Living with Cancer
By Heidi Dishneau, ARNP
There are a growing number of reasons to remain hopeful in the face of cancer. Just look into the faces of the 10 to 12 million cancer survivors in the U.S. Thanks to earlier detection and advanced cancer care and treatment, The American Cancer Society expects this impressive number to grow tremendously in the next few decades. But living with or living beyond cancer has its own set of challenges, and survivorship is now being recognized as part of the cancer care continuum.
Surviving the disease is always the first goal for cancer patients and the healthcare professionals who treat them. Cancer is a strikingly complex disease that can require many forms of treatment, taking months and sometimes even years to complete. This can be overwhelming for many patients as they learn a whole new language of cancer facts, statistics, recommendations and treatment options. But what comes next? Many people believe that once a person is cancer-free, it’s time to get right back into their routine and continue life as before. But healthcare professionals suggest survivors think about a ‘new normal,’ a new phase of life that can benefit from as many sources of support as possible and continued and careful monitoring of their healthcare needs.
Common concerns for survivors include managing stress and fatigue, addressing finances and maintaining overall long-term health. Some treatments can make survivors more vulnerable to chronic conditions and a secondary recurrence of cancer is always a concern. Some forms of radiation treatment may also result in a secondary cancer years later. Even though survivors may have walked away from cancer, providers recommend survivors maintain close monitoring of their health to prevent recurrence.
Survivor programs and additional staffing are becoming more common at many cancer centers across the U.S. and they underscore one key fact: Support is critical for survivors. Patients may be overwhelmed with support early on in their disease and often throughout treatment. At this time, patients have a treatment team in place that might include their primary care physician, oncologist, radiation oncologist, nurse, nutritionist, social worker and others. Family members often mobilize a network of loved ones and friends to help with household chores, transportation to treatment and general emotional support, etc. But once treatment is completed, this entire layer of support is gone and patients can feel suddenly abandoned and lost.
Survivorship clinics were designed to provide continuity of care post-treatment. Staffed by nurses, nurse practitioners or social workers, the clinics can provide survivors help with issues around returning to work, as survivors often do shortly after treatment. Clinics can also offer resources for financial assistance. Patients who have not previously faced a serious illness may need help understanding medical bills, insurance forms and payment limits.
In addition, many survivors need emotional support. During active treatment, patients routinely report feeling empowered, knowing they are actively fighting the cancer and battling the disease. Once that’s complete, it can be difficult to ‘do nothing.’ Clinic staff help survivors adapt to their ‘new normal’ in this time of transition. Peer-to-peer support groups can also play a pivotal role, helping connect survivors to those who have been through post-treatment struggles and successes.
Maintaining regular checkups and good preventive care with a primary care physician is also important so survivors continue to monitor their weight, blood pressure, blood sugar and cholesterol, etc. Many patients become so focused on the cancer treatment that they forget the importance of routine medical care and prevention of diabetes, cardiovascular disease and other chronic conditions.
Nutrition and exercise are important considerations for survivors and the American Cancer Research Institute has developed 10 health recommendations for anyone interested in cancer prevention:
- Be as lean as possible without becoming underweight.
- Be physically active for 30 minutes each day.
- Avoid sugary drinks.
- Eat a variety of vegetables, fruits, whole grains and legumes.
- Limit consumption of red meat and avoid processed meats.
- Limit alcoholic drinks to 2 for men, 1 for women, per day (if consumed at all).
- Don’t use supplements to protect against cancer.
- New mothers should breastfeed infants exclusively for six months before adding other foods.
- After treatment, cancer survivors should follow the recommendations for cancer prevention.
Active cancer treatment is just a small part of the journey for cancer patients. Survivors are growing in numbers every year and now survivors have the healthcare services and support to help see them through their next phase of life.