Distress after Cancer

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work, Emeritus

AUGUST 13, 2018

Navigating the New Normal 

The early months after finishing cancer treatment are often shockingly difficult. Most people expect to quickly feel normal again. They anticipate having energy, appetite, enthusiasm for life and hair. Assuming that their pre-cancer lives will quickly resume, they may find it depressing and scary when that is not the case.The term new normal is often used to describe the changes that fill life after cancer. Most people grow into this new phase of life, and eventually there may even be positive changes.

A good rule of thumb is that it takes at least as long as the total duration of treatment to feel fully physically and emotionally well. The trend of those months is upward, but there are less good days, and those days can be upsetting. It is easy to worry that robust health will never return or that persistent fatigue means that cancer is still lurking. It is hard to be patient, to understand that your body needs time to heal and that some adaptations may need to be made. A few people finish treatment and never look back; they seem to pick up life exactly where they left off and to completely believe that cancer is behind them forever. Remember that these lucky people are the exceptions. Remember, too, that your family and friends also expect you to have a quick recovery, and they likely are more than ready to presume that you can meet all your obligations immediately.

It is never possible to fully predict who will have more or less trouble with recovery. Many people are doing quite well a year after treatment, but some continue to struggle for several years and may have to make permanent changes in their lives. How do you know if you are in trouble? Here are five ways to identify social distress if you are more than a year past treatment.

  1. You are having trouble managing your feelings and are too often in tears or angry or anxious.
  2. You are having difficulty sleeping many nights, especially if you go to sleep but then awaken in the very early hours and cannot get back to sleep.
  3. Your important relationships are strained; this includes your spouse/partner, children, parents, close friends.
  4. Your work life is not going well. Perhaps you can’t concentrate, meet deadlines or focus as you could in the past.
  5. Your energy level continues to be low, and you can’t exercise or complete a day’s tasks as you have in the past.

Other areas of life that may be concerning are finances, sexuality and self-esteem.

If you see yourself in this list, it is time to look for help. An oncology social worker or another therapist who is experienced with cancer patients/survivors can work with you on all of these issues. Ask your doctor or nurse for a referral or call the nearest large hospital or cancer center and ask to speak with an oncology social worker. If you are wondering whether it will help you to talk with someone, do so. Don’t spent unnecessary time feeling bad when there is help at hand. Many people successfully navigate cancer treatment and only then experience the emotions I have described.

If finances are a problem, consider talking with a financial planner. Cancer is expensive, and many people are left with big bills, reduced incomes and fears about money. Hospitals and medical offices have staff who can talk about payment plans, bill reductions or other ways to manage some of the bills. Ignoring them is never a good strategy; interest will accumulate and the problems will get worse.

Think about joining a cancer support group. Your family and friends love you and want to support and help you, but no one understands like others who have gone through it. As many people say: This is a sister/brotherhood that no one wants to join, but we are always there for one another.

Please share your experiences and thoughts here: http://www.cancercommunity.bidmc.org/