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This information is for people who have had a type of cancer
that can recur (come back) after treatment. It may not apply to those
who were treated for a type of cancer that almost never comes back if
it was found early and completely removed, such as a small basal cell
skin cancer. It is intended for people whose cancer required surgery,
chemotherapy, and/or radiation treatments. If you have questions about
what type of cancer you had and what your risk of recurrence might be,
talk to your cancer doctor. Or call the American Cancer Society at
1-800-ACS-2345 (1-800-227-2345) for more information.
A patient's story
Frances had a mastectomy for breast cancer. She has completed
chemotherapy and radiation to her chest wall. Her doctor has told her
that no cancer can be found in her body. Even though she will be seen
in his office every 4 to 6 months for the next 5 years, her doctor
feels as if the worst is over. But it's hard for Frances to trust that
her cancer is gone. She wants to know the chances of her cancer coming
back. "I feel like if I knew my exact chances of the cancer coming
back, I could deal with it. But when I ask my doctor, he gives me a
range of statistics over a number of years. I can't live like this. I
need more specifics."
Frances is expressing many of the common concerns a person has
after completing cancer treatment (or the main portion of it). She is
now in a "holding pattern." She feels sort of like a cancer survivor,
ready to put the experience behind her. But she is afraid that the
cancer may come back and she will be reliving it all again soon. She
wants to know the odds of her cancer coming back. But what she really
wants is to know that she will never have cancer again.
Emotions after treatment
You have completed your cancer treatment and are ready to move
on with your life. Completing treatment can be both stressful and
exciting. All is well – or is it? Once treatment is over,
many cancer survivors find they have issues and concerns that they did
not expect.
Going back to "normal"
You have been seeing your doctor quite often; now, suddenly,
you don't have to visit for many months at a time. When their treatment
is done, some people feel that they are no longer fighting their
cancer. You may find that you feel alone and lost without the support
of your health care team. These people may have become an important
part of your life. Not seeing them may make you anxious and sad.
You may also find that going back to your family role is not
as easy as you thought it would be. Things that you did before your
cancer are now being done by others. Maybe they're not willing to give
the tasks back to you. Or maybe you disagree with how others have done
things, but are afraid to say anything. After all, you should be
grateful for everything they've done, shouldn't you?
For some people, emotions that were put aside during cancer
treatment come flooding back all at once, and they feel overwhelmed
with sadness, anger, or fear. Maybe you feel emotionally exhausted and
tired all the time. Some of it may be the lingering side effects of
treatment, but some of it feels as if your body and spirit are tired
and need a long rest. It's been a long time since you could just relax.
All of these feelings make sense. You have just been through a
difficult time. You have had to make some major life decisions. Your
body has been assaulted by cancer and its treatment. Your outlook and
your whole way of life have changed, at least for a time.
Dealing with the "what ifs"
You want to believe it's over and put the cancer behind you,
but can you? You may notice that you are paying a lot of attention to
the aches and pains you are having in your body. You may feel like a
"sitting duck." The doctor says you have no signs of cancer now, but
can you be sure? You may be wondering…
- Will it come back?
- What are the chances it will come back?
- How will I know if it has come back?
- What will I do if it comes back?
- When will it come back?
The fear grips you, and you have trouble sleeping, being close
with your partner, and even have trouble making simple decisions. You
are not alone. About 70% of cancer survivors are concerned about their
cancer coming back. The fear of recurrence is a normal fear.
It is important that you understand that there is a chance
that after treatment your cancer could come back or recur. Sometimes
your health care team may not warn you about this. This may be because
they are trying to protect you from uncertainty and fear, especially
when you are first starting treatment. Sometimes the team may assume
you know this. They may think you know that your cancer can return, but
when the focus is on cure or long-term survival, it seems pessimistic
to talk about recurrence. It is natural for your health care team to
want to have that moment of victory over the cancer with you without
talking about anything negative that might occur in the future. But you
need to be aware that cancer recurrence is a very real possibility
– it is what we will discuss here.
What
is cancer recurrence?
Cancer recurrence is defined as the return of cancer after
treatment and after a period of time during which the cancer cannot be
detected. (The length of time is not clearly defined.) The same cancer
may come back in the same place where it first started or in another
place in the body. For example, prostate cancer may return in the area
of the prostate gland (even if the gland was removed), or it may come
back in the bones. In either case it is a cancer recurrence.
Recurrence or progression
Progression is when cancer spreads or gets worse. Sometimes it
is hard to tell the difference between recurrence and progression. For
example, if cancer has been gone for only 3 months before it comes
back, was it ever really gone? Is this a recurrence or progression?
Chances are this is not a recurrence. It is likely 1 of 2
things happen in cases like this. One is that, in spite of what the
tests showed, the cancer was never completely gone. Sometimes, even
with surgery, small clusters of cancer cells that cannot be seen or
found on scans can be left behind. Over time they grow large enough to
be detected or cause symptoms. These cancers tend to be very
aggressive, or fast-growing.
The second possibility is that the cancer may be resistant or
refractory to treatment. Chemotherapy or radiation may have killed most
of the cancer cells, but some of them were not affected or changed to
survive despite the treatment. Any cancer cells left behind can then
grow and show up again.
The shorter the time between when the cancer was thought to be
gone and the time it came back, the more serious the situation. Most
doctors would agree that 3 months of appearing to be cancer-free is too
short to be considered a recurrence if the cancer does come back.
Although there is no standard period of time in the definition of
recurrence, most doctors consider it a cancer recurrence if you have
had no signs of cancer for at least a year. If your cancer has been
gone for only 3 months, this would most likely be a progression of your
disease. In this case, the doctors would assume that the cancer (even
though they could not find it in any of the tests) never totally went
away.
What are the types of cancer recurrence?
There are different types of recurrence:
- Local
recurrence means that the cancer has come back at the
same place where it first started.
- Regional
recurrence means that the cancer has come back in the
lymph nodes near the place where it started.
- Distant
recurrence means the cancer has come back in another part
of the body, some distance from where it started (often the lungs,
liver, bone marrow, or brain).
If you have a cancer recurrence, your doctor can give you the
best information about what type of recurrence you have and what it
means to have that type.
What is the risk of recurrence?
The risk of recurrence for cancer survivors is different for
each person. It depends on many factors, including the type of cancer,
the treatment you had, and how long it has been since your treatment.
If you find yourself haunted by questions about your chance of
recurrence, talk with your doctor about the realistic chance of
recurrence in your specific situation. You may find this information
reassuring or somewhat unsettling. Whatever information you get,
remember that each person's situation is unique, no matter what
statistics you are given. There may be factors that may make your case
different from the usual.
You may want to ask your doctor or nurse questions like these
if you are concerned about recurrence:
- Is it possible that my cancer can come back?
- When is it most likely to come back?
- Where would it most likely come back?
- How likely is it to come back? (numbers and statistics)
- Is there anything I can do keep it from coming back?
- How can I know if it's back? What should I look for?
Can I do something to prevent a recurrence?
It is important to eat right, exercise, and see your doctor
for follow-up visits, but please understand that you cannot prevent a
cancer from recurring. Many cancer patients blame themselves for
missing a doctor visit, not eating right, or postponing a CT scan for a
family vacation. Yes, there are times when it is crucial to keep
follow-up appointments, especially if you are having symptoms that you
have not had before, because these could be signs that your cancer is
back. But even if you do everything just right, you cannot change the
possibility of a cancer recurrence.
Diet
After completing cancer treatment, many people decide to eat
better and exercise in the hope that these changes will improve their
quality of life and their chance for survival. Though current research
does not show that nutrition can influence cancer recurrence, it still
is wise to eat well and do what you can to be as healthy as possible.
The American Cancer Society recommends that cancer survivors
follow the same nutrition guidelines as those recommended for cancer
prevention. The same factors that increase cancer risk might also be
important in promoting cancer recurrence after treatment. For example,
breast cancer research has supported dietary effects by suggesting that
the risk of recurrence might be increased by obesity and by diets high
in fat and low in fruits and vegetables. Prostate cancer recurrence
might be increased by high saturated fat intake.
Vitamins and supplements
Sometimes people think taking certain vitamins, herbs, or
other dietary supplements will give them an extra edge in preventing
recurrence. Available research does not support this belief. In fact,
some research has shown that supplements containing high levels of
single nutrients (greater than the Dietary Reference Intakes and the
tolerable upper intake limits) may have unexpected harmful effects on
cancer survivors.
There are supplements that improve your level of certain
vitamins which may, over time, lower your risk of developing a cancer.
But this evidence is weak at best. Even if it might help, it could take
many years of use to alter the chance that cancer will progress or show
up again. Talk with your doctor before starting any vitamin or other
dietary supplement.
To learn more about supplements, you may want to read the
American Cancer Society's document, Dietary Supplements: How to Know
What is Safe.
Physical activity
There have been a few studies of the effect of physical
activity on survival of people with cancer. Researchers have not yet
been able to find out whether physical activity can prevent recurrence
of cancer or slow the progression of disease. But studies have shown
that regular physical activity can reduce anxiety and depression,
improve mood, boost self-esteem, and reduce symptoms of fatigue,
nausea, pain, and diarrhea. These benefits can be gained through
moderate physical activity on most, if not all days of the week.
Moderate activities are those that make you breathe as hard as
you would during a brisk walk. Activities like walking, biking, and
swimming are considered moderate, and so are activities like yard work
and brisk house cleaning. Ideally, you should take part in at least 30
minutes of moderate activity each day. Cancer survivors can find many
ways to work physical activity into their daily lives. Parking further
away and using stairs instead of elevators are easy ways to be more
active throughout the day.
A little bit of physical movement is far better than none. It
helps more if you start easier and slowly build up to greater amounts
of physical activity. In choosing a level of activity, it is important
to keep in mind your physical abilities and your recent levels of
activity. It is also important to talk to your doctor before changing
your level of physical activity.
Bottom line
It would be very comforting to have something that would keep
cancer from coming back after treatment. We want a real weapon to fight
back with – something that will give us insurance against the
cancer coming back. Both doctors and patients wish for cures. At this
time there is nothing you can do to be sure the cancer will not come
back. Even with our current understanding of how cancer develops and
grows, cancer is still a mystery in many ways.
Some common questions after treatment
Can I be assured the cancer will never come
back?
No, it is not possible to guarantee that once you have
completed cancer treatment your cancer will never come back. Although
your doctor may say, "Your cancer is gone" or "I think I removed all
the cancer" or "I see no evidence of any cancer," the fact remains that
there is always a chance that there are some cancer cells left in your
body that survived, even though they cannot be seen or found with any
test used today. These cells can begin to grow over time and cause your
cancer to recur.
And while you don't want to ever think about the chance of
having a second cancer, it is possible. Having one cancer doesn't make
you immune to having a second or even a third different cancer.
Some people find it very hard to get this thought out of their
minds. While it is useful to take measures to prepare for the chance
that the cancer can return, for some people the thought can become a
fear that interferes with daily life. Some people deal with these
thoughts by distraction, or by focusing on what is most important to
them on a day-to-day basis. Others must take further measures, such as
joining a peer support group or seeing a mental health professional.
After the stress of cancer, the way you deal with the emotional pain
can be key to moving on with your life.
Is a "no-cancer guarantee" possible?
Cancer is not predictable. In most cases it will never come
back, but in some cases it will. No doctor can guarantee cancer will
stay gone forever.
A recurrent cancer starts with cancer cells that the first
treatment didn't fully remove or destroy. Some clusters of cancer cells
may have been too small to be detected in follow-up tests, scans, or
blood work. This does not mean that you got the wrong treatment. It
does not mean that you did anything wrong after treatment, either. It
means that a small number of cancer cells survived the treatment you
had. Over time, these cells grew into tumors or cancer that your doctor
could finally detect as a recurrence.
Just as it happened the first time, there is also a chance
that your normal cells may, for any number of reasons, develop the same
damage in their DNA. (DNA holds genetic information on cell growth,
division, and function.) This damage then causes a gene (a small
section of DNA) to change (mutate). When genes mutate, they can become
oncogenes, which allow cells to become cancer cells that divide quickly
and out of control.
There is also something called a tumor suppressor gene, which
tells cells when to repair damaged DNA and when to die (a normal
process called apoptosis, or programmed cell death). This gene is like
the brake pedal on a car. Just as a brake keeps a car from going too
fast, a tumor suppressor gene keeps the cell from dividing too quickly.
When tumor suppressor genes are mutated or turned off – that
is, when the brakes fail – the cells divide very fast,
allowing cancer cells to develop. Changes in tumor suppressor genes can
be inherited (you are born with them), or they can happen during your
life. (See our document, Oncogenes and Tumor Suppressor
Genes for more information.)
Not all of the growth factors for cancer cells have been found
yet. Even though treatment may seem to have gotten rid of all of the
cancer, there may be just one tiny cancer cell left someplace in the
body. This cell may not cause any harm for many years. Suddenly,
something can happen that will change the immune system and the cell
becomes active, grows, and makes other cells. The result is a cancer
recurrence.
What should I look for if I am worried about
a recurrence?
It is easy to obsess about every ache and pain if you are
worried about your cancer returning. But in reality, there are few
major symptoms that could mean serious problems. If you have any of the
problems listed below, tell your doctor at once.
- return of the cancer symptoms you had before (for example,
a lump or new growth where your cancer first started)
- new or unusual pain that seems unrelated to an injury and
does not go away
- weight loss without trying
- bleeding or unexplained bruising
- a rash or allergic reaction, such as swelling, severe
itching, or wheezing
- chills or fevers
- headaches
- shortness of breath
- bloody stools or blood in your urine
- lumps, bumps, or swelling
- nausea, vomiting, diarrhea, loss of appetite, or trouble
swallowing
- cough that doesn't go away
- any other signs mentioned by your doctor or nurse or any
unusual symptoms that you just can't explain
Whenever you have a symptom, your first thought might be that
your cancer has returned. Remember that there are illnesses and medical
problems that have nothing to do with your previous cancer. You can
still get colds, infections, arthritis, heart problems, etc.
– just like anyone else. As with any illness, your doctor is
the best person to find the cause of your symptoms.
What about future health problems I might
get from cancer treatment?
You should also know that some cancer treatments may cause
health problems later on. These problems may not appear right away and
some don't show up until years after treatment. Ask your doctor:
- if the treatment you had will put you at risk for short- or
long-term problems
- what those problems are and how you can recognize them
- what you should do if you notice them
- what you should do to take care of your health
What does "5-year survival rate" mean?
The 5-year survival rate refers to the percentage of patients
who are alive at least 5 years after their cancer is diagnosed. Many of
these people live much longer than 5 years after diagnosis. The 5-year
rate is used as a standard way to discuss prognosis or the survival
outlook.
You may also hear the term 5-year relative survival
rate. Relative survival compares survival among cancer patients to that
of people not diagnosed with cancer, but of the same age, race, and
sex. It is used to adjust for normal life expectancy when cancer is not
present. 5-year relative survival rates are considered to be a more
accurate way to describe the prognosis (long-term outlook) for groups
of patients with a certain type and stage of cancer. But they cannot be
used to predict individual cases.
Keep in mind that 5-year rates are based on patients who were
diagnosed and first treated more than 5 years ago. These statistics may
no longer be accurate because improved treatments often result in a
better outlook for those who were diagnosed more recently.
There is another point to remember when talking about survival
rates. Survival rates look at survival only, not whether the person is
cancer-free 5 years after diagnosis. They are based on a group of
people of all ages and health conditions diagnosed with a certain type
of cancer. These statistics include people diagnosed early and those
diagnosed late. As with any statistics, they should only be used to get
an idea of the overall picture. They cannot be used to predict any one
person's outcome.
Why won't the doctor say, "You are cured"?
Most doctors avoid using the term "cure" because it implies
that your cancer is gone forever. As we have discussed, this is almost
impossible to say in any case of cancer. The best a doctor can do is
say that they can find no signs of cancer in your body at this time.
This is most often stated as "No evidence of disease." Your doctor may
continue to follow you closely for many years and do tests to watch for
any signs of cancer recurrence. There is no harm in assuring yourself
that you are cancer-free if that's what all the evidence shows. Enjoy
the feeling that you do not have cancer. But be aware that it is still
possible for cancer to come back even after you have been cancer-free
for 5 years or more.
What does it mean if the doctor says, "Your
cancer is controlled"?
A doctor may use the term "controlled" if your tests or scans
show that your cancer is not changing over time. Another way of
defining control would be calling the disease "stable." Controlled
means that the tumor does not appear to be growing. Some tumors can
stay the same for a long time, even without any treatment. Some stay
the same size because of the cancer treatment and they are watched by
the doctor to be sure that they don't start growing again.
What does it mean if the doctor says, "Your
cancer has progressed"?
If the cancer does grow, the status of your cancer would
change and your doctor might say that your cancer has progressed. Most
clinical trials define a tumor as progressive when there is a 25%
measured growth in the tumor. (See the section "What is cancer recurrence?"
for more on the difference between recurrence and progression.)
How is treatment response described?
When a treatment completely gets rid of all tumors that were
able to be measured or seen on a test in some way, it is called a complete response.
The decrease in tumor size must last for at least 1 month to count as a
response.
In general, a partial
response means your cancer responded somewhat to your
cancer treatment, but still has not gone away. If you are in a clinical
trial this usually is defined more precisely. A partial response is
most often defined as at least a 50% reduction in measurable tumor. The
reduction in tumor size must last for at least 1 month to qualify as a
response.
How long is treatment given before the
doctor can tell if there is a response?
The treatment that is first prescribed is based on the last 20
to 30 years of clinical experience in treating that kind of tumor. But
no 2 cases are exactly alike, and response to treatment cannot always
be predicted.
Standard practice is to wait for 2 full cycles of treatment
before looking for any response to it. This usually takes about 2 to 3
months. Response is checked by repeating the tests that show the
cancer. If the tumor fails to respond to the first treatment, changes
will be made, perhaps to a chemotherapy combination that has shown
promise in similar cases.
Preparing for recurrence
While no one wants to think about it, every cancer survivor
needs to be prepared for the chance that their cancer may come back
some day. This is very hard to think about, especially right after
successful cancer treatment. But not being aware of this possibility
could be dangerous to your long-term health. There are some things you
can do and things you should know that will help you deal with the
uncertainty of cancer recurrence.
Keep your health insurance
You probably already know that having cancer is very
expensive. Your first cancer experience probably cost a lot of money.
You may have had to change your work schedule or job status because of
the side effects of a certain treatment. Your partner may have had to
take time off from work to help you. These changes affect your
finances.
Though money may be tight, keep your health insurance if at
all possible after you have finished your first cancer treatment. You
will need regular follow-up care for many years. Unless you are over 65
and can get Medicare, it can be hard to get medical insurance,
especially if your cancer comes back. Insurance is expensive, but
cancer treatment is even more costly. There are some options for
uninsured people who need cancer treatment, but they are not easy or
inexpensive. There are no "free" government programs to pay for cancer
care.
For some people, going back to work after having had cancer is
very hard to do, but they feel they cannot look for a different job
because they are afraid to lose their health insurance. Although the
Health Insurance Portability and Accountability Act (HIPAA) is supposed
to help you to get insurance coverage when you change jobs, some people
worry about the risk of having different coverage in their new job.
Although employers are not legally allowed to discriminate against
hiring people who have had cancer, cancer survivors are often afraid to
look for a new job. They are also afraid to discuss their cancer with a
new employer. For ideas on how to handle this, you may want to see our
document, Financial Guidance for Cancer
Survivors and Their Families: Off Treatment,
which you can get by calling our toll free number. It also helps to
know what rules the employer must follow. You may also want to read our
documents about HIPAA and COBRA. They are listed in the "Additional
resources" section.
Keep your follow-up visits with your doctor
While there is no guarantee that seeing your doctor regularly
will keep the cancer from coming back, it will allow you to find any
recurrence as early as possible. The earlier cancer is found, the
better it responds to treatment. It is also reassuring to know that
your doctor is closely watching you to be sure that no cancer is found.
Continue to talk with your health care team. Let them know how you are
feeling and discuss any concerns you might have. One of the greatest
benefits you will get from your follow-up visits with your doctor will
be peace of mind.
Get the tests your doctor suggests
There are tests that you will need to have done as part of
your follow-up after cancer treatment. These will help your doctor be
sure that you stay in remission (without evidence of disease). The
tests will vary depending on the type of cancer you had.
For example, if you have prostate cancer and were offered
close follow-up with no immediate treatment (this is often called
watchful waiting), follow-up tests would include a digital rectal exam
(DRE) and PSA (prostate-specific antigen) test every 6 months. A needle
biopsy of the prostate gland would likely be done within 6 months, be
repeated within 18 months, and done anytime after that if it looks like
the cancer is growing.
The follow-up for certain early-stage bladder cancers after
treatment includes a visit to your doctor every 3 months for the first
year, then at regular intervals after that. During these visits, your
doctor will likely do a cystoscopy (look at the inside of your bladder
with a cystoscope–a slender tube with a lens and a light) and
collect a urine sample to check for bladder cancer cells.
As you can see, each follow-up schedule is different based on
the specific cancer. Talk to your health care team about what your
follow-up care is going to be, what is expected of you, and what you
can expect of them during this time.
It is tempting to avoid following all the steps and tests
required in follow-up. By the time you have completed treatment for
cancer, you may be tired of being a cancer patient and just want to
forget about this part of your life and move on. It is understandable
to want to avoid tests and doctors that make you face the possibility
that your cancer has returned. This is a natural impulse, but not a
wise choice.
Learning to live with uncertainty
Worrying about the cancer coming back (recurring) is normal,
especially during the first year after treatment. This is one of the
most common fears people have after cancer treatment. And even many
years after treatment, this fear may still be in the back of your mind.
As time goes by, many people say that their fear of cancer returning
decreases and they find themselves thinking less often about their
cancer. But even years after treatment, some events can cause you to
worry about your health. These may include:
- follow-up visits
- anniversary events (like the date you were diagnosed, had
surgery, or ended treatment)
- birthdays
- illness of a family member
- symptoms much like the ones you had when you first found
you had cancer
- the death of someone who had cancer
Here are some ideas that have helped others deal with
uncertainty and fear and feel more hopeful:
- Be informed. Learn what you can do for your health now and
about the services available to you. This can give you a greater sense
of control.
- Be aware that you do not have control over some aspects of
your cancer. It helps to accept this rather than fight it.
- Be aware of your fears, but don't judge them. Practice
letting them go. It is normal for these thoughts to enter your mind,
but you do not have to keep them there. Some people picture them
floating away, or being vaporized. Others turn them over to a higher
power to handle. However you do it, letting them go can free you from
wasting time and energy on needless worry.
- Express feelings of fear or uncertainty with a trusted
friend or counselor. Being open and dealing with emotions helps many
people feel less worried. People have found that when they express
strong feelings, like fear, they are more able to let go of these
feelings. Thinking and talking about your feelings can be hard. While
it is important not to let cancer rule your life, it may be hard to do.
If you find cancer is taking over your life, it may be helpful to find
a way to express your feelings.
- Take in the present moment rather than thinking of an
uncertain future or a difficult past. If you can find a way to be
peaceful inside yourself, even for a few minutes a day, you can start
to recall that peace when other things are happening – when
life is busy and confusing.
- Work toward having a positive attitude, which can help you
feel better about life now.
- Use your energy to focus on wellness and what you can do
now to stay as healthy as possible. Try to make healthy diet changes.
If you are a smoker, this is a good time to quit.
- Find ways to help yourself relax.
- Exercise and be as active as you can.
- Control what you can. Some people say that putting their
lives back in order makes them feel less fearful. Being involved in
your health care, getting back to your normal life, and making changes
in your lifestyle are among the things you can control. Even setting a
daily schedule can give you more power. And while no one can control
every thought, some say they've resolved not to dwell on the fearful
ones.
Get support
A support group can be a powerful tool for both survivors and
families. Talking with others who are in situations like yours can help
ease loneliness. You can also get useful ideas from others that might
help you.
There are many kinds of support programs, including individual
or group counseling and support groups. Some groups are formal and
focus on learning about cancer or dealing with feelings. Others are
informal and social. Some groups are made up of only people with cancer
or only caregivers, while others include spouses, family members, or
friends. Other groups focus on certain types of cancer or stages of
disease. The length of time groups meet can range from a set number of
weeks to an ongoing program. Some programs have closed membership and
others are open to new, drop-in members.
It is very important that you gather information about any
support group you are considering. Ask the group facilitator what types
of patients are in the group and if anyone in the group is dealing with
survivorship issues.
Online support groups may be another option for support. The
Cancer Survivors Network, an online support community supported by your
American Cancer Society is just one example. You can visit this
community at www.acscsn.org.
There are many other good communities on the Internet that you can join
as well. You may also enjoy a person-to-person connection with a
counselor who can give you one-on-one attention and encouragement. Your
doctor may be able to recommend a counselor who works with cancer
survivors.
Religion can be a source of strength for some people. Some
find new faith during a cancer experience. Others find that cancer
strengthens their existing faith or their faith provides newfound
strength. If you are a religious person, a minister, rabbi, other
leader of your faith, or a trained pastoral counselor can help you
identify your spiritual needs and find spiritual support. Some members
of the clergy are specially trained to help minister to people with
cancer and their families.
Spirituality is a part of many people's lives and does not
always involve a formal religion. Many people are comforted by
recognizing that they are part of something greater than themselves,
which helps them find meaning in life. Meditating, prayer, practicing
gratitude, and spending time in nature are just a few of the many ways
that people address spiritual needs.
Support in any form allows you to talk about your feelings and
develop coping skills. Studies have found that people who take part in
a support group have an improved quality of life, including better
sleep and appetite. You can contact your American Cancer Society to
find out about available sources of support in your area.
When treatment ends
When treatment ends, people begin a new chapter in their
lives, one that can bring hope, happiness – and fear. The
fear of recurrence is common among cancer survivors and can sometimes
be quite intense. Because no 2 people are alike, each person has his or
her own way of coping. Learning to manage these emotions will take time
and practice.
Keep in mind that you are a cancer survivor and remember the
good news: you are one of nearly 11 million Americans alive today who
has had cancer, and the survival rate is improving all the time.
Additional resources
We have selected some related information that may also be
helpful to you. These materials may be ordered from our toll-free
number.
- Financial Guidance for Cancer Survivors and Their Families:
No matter who you are, we can help. Contact us anytime, day or
night, for information and support. Call us at 1-800-ACS-2345 (1-800-227-2345) or
visit www.cancer.org.
References
Baker F, Denniston M, Smith T, et al. Adult cancer survivors:
How are they faring? Cancer.
2005;104: 2565-2576.
Brown, J, Byers, T, Thompson, K, et al. Nutrition during and
after cancer treatment: A guide for informed choices by cancer
survivors. CA: A Cancer
Journal for Clinicians. 2001;51:153-181.
Doyle C, Kushi LH, Byers T, et al. Nutrition and physical
activity during and after cancer treatment: An American Cancer Society
guide for informed choices. Cancer
J Clin. 2006;56:323-353.
Hewitt M, Greenfield S, Stovall E, eds. From Cancer Patient to Cancer
Survivor: Lost in Transition. Washington, D.C. The
National Academies Press; 2006.
Mikkelsen TH., Søndergaard J, Jensen AB, Olesen F.
Cancer rehabilitation: Psychosocial rehabilitation needs after
discharge from hospital? Scandinavian
Journal of Primary Health Care. 2008;26(4):216-221.
Weissman, D. Fast Fact and Concept #14: Palliative
Chemotherapy. End of Life/Palliative Education Resource Center.
Accessed February 4, 2009 at
www.mywhatever.com/cifwriter/library/eperc/fastfact/ff14.html.
Last Medical Review: 03/05/2009
Last Revised: 03/05/2009
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