Approaching the End of Active Treatment
What Happens Next?
by Lidia Schapira, MD
The end of “active” cancer treatment is often a time when feelings of relief collide with worry. Many cancer survivors express their joy at having finished a physically tedious or even grueling time in their lives and yet also feel frightened about being “on their own,” without the attentive concern and supervision of their doctors and nurses.
Fear is both common and reasonable. Many survivors describe a period of many months during which they are not quite back to “normal.” Spouses and relatives often wish that the end of active treatment meant everything snaps back into pre-cancer mode. In my experience, that rarely happens. Instead, it is more reasonable to expect a gradual normalization of roles and routines.
Finding concrete ways of reducing stress and promoting physical and emotional well-being can help. Although there is no single prescription for well-being, here are a few suggestions that might work for you:
- Get fit.
Begin or resume a gradual exercise program. If you are new to exercise, ask for help from a professional in order to avoid injuries.
- Get some fresh air.
Contact with nature is restorative and healing. Plant a garden, take a walk, or bike ride on a regular basis.
- Eat well.
This is important in order to preserve your health, decrease the chance of cancer recurrence, and prevent some long-term complications of cancer therapy. Take the time to learn more about nutrition and experiment by trying new fruits and vegetables.
- Find time for activities that give
Playing with children, meditation, cooking, watching films – all of these can distract you from your worries and give you the emotional energy you need.
- Find ways of reducing stress in
This is not easy and requires reflection and patience. Take one step at a time and try to simplify your life.
The end of active treatment is also a time when many cancer survivors feel very motivated to make important changes in their lives and to give something back to those who helped during difficult times. Take advantage of this motivation and find a personal way of using your new knowledge and experiences to help transform your own life for the better or to help others. Some people find that giving something back as a volunteer provides personal satisfaction. Setting realistic goals that help you make changes in different areas of your life are important. These can range from quitting smoking to losing or gaining weight, or taking up a spiritual practice.
Some survivors find this period to be troubling and have difficulties getting on with their lives. Intrusive thoughts and fears of recurrence may diminish the joy of the present. Trouble sleeping, persistent fatigue, or lingering physical symptoms can complicate recovery, and these deserve attention. Talk to your nurse or oncologist and learn more about what you can expect after finishing active treatment. Feelings of distress or even depression are common and should be taken seriously. There are effective treatments for this as well.
Take small steps and expect setbacks. Prepare for ways to meet the challenges that may arise during recovery. The community of cancer survivors and healthcare professionals is prepared to provide support, guidance, and care.
Practical Tips for Coping with the End of Active Treatment
• Accept your fears. Treat yourself gently if you are frightened about a recurrence of cancer, and remember fears diminish with time.
• Don?t worry alone. Talking about your worries and concerns may help. Many survivors find that joining a support group at this particular juncture is very helpful.
• Chart your own path to recovery and well-being. You do have some control over your life after all. Map out your journey and set clear goals for getting fit and redefining your personal and professional ambitions.
• Be well informed. Information can be soothing. Ask your oncologist to give you specific information about your follow-up visits, testing, and what symptoms you need to report to your medical team.
• Prepare your survivor care plan. With your schedule of appointments and enough information, make your own care plan for the next year, which includes your personal goals.
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Dr. Lidia Schapira is a medical oncologist at the Gillette Center for Breast Oncology at the Massachusetts General Hospital Cancer Center in Boston. She specializes in the care of women with breast cancer. Her research focuses on psychosocial aspects of cancer care and communication.
This article was published in Coping® with Cancer magazine, July/August 2008.