Few things are as discouraging as being told you have cancer again, especially once you have worked really hard to beat cancer once and rebuild your life. Just when thought you could focus on work, friends, travel, now you are back getting scans, blood draws and meeting with doctors, maybe even more doctors than the first time around. The first time you heard the words “You have cancer” there may have been worry, fear and uncertainty about what treatment will mean for you and how cancer may change your life. But when you hear “It’s back,” you know what treatment means, you know how cancer interrupts your life and how treatment may effect your body. This time the thoughts are not, “Cancer, me? What? How?” but more like “I’ve already been through treatment! I do not want to do that again!”
The very first thing to do when a doctor says “It’s back” is to take a long, deep breath, pause, slowly exhale, then repeat. The next thing is to give yourself a break – don’t beat yourself up if you are emotional (tearful, irritable, frustrated). Those emotions are normal. And don’t blame yourself. The cancer is here now – there’s no use drudging up the past. Now is the time to start thinking about what you can do to stay as well as possible. Of course it’s normal to be upset, but if you’re feeling completely hopeless, staying in bed for weeks, and/or kicking the dog, let your doctor know you are struggling.
As you move forward, it’s important to hold on to key facts:
Fact #1 – You have managed cancer before, which means you can manage it again. Of course, everyone involved wishes you never had to use these management skills again, but here you are. The CT scan or MRI show the cancer, so now it’s time to make a plan for keeping in under control as much as possible.
Fact #2 – No one can say exactly how much time you have. Yes, some cancers are life limiting, and the situation is more serious with the second diagnosis. But the second cancer diagnosis does not mean you have one week or one month. As you learned with the first cancer experience, making the most of today really matters, because nobody knows exactly how much time they have.
Fact #3 – Good care matters. Get treated by an oncology team you feel cares for you and practices evidence-based medicine. Clinical trials are available a major medical centers with NCI (National Cancer Institute) and NCCN (National Comprehensive Cancer Network) designations, and are worth knowing about. Visit clinicaltrials.gov, but only do cancer internet research early in the day. Doing cancer research at night will disrupt your sleep.
Fact #4 – Quality of life should be a priority. Managing symptoms takes work, as you learned with your first cancer diagnosis, but doing so improves your quality of life day to day. Scientific studies show that people with cancer who spend time outside or time as part of a social group have less distressing mood symptoms and more worry control. Actively manage your schedule and calendar to include time in parks or at the lake, and time with friends, a reading group, your church community or a cancer support group.
There are many people who have a second cancer diagnosis, have braved major body-changing surgeries, years of chemo and radiation therapy, and are living full and joyful lives. For instance, one man with tongue cancer had a surgery that left him unable to eat any regular food by mouth ever again. It took a long time, but he has adjusted to living with a tube to give him nutrition through his abdomen. Now he focuses on how much he loves fishing and playing bridge, instead of cooking or going out to dinner. A woman with ovarian cancer has been getting chemotherapy for five years. The infusions have not stopped her from taking trips every other month to the beach where she paints watercolors. Even having brain metastasis has not stopped a fifty year old woman from continuing her work with the homeless. She does have to go in for radiation therapy, and does not know when the disease will advance so far she can’t work, but for now she continues to serve meals weekly to the homeless and help them find more permanent housing solutions.
If cancer teaches us anything, let it be the importance of not taking time for granted. Getting diagnosed a second time with cancer is really hard – it’s a tremendous psychological and physical challenge. But people are resilient, more resilient than cancer, and with an evidence based treatment plan devised by an oncologist you trust, there can be good days ahead.