Navigating Life After Cancer Treatment

The experience of completing active cancer treatment and beginning the rest of your life is often shockingly difficult. Many people are unprepared for the psychological and physical difficulties that lie ahead and are blindsided by the intensity of their reactions. Most of us count off the number of remaining radiation or chemotherapy treatments, expecting that we will be thrilled to walk out of the hospital on that final day. Instead, we may well be exhausted, frightened and sad, and about to discover that the real crisis, in many ways, is just beginning. It may well not feel like a time to celebrate.

Your life may never be the same as it once was, but it may eventually be even better.

Most people manage the months of treatment with determination and grit. We somehow juggle our personal and work responsibilities, make sure that our children are cared for, and plan for the days we know we will not feel well. Hopefully, our families and friends rally and offer rides, bring over dishes of lasagna, and send cheery notes and small gifts. Then it ends. Just about everyone quickly returns to their own lives and assumes that you are immediately able to pick up the pieces of yours. You may even quickly begin to get requests to drive the soccer carpool or travel for business.

It has been my observation that many people have a long-delayed emotional crisis at this point. You have somehow gotten through the months, just taking it one day at a time, focusing on the next appointment or the next treatment. When everything is done and there is a moment to take a breath, it hits you. What has happened to me? What is my life like now? One woman told me that her life resembled a bombed city: she needed to rebuild everything brick by brick. Even if you feel less destroyed than she did, you almost certainly have a life that is different from the one you had before cancer. Your life may never be the same as it once was, but it may eventually be even better.

This is not to say — in fact, I would never say — anything like, Having cancer can be a blessing. Or Cancer is the best thing that ever happened to me. I know there are people who come to that conclusion, but I have never met them. I do believe, however, that going through cancer forces us to temporarily step out of our usual lives. In stepping back, we have an opportunity to consider our choices and commitments and, if we want, to make some changes. Almost certainly, we will be more careful and thoughtful observers of the world around us: I actually do stop to smell the roses during a June walk or pull over on the road to watch the sunset over the ocean.

Here is the important rule of thumb: It takes as long to fully recover physically and emotionally from cancer as the total duration of your treatment. This usually is months, maybe even longer. It is important to remember this rule as your family shows surprise at your continued fatigue or as you worry about your ongoing aches and need for more sleep. The slope of the curve is towards improvement, but it takes a long time. Try not to be discouraged, and absolutely do not be frightened or worried that the cancer is lurking if you are not feeling 100%.

Lingering physical issues may include general aches and pains, muscle stiffness, forgetfulness, joint pains, headaches, hot flashes, sleep problems. Remind yourself of the Two-Week Rule: Most problems disappear on their own within two weeks (this obviously does not apply to symptoms of a possible heart attack, stroke or any other emergency).

It may help to make a note of when you first noticed something like back pain or a twinge in your shoulder — it probably will go away, but without a note, it will be tough to recall exactly when it started. If the symptom persists longer than two weeks, call one of your doctors. It very likely will not be cancer-related, but you will appreciate the reassurance. Especially in the first months after treatment, every single twinge is going to produce anxiety. For example, if you wake up with a sore back, you might first think of cancer spreading rather than remembering that you moved furniture yesterday.

For many people, the psychological and emotional concerns are even more difficult. This may be the first time that you have really considered the existential realities as well as the trauma you have endured. No one comes through unscathed. You likely were so focused on getting through all the medical treatments and so busy with your life as a cancer patient that you did not really deal with the issues confronting you now.

In addition to the ones brought on by cancer, any other life problems that you put aside have been patiently awaiting you — and likely accruing interest. It is completely normal and appropriate to sometimes feel anxious, depressed, or generally out of sync with your family and friends. Their concerns may seem trivial compared to yours, and it can be tough to be empathetic when you are worried about your survival.

Over the years of my work, I have met many people at this juncture. If you find that your worries are interfering with your life, consider joining a support group or finding a therapist who has worked with cancer patients. Being reassured that these feelings are all normal and that you have company during the experience may be a big help. You can speak with an oncology social worker as a good place to start.

There is so much to say about this post-treatment period that I wrote a book about it. Titled After Breast Cancer: A Commonsense Guide to Life After Treatment, it is available in many libraries and bookstores. Keep in mind that only a few chapters are specific to breast cancer, and most of the book is just as relevant for people recovering from other types of cancer treatment.