to reach out for help.

Reappraisal
Cancer offers survivors an opportunity to stand back and reappraise life. Many see this as a chance to do things they always put off doing, take time for themselves, and appreciate life to a fuller extent. It is also a time to realistically appraise yourself and your feelings.

Some symptoms, whether physical or psychological, may be very distressing to you but not obvious to friends and family. Share your feelings. Those close to you might very well need help in understanding the ups and downs of recovery and what symptoms you are coping with every day.

Renewal
What is most important to you now? How do you want to live each day? Set personal goals for yourself. Most importantly, love yourself for who you are. You may need some help in creating a “renewal” plan – experiment, try something new, revert to something old, or keep things the same if that is what makes you happy. Millions of survivors are living healthy, happy, fulfilling lives – many with a new perspective on life.

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Dr. Tish Knobf is a professor at the Yale University School of Nursing in New Haven, CT, where she is the faculty coordinator for the Oncology Nurse Practitioner program. Her clinical practice and program of research has focused on physical and psychological symptom distress and quality of life for women with breast cancer during and after treatment.

This article was published in Coping® with Cancer magazine, January/February 2011.