Living with cancer
Living with cancer involves navigating the complexities of life after a diagnosis and treatment, focusing on maintaining an active and fulfilling life. Each year, millions of individuals are diagnosed with cancer, facing a range of emotional responses, such as disbelief, fear, and anxiety. It is essential for patients to engage with their healthcare teams to understand their specific situation, including details about the type and stage of cancer, treatment options, and prognosis. Education plays a crucial role, encouraging patients to seek information from reliable sources and connect with others who share similar experiences through support groups.
Coping with cancer can be emotionally challenging, as patients may experience feelings of loss, depression, and guilt. Addressing physical and mental health needs through rest, nutrition, and engaging in enjoyable activities can foster well-being. Communication about intimacy and changes in relationships is vital, as cancer can alter emotional dynamics and physical capabilities. Additionally, cancer impacts family life, often shifting roles and responsibilities, necessitating open dialogue and support within the family unit.
Spirituality can also be a source of comfort, helping patients find meaning and cope with their illness. Life after cancer presents new challenges, including health concerns and ongoing follow-up care, but many survivors report a renewed perspective on life, relationships, and priorities.
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Living with cancer
DEFINITION: Living with cancer means being alive and as active as possible to enjoy life after having been diagnosed with and treated for cancer.
Diagnosis: Each year, millions of individuals are diagnosed with cancer, and millions more continue living with various stages of cancer. Although cancer mortality statistics are generally improving in the developed world, a cancer diagnosis may spark feelings of disbelief, denial, fear, or a sense of being overwhelmed. To provide the best care, the healthcare team will perform tests and stage the cancer to see how far the disease has spread. With this information, patients and their healthcare providers can decide on treatments to cure, control the disease, or minimize symptoms. Each person experiences cancer differently. Becoming a partner in the treatment plan means making choices in many aspects of life.
Education: C. Everett Koop, former United States Surgeon General, advised that “the best prescription is knowledge.” One effective way for patients to face life with cancer is for them to learn as much as possible about the specific diagnosis. Numerous sources are available to provide further education on cancer in general and in detail. Cancer patients may want to know about statistics, risk factors for their type of cancer, staging terms and what they mean, treatment options, and the likelihood of the patient's surviving and recovering from cancer and treatments (prognosis).
The first contact for patient education is the healthcare provider. These professionals can offer information specific to the patient, such as the type of cancer, stage of cancer involvement, and options for therapy. Cancer patients should take the initiative to talk with their healthcare providers to fully understand their unique situation. With that information, patients can pursue other avenues of education.
There are many sources for learning more about cancer. Information can range from simple explanations to complex scientific documentation. Patients can read articles in popular magazines, buy books on most aspects of cancer care, study healthcare journals, or look up their cancer online. Generally, reliable information comes from well-respected and well-established cancer care centers, cancer care organizations, government agencies, or healthcare organizations.
Another source of education is other cancer patients. Attending local support groups and conversing with others at different cancer stages can support and encourage patients. Websites offer message boards where cancer patients can share their experiences. Though these can be useful, it is essential to remember that this type of information comes from a particular person’s point of view. Cancer patients must seek further information and clarification from their healthcare providers or other reliable sources before acting on what another cancer patient says.
Coping with cancer: A cancer diagnosis can be stressful for both patients and their families. Patients respond in different ways to their cancer. Many emotions may surface, such as shock, disbelief, fear, sadness, anxiety, depression, anger, and guilt. Patients may question why they have cancer and what lies ahead. Disbelief may come to those who feel physically well. Fear is a common emotion, but the reasons may range from fear of the treatments and side effects to fear of death and the impact on remaining family members. Fear feeds anxiety, which can interfere with normal daily functioning.
Guilt is another common emotion of cancer patients. Patients may replay their lifestyle choices and wonder if something they did caused the cancer. They may feel guilt over decisions that stole precious time from their life or guilt about their priorities. As some cancers tend to be hereditary, cancer patients may worry about the impact on their children.
Feelings of sadness and hopelessness can block recovery and resumption of meaningful life activities. Depression can come with sleep problems, loss of appetite, feelings of worthlessness, decreased energy, irritability, or lack of interest in activities once enjoyed. Physical symptoms such as headache or digestive problems may occur. Feeling sad is a normal reaction when people learn that they have cancer, but if depression continues and thoughts of suicide surface, patients may require help through counseling and prescribed medications.
Cancer patients experience the feeling of loss of control, autonomy, dreams, choices, or the future. Loss is a normal feeling and allows cancer patients to grieve over actual or perceived interruptions in their lives. Counseling may be useful for both cancer patients and their families.
Taking action: Cancer can be a long-term disease and last for many years. Cancer patients experience an initial adjustment to their diagnosis and treatment. The focus of their first thoughts may be on dying, but as time goes on, these thoughts shift to their normal lives. Taking certain steps can help cancer patients reengage in their usual activities of daily living.
One helpful step is paying attention to personal needs for rest, nutrition, recreation, and relationships. Relaxation activities such as meditation and guided imagery can assist in healing and encourage good mental health. Adequate nutrition is important to keep the immune system at an optimal level.
Participating in activities that patients enjoy, such as going to the movies, listening to music, going to lunch with friends, or pursuing their hobbies, can relieve depression. Creative expression through journaling, writing poetry or stories, reading, or drawing can keep patients’ minds off cancer and minimize projecting into the future. Simply going shopping can boost morale.
Starting or resuming an exercise program can help cancer patients increase strength, flexibility, and endurance. Studies show that exercise can also improve long-term survival. Radiation treatments can result in fatigue, but light or moderate walking can boost energy and stimulate the appetite. Another benefit of exercise is that releasing natural body chemicals, called endorphins, can improve patients’ moods and help relieve pain. Various levels of exercise, such as walking, swimming, cleaning the house, gardening, or dancing, can provide pleasure and health benefits.
The media reports on the value of alternative or complementary therapies almost daily. Cancer patients may become interested in these therapies as ways to relax, reduce the side effects of cancer treatment, or cure their disease. Some of these practices, such as massage, guided imagery, acupuncture, or hypnosis, may be useful with traditional cancer treatments. Vitamins and herbal supplements have gained monumental popularity in the United States. Although some sources claim that herbs and vitamins can cure cancer, these statements are often unfounded, and some supplements can lower the effectiveness of some cancer therapies. Patients should speak with their healthcare providers before using alternative therapies.
Sometimes, individuals with cancer are unable to perform activities of daily living without assistance. However, by seeking help, they can continue going to the grocery store or church. Friends and family often welcome the opportunity to provide meals or transportation. Asking for help is often uncomfortable for patients who covet their autonomy. However, taking action to seek help is a healthy behavior.
Sexuality: Having cancer does not alter the human need for sex and intimacy. However, having this disease can temporarily alter people’s attitudes and desires. Changes in emotions are normal for cancer patients but can affect their relationship with their partners. Physical side effects from cancer treatments, such as nausea, vomiting, and fatigue, can decrease interest in sex. Cancer therapies can affect the patient’s body image and lessen their confidence in their attractiveness. Women may experience vaginal dryness, and men may have trouble having or maintaining an erection.
Some people believe that cancer can be passed to another person by intimacy. Partners may be hesitant to engage in sexual intercourse with cancer patients. Also, cancer patients may need to refrain from sex for some time because of surgery or a lowered immune system. This can be difficult for the patient and their partner. Communication is vital in resolving misunderstandings. Cancer patients should be open and honest about their concerns with their healthcare professionals. These professionals can help make referrals for counseling and support when needed.
Family dynamics: Cancer changes all aspects of family life. Priorities change, and unresolved emotions may surface. There may be more struggles in the family dynamics. Roles may change as cancer patients must use energy and time to take treatments or care for themselves. A reassignment of roles can be overwhelming, especially for older children or youths who now become caregivers. Patients must be allowed to fill as many parts of their family role as possible and not be treated as invalid. If the dynamics of family life become dysfunctional, a family counselor can help.
Spiritual support: Cancer is a serious illness that can challenge people’s spiritual beliefs. Spiritual distress (unresolved spiritual conflict or doubt) can compromise patients’ coping skills. Unlike religion (a set of beliefs, practices, or doctrines), spirituality includes the person’s sense of purpose, relationship to others, and beliefs about life’s meaning. Some cancer patients may feel a higher power is punishing them or may lose their faith, while others experience a deepening of their faith during their illness.
Pastors, rabbis, or other faith leaders may be valuable resources during this difficult time. Some home health and hospice care agencies have chaplains on their interdisciplinary teams, offering home support for cancer patients. The best person for cancer patients to talk with is the one who provides compassionate and supportive communication. Spiritual support can create an improved quality of life for cancer patients. Patients may experience decreased stress, anxiety, or pain. Connecting to others results in less isolation. Spirituality can help cancer patients tolerate treatments better and bring peace in a time of chaos.
Life after cancer:Cancer survivors face different challenges. Intensive cancer therapy can leave people with lifelong health concerns. After the treatments or surgery are complete, patients have new questions. Will the cancer come back? Will my life be the same as before I was diagnosed with cancer? Will I need continued observation? Where do I go from here?
Follow-up care includes regular medical checkups, usually with the primary physician. Tests will likely occur at specific intervals to check for continued remission (when the cancer is reduced or disappears). If any tests indicate concerns, cancer patients are referred to the cancer healthcare provider for further assessment.
Many survivors say that life has new meaning for them, and they see life in a new light. Priorities have changed. Their bodies have changed. Cancer patients may have made new friends and developed new relationships. Even their diets may have changed. Life and all it has to offer have changed forever.
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