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What Happens After

Posted 3/17/2015

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  The weeks and months and even years after finishing active cancer treatment, usually referred to as Survivorship, are often a confusing and difficult time. Most of us get through treatment by keeping our eyes on the horizon and our feet firmly planted in the necessities of the day. We concentrate on getting to appointments, drinking the recommended gallons of fluid daily, trying to stay awake past 6 PM, and generally just getting by. Being a cancer patient can easily become a full time job, and it is always added to already busy lives. If we are lucky, we have support from friends and family, and somehow the time passes.

  There are medical centers that celebrate the final radiation or chemotherapy treatment with confetti or horns or a cupcake. I like to think that thought has been given to these traditions, but I am always suspicious that any thought belonged to staff who have not themselves been treated for cancer. For us, the patients, it usually does not feel like a celebration. Yes, indeed, it is a hugely important moment, and we need to reflect on what we have accomplished and managed. Deep sigh of gratitutude, yes. Party time, usually not.

  Many people get through treatment by keeping the blinders on and concentrating only on what is directly ahead. This works. But, when it's done, the blinders must come off, and the wide view is often shocking. What has happened to me? Who am I now? What lies ahead? I think that the concept of PTSD is often applicable here; a cancer diagnosis and treatment surely is a trauma. It is common for those around us to assume that we are instantly back to normal, able to resume the usual obligations, jump out of bed with the usual energy, and return to our pre-cancer selves. It rarely happens that way.

  Instead, it takes at least as long as the total elapsed cancer time--from the moment of diagnosis to the moment the last machine is turned off or the last needle is removed--to feel fully emotionally and physically well. The direction in those months is towards improved health, but it is slow. There are set backs and disappointments, and many readjustments. Self promoting plug: If you haven't seen my book, After Breast Cancer: A Commonsense Guide to Life after Treatment, you might look it up. There are probably two chapters that are breast cancer specific, and the rest of the book is relevant for anyone.

  As is this beautiful essay from The New York Times:

Life, Interrupted
Suleika Jaouad writes about the challenges faced by young adults and her experiences with cancer.
“You are being deported,” a surgeon announced to me last fall. That’s a scary thing for a child of two
immigrants to hear. But he was referring to the removal of my port, a medical device implanted just
beneath my right collarbone — a gateway for the dozens of rounds of chemotherapy, antibiotics and blood
transfusions that have entered my body since I received a leukemia diagnosis at age 22.
I love a good pun, but I wasn’t in the mood for laughter or lightness that day. After three and a half years
of cancer treatment, I no longer needed the port. My doctors had finally pronounced me in remission. I
had thought I’d want to celebrate or dance a jig in my hospital gown or throw a rager when I got there. But
it didn’t feel anything like the endgame I had imagined.
It took me a long time to be able to say I was a cancer patient. Then, for a long time, I was only that: A
cancer patient. Now that I’m done with my treatment, I’m struggling to figure out who I am. On paper, I
am better: I no longer have cancer, and with every passing day I’m getting stronger. The constant flood of
doctor’s appointments, blood tests and phone calls from concerned family and friends have trickled to a
slow drip. But off paper, I feel far from being a healthy 26-year-old woman.

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