I met with a young patient recently, a woman who has been done with chemotherapy for lymphoma for close to a year. She was feeling well, and she had no symptoms of cancer, nothing that made her suspicious of a recurrence. After I examined her and reviewed her most recent CT scan and labs, I agreed. No recurrence. I wrote in my note, “NED,” the acronym for no evidence of disease.
As we were wrapping up the visit, I asked her if there was anything else on her mind, anything else she was concerned about.
“I still get really nervous and anxious before coming to see you and before each scan,” she said. “I was prepared for how chemotherapy would make me feel. I expected to feel tired, to get sick. What I wasn’t prepared for was how to move on with my life, without letting cancer take over. No one told me that getting on with life after cancer would be like this. No one told me that this would be so hard.”
And, to a large degree, I think she’s right.
We’re very good at getting people through chemotherapy treatments. Oncologists and oncology nurses are great at counseling on side effects, helping to manage nausea and other ill-effects of treatment. Families rally around the cancer patient during this time, providing much-needed emotional support and physical support. Friends – hopefully – step up to the plate and offer shoulders to cry on, hugs, personal experiences, and distraction.
But when treatment is over? Well, life gets back to normal. Right?
Hmm … not so fast. It’s just not that easy. That’s what we forget to tell patients. Getting back to normal, getting on with life, is harder than everyone expects.
Picking up the pieces of your life before cancer – before chemotherapy or radiation wreaked havoc on the body and soul – takes much longer than one might expect. With the end of treatment comes an upwelling of fear of recurrence, fear that because active treatment has stopped, the cancer will be able to grow again. There is fear surrounding each scan and each blood draw. Anxiety swells before each oncology visit.
We might have forgotten to tell you that this is all normal. It’s an expected part of the recovery process. The fatigue from chemotherapy will get better over time. The hair will grow back. The fear of recurrence will subside with the passing of the months.
Another thing that we may have forgotten to tell you? You will be able to get on with your life again after cancer treatment. You’ll probably be a changed person after your experience, but you’ll get back to normal. If not the old normal then for sure a new one. Your life will resume, despite cancer, beyond cancer.
Just be sure to rally the support during this time. You still need it.
Merry Jennifer Markham is an oncologist who blogs at Living Despite Cancer.
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