Writing the next chapter: Living well following cancer

When someone we care about experiences a cancer diagnosis, our focus is naturally on the immediate needs of that person — determining a treatment plan, coping with side effects, identifying sources of support for meals, rides, or childcare… But what happens when treatment is complete and the patient attempts to return to regular life?

Thanks to advances in preventative care, diagnostic tools, and treatment options, more and more people are surviving cancer. In fact, the American Cancer Society, in collaboration with the National Institutes of Health, estimates that there are currently 17 million cancer survivors living in the U.S. That number is expected to increase in coming years. And while that growing number is undeniably good news, long-term survivorship is not without its challenges.

“Life after cancer care is often like the second part of a book — a new section, with new realities, and new challenges,” explains Clayton Hess, MD, Radiation Oncologist at Dignity Health Sierra Nevada Memorial Hospital. “Following cancer and its treatment can often mean chronic toxicities that may wax and wane but, for some, never resolve. This often means loss and grief — loss of a function, a limb, sensation, taste, sexual function, or even the hope of life as once dreamed.”

Survivors of cancer may also face financial hardship related to their medical bills or lost wages; they may struggle with anxiety related to health fears and trauma; and significant relationships may be changed or even ended due to the strains of facing a life-threatening illness. “Distress and depression are common,” Dr. Hess says. “I advise patients to not lose passion for life —even for altered life.” Dr. Hess says as with all things related to cancer, survivorship is distinctly unique for each person. “Side effects and their management are specific to each patient and merit a survivorship care plan and a survivorship clinic to maintain and optimize function in the years following treatment,” he explains.Cancer survivorship clinics provide services that help cancer survivors live well following cancer treatment. A cancer survivorship clinic may include clinical support to help manage physical and emotional side effects, as well as resources to help the survivor to navigate their return to everyday life.

For Dr. Hess, a vital part of this post-treatment plan includes the acknowledgement that for all of us (not just those diagnosed with cancer), our days are numbered.

“I advise cancer patients completing treatment to live like authors write — intentionally — and to make a plan they love and go live it,” Dr. Hess says. “I admonish them to embrace their survival and their end-of-life as two parts of one whole. No book binds with only a front to its cover; every book — every life —must end. Embracing and even planning for death can surprisingly enable a more vigorous life now. Whether writing the story of life's next chapter or its final chapter, how well one writes is far more fulfilling than how long one writes.”

Partnering with your care team to ensure you are taking the best steps forward to ensure your mental and physical health is critical [see sidebar]. Dr. Hess shares that as a physician treating patients living with cancer, he has seen firsthand that finding purpose in our days is the real key. “I witness many compelling patient examples of lives lived well,” he says. “Among these, length of remaining life seems irrelevant. Those with longer to live are not necessarily more fulfilled. Your life's story may have taken a turn, but it won';t be written just by adding pages. There must be a story to tell — your story — so go tell it. The end is often a book's most compelling scene.”

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Taking care after cancer

After treatment, cancer survivors need time to recover, improve their mental health, and process their emotions. It’s normal to feel relief, gratitude, and excitement, and at the same time feel worried or sad. Steps that can help maintain both mental and physical health following cancer treatment include:

- Take care of your body by eating well, exercising as much as recommended by your care team, and getting enough quality sleep.

- Follow through with your follow-up care, including appointments, tests and preventative care.

- Seek emotional and mental support through support groups, therapy, yoga and/or meditation.

- Ask for and accept help when you need it.

For more resources to help with cancer survivorship, visit the American Cancer Society’s website at cancer.org/treatment and click on “survivorship.”

Photo caption: Even following treatment, support groups can be helpful for people diagnosed with cancer, as well as for their family and loved ones who care for them.