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Recognizing Trouble after Treatment

Posted 1/29/2016

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  A week never goes by that I don't have a call and/or meet with a new patient who is emotionally struggling after treatment has been completed. This is often shocking as the natural assumption is that once the chemo or radiation is done, you will immediately start to feel better. This reaction seems especially common among women (or men) who have managed the months of treatment quite well. During those difficult times, they stayed focused, concentrated on what needed to happen, and took appropriate pride in their behavior and accomplishment. 

  So why does this so frequently happen? Partly, I think, we build and maintain emotional defenses and barriers that protect us; we only allow ourselves to feel what we can manage. During treatment, that is likely less as we are having to concentrate of physical ailments, getting to appointments, doing enough at work and home to get by. Once it is done, there is finally a moment to look around, survey the new life landscape and think something like: "OMG! What just happened to me?"

  It does not help that inevitably our families and friends fully expect us to be right back to normal, able to pick up the usual responsibilities without missing a beat. It can seem that no one understands. It is also sometimes scary because we may interpret fatigue or low energy or ongoing anxiety as signals that there is ongoing cancer trouble--rather than the reality that our bodies and our souls need time to heal. As some of you know, I have a wonderful group for women who have completed treatment for breast cancer, and most of the participants did not attend a group or seek help until treatment was done. Then the feelings hit.

  A little self promotion here: If you haven't read it, you might find my book After Breast Cancer: A Commonsense Guide to Life after Treatment helpful. If your cancer was something other than breast, there will be two or three chapters that are less relevant, but everything thing is equally appropriate for you.

  This is all an introduction to a blog that I was just asked to write for ASCO's CancerNet. Here is the start and a link:

Struggles After Cancer Treatment? 5 Signs to Seek Help

The early months after finishing cancer treatment are often shockingly difficult. Most patients expect to quickly feel normal again. They anticipate having energy, appetite, enthusiasm for life, and hair. Many assume that they will quickly return to their before-cancer lives. But this is rarely the case, and it may be depressing and scary to find that out. The phrase “new normal” is often used to describe the changes that fill life after cancer. Most people grow into this new phase of life, this new normal. Although I would never suggest that cancer is a “blessing,” you may discover that you are making choices that create a more satisfying and happier life. As more people survive after cancer, more attention is being paid to living after cancer.

Here’s a handy rule: it takes at least as long as the total duration of treatment to feel fully physically and emotionally well. It is easy to worry that robust health will never return or that persistent fatigue means that cancer is still lurking. It is harder to be patient, to understand that your body needs time to heal, and to recognize that some adaptations may need to be made. Remember, too, that your family and friends may also expect you to quickly recover. They may presume that you can meet all your obligations immediately. There are a few people who finish treatment and never look back. These lucky people seem to pick up life exactly where they left it and to completely believe that cancer is behind them forever. Remember that they are the exceptions.

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