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Surviving survival - Navigating cancer care after the cancer is gone

For those of us who have never experienced a cancer diagnosis, the only thing we can imagine that might exceed the dread of the words “you have cancer” is the sheer joy of joining the group that proudly call themselves cancer survivors. And certainly, given the extreme feelings, real and imagined, that are associated with having cancer, being told that you’ve beaten cancer can feel like you’ve beaten death itself.

The fact is that, thanks to advancements in treatment, survival is a real possibility today with many cancers. In fact, the latest statistics in Canada reveal that about 60% of all people with a cancer diagnosis will still be with us 5 years later. That prognosis will vary dramatically depending on the type of cancer you have and how early it’s detected and treated, but the chances are better now than they’ve ever been that you and I will be able to beat a cancer diagnosis.

                Read: World Cancer Day – Care, cure and cost

But anyone who has been through cancer and back can also tell you that remission is not really the end of the story, but only the beginning of a journey that can be filled with uncertainty and no small amount of fear. It’s no secret that cancer can and does return in some cases, and as with an initial diagnosis, early detection is key to beating it again. The hope, of course, is that the cancer won’t come back, and the magic number that most experts point to is five years. If your cancer is going to come back, it’s much more likely to happen in the first five years.

So it goes without saying that the first five years after remission are not only critical from a medical perspective, but nerve-wracking from an emotional perspective. The details vary depending on your specific diagnosis, but you can be guaranteed that there will be follow-up appointments - three or four times a year for at least the first two years - tests, and fear. Lots of fear and worry.

And the fear of the cancer coming back is just one part of cancer care after the cancer is gone. In some cases, if you’ve had chemotherapy and/or radiation treatment, those life-saving therapies can also put you at an increased risk of developing other cancers later in life. In the shorter term, they can lead to serious side-effects, including chronic pain, fatigue and infertility. It may seem a little too obvious to mention it, but cancer survivors are also more likely than most to battle depression.

                Read: How pharmacists can help patients with depression

The key to getting through it all is a combination of vigilance, lifestyle changes to be sure, and a certain degree of acceptance. The Serenity Prayer, which has been popularized through its use at Alcoholics Anonymous meetings, reads, “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” This is good advice for all of us, and especially cancer survivors.

So first, changing the things you can change. That means controlling what you can control to increase your chances of living a long, cancer-free life. Quit smoking, exercise, lose weight, eat more fruits and vegetables. If your cancer is in partial remission and your doctor has put you on medication to prevent a relapse, take your medication as prescribed.

Watch our #AskThePharmacist videos for tips on: how to quit smoking and starting an exercise regimen.

Also, just as importantly, take your follow-up appointments seriously. There’s a reason the appointments are so close together. If the cancer comes back, you need to know sooner than later. Attending all scheduled appointments is critical. So is paying attention to your body and letting your doctors know if you notice any of these indicators that the cancer may be back:

  • Unexplained pain, especially if it lingers for more than a few days
  • Any unusual bleeding, bruising or rashes
  • A cough that won’t go away
  • Unexplained fever
  • Unusual swelling or lumps

Even if these symptoms don’t seem related to your original cancer (e.g., you had colon cancer and you notice a persistent pain in your foot), you should report them to your doctor right away. Don’t wait for your next follow-up appointment.

If you’re doing all that, you’re doing all you can. The other big piece of the puzzle is finding the serenity to accept that which you cannot change. Accepting that you might do all the right things and the cancer might come back anyway. Living with chronic pain. Dealing with infertility or any number of secondary conditions brought on either by the cancer, or the cancer treatment.

That’s the mental health side of the equation, and it’s no picnic. Living with cancer looming over you is bound to take a mental and emotional toll. Don’t forget to take care of those needs too. There are lots of resources available for you. The first you should check out is one of many cancer survivor support groups in your area. Sharing does help to ease the burden. Of course, depending on the severity of your mental stress and/or depression, your doctor can recommend one-on-one counseling or one of a number of anti-depressant medications.

Surviving cancer is a great accomplishment. If you’ve come this far, you’re a fighter, and you have a zest for life. Don’t give up now. It does get better.

 

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