July 16, 2020

Coping with Life Changes After Cancer

Life is a journey, and cancer is a major detour that no one plans for.

If that “regular” life journey is like driving on the interstate, cancer is “like taking the side roads,” says Mary Helen Davis, MD, a psychiatrist who works with patients from Baptist Health Medical Group’s CBC Group in Louisville. “Your life is changed.”

And the journey isn’t over after your treatment concludes. Cancer changes survivors’ lives, in ways both good and bad.

More and more people are living this experience: More than 15.5 million cancer survivors are living in the United States, almost 5 percent of the population. That number is expected to grow exponentially, Dr. Davis says, because cancer is being detected earlier and treatments have improved.

Here are some common challenges survivors are likely to face.

Anxiety and Finding a “New Normal”

A lot of times people will cope until they are done with their treatment…but when treatment ends, this can be anxiety-inducing for people who were expecting to feel better.

Dr. Mary Helen Davis

People undergoing cancer treatment get a lot of support during the process from family, friends, nurses, and doctors, Dr. Davis says, but they can experience enhanced worry and anxiety after they finish treatment.

“A lot of times people will cope well until they are done with their treatment,” she says. “That can be a high mark for anxiety symptoms because before they were figuring ‘I just have to tolerate it; I’ll get through it.’” But when treatment ends, not all the symptoms, such as fatigue, do. This can be anxiety-inducing for people who were expecting to feel better.

Then there’s fear about the future. Survivors often fret both about a recurrence of their disease as well as possible side effects that don’t show up for years, says Naveed Chowhan, MD, a medical oncologist with Baptist Health Cancer Center at Floyd.

Many survivors are on a schedule to get scanned periodically to see if cancer has come back, or if they’ve developed a different type of cancer. These visits, while critical for the person’s continued health, can be nerve-wracking.

Support groups are helpful in that regard, Dr. Davis says. “It normalizes what people are going through when three or four people in the room say, ‘Oh, my gosh, the same thing happened to me.’ It’s important to have that shared experience and to see people at different stages of recovery.” (Here’s where to find support groups in Louisville and in southern Indiana.)

Lasting Fatigue is Possible After Cancer

Even after treatment ends, survivors may feel a lasting sense of fatigue or the sense of not feeling quite like themselves in terms of energy, Dr. Davis says.

The best thing to do is stay active. Find consistent ways to move your body.

For people in treatment or those who have completed treatment in the past year, Baptist Health offers the Cancer and Restorative Exercise (CARE) program at the Baptist Health/Milestone Wellness Center.

The Cancer Resource Center at Baptist Health Louisville also hosts classes such as tai chi to keep people moving in a gentle way, says Crystal Spellman, a clinical nurse specialist with the center. The Cancer Resource Center can also help you plug into local support groups.

Body Image Concerns After Cancer

Cancer can wreak havoc on one’s appearance and how the body works. Treatment may cause hair loss, weight gain or loss, scars or lymphedema, which is swelling in the arms or legs. Women with breast cancer may have had one or both breasts removed. Men who have undergone treatment for prostate cancer sometimes deal with urinary incontinence or erectile dysfunction.

Survivors should feel empowered to talk to their doctors about ways to minimize physical issues that trouble them; a mental health professional who can help the person work on self-esteem can also be valuable.

And it’s important that people around cancer survivors know that just because someone is “looking normal,” or more like themselves, doesn’t mean the emotional trauma of cancer is gone, or that the pre-cancer energy is back.

Long-Term Complications After Cancer

Some chemotherapy and radiation treatments are associated with long-term complications, Dr. Chowhan says.

For example, people who have had Hodgkin lymphoma could develop heart problems years later as a result of radiation to the chest. Some women who have been treated for breast cancer might experience pain when they go on anti-estrogen agents, a treatment that can last a decade.

Radiation can result in decreased saliva production, which can cause dental problems. Sometimes chemotherapy can cause early menopause, or it can cause tingling in hands and feet, a condition called neuropathy. Chemotherapy can also cause vision problems, such as dry eyes and cataracts.

Oncologists want people to know there are options for easing or eliminating these symptoms; don’t be afraid to talk to your doctor and ask for help.

For those who have completed treatment, Baptist Health providers put together a “survivorship plan” that includes a summary of the treatment received and the surveillance schedule for future recommended tests.

This is a chance to talk about ongoing side effects from treatment and to address patients’ anxiety.

“We want to make sure their apprehension about their risk of recurrence matches the available evidence, that it doesn’t become an excessive worry,” Dr. Davis says.

A New Normal

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