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Navigating the Journey after Cancer Treatment

by Tish Knobf, PhD, RN, FAAN, AOCN

Wellness image

The end of cancer therapy is often a long awaited milestone that many cancer survivors joyously celebrate. However, your last day of treatment doesn’t signal the end of your cancer journey. No, the end of active therapy simply marks the start of a new voyage, one where you will traverse the uncharted path to survivor­ship. Here are some navigation tips to help you SURVIVE your first year after treatment.

Side effects
Most cancer survivors will continue to experience side effects after treatment ends. Fatigue is almost universal. It may take months before you feel like you have your energy back. You may also experience side effects that are unique to your cancer site and the type of treatment you received. Some persist; others resolve soon after treat­ment ends. Some may wax and wane. And new ones may even crop up unexpectedly. Talk with your doctor about how you can best manage the side effects and late effects of your treatment. And if these don’t improve satisfactorily, ask your doctor for additional coping strategies or palliative treatment options.

After treatment ends, visits to healthcare providers de­crease and support from family and friends may begin to wane. You may feel pressure to get back to “normal,” or to how you were before cancer. This can lead to a lot of uncertainty surrounding this leg of the journey: How long will my side effects last? What can I do to get healthier? Why am I so emotional? How do I respond to my family who wants me to put this behind me when it’s still so new? Will I ever feel normal again? Just relax. It takes time to recover both physically and emotionally from cancer. And it is normal to have these questions. Talk with your friends and family mem­bers about how you are feeling, and let them know how they can help. If your feelings of uncertainty are interfering with your daily life, talk with your doc­tor or a counselor about what you can do to manage your anxiety.

The end of active therapy simply marks
the start of a new voyage.

Author of Article photo

Dr. Tish Knobf

Fear of recurrence is one of the most common concerns of cancer survivors. To help mitigate your fears, talk to your doctor about your risk for recurrence and work with him or her to develop a survivorship care plan that includes instructions for follow-up visits, as well as suggestions for positive lifestyle changes to reduce your risk of recurrence and improve your post-cancer health. However, keep in mind that even with a plan in place, there are certain situations that can trig­ger a surge in fears – follow-up visits, scans or tests, the appearance of un- explained symptoms. Let your doctor know if you are having trouble manag­ing your fear. He or she can point you to resources that can help.

You are a cancer survivor. Take a moment to consider your strengths, and acknowledge your ability to overcome the challenges you may face during this phase of your cancer journey. If you feel your vitality waning, you can help restore it by eating well, getting adequate sleep, exercising, and seeking support.

Interpersonal relationships
The ad­age “No man is an island” is never more true than during the cancer jour­ney. This path you are navigating will be made easier by having companions walking alongside you, whether they be family, friends, or other survivors.

Good communication with your healthcare providers is crucial to a successful survivorship journey. Follow-up visits are often brief. Com­ing to your appointment prepared with specific questions and concerns you’d like to address will help you get the information you need. Don’t be afraid to speak up if something isn’t clear.

Daily physical activity is recommended for nearly all adult cancer survivors. Exercise can improve your mood, help you sleep better, reduce fatigue, and combat depression. Mod­erate exercise can also reduce your risk of high blood pressure, cardiac disease, and diabetes. Even just walking as little as 20 minutes a day can help.

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Dr. Tish Knobf is a professor at the Yale University School of Nursing in West Haven, CT, where she is also chair of the Acute Care/Health Systems Division. Her clinical practice and program of research focuses on quality of life for women with breast cancer and interventions for those who transition into survivorship.

This article was published in Coping® with Cancer magazine, September/October 2015.