John, a young adult who had just completed chemotherapy for lymphoma, came to his talk therapy appointment with three questions written down on a piece of paper:
- “How do I go on living knowing that my cancer could come back at any time?”
- “Should I change my job?”
- “How do I control my worry about the next set of labs and CT scans?”
John’s questions are very common for a cancer survivor. While there are no “right” answers to these questions, they can provide a valuable framework for your thinking as you go forward with your life after cancer treatment.
How do I go on living knowing that my cancer could come back at any time?
At the end of treatment we all hope that cancer is gone forever, but recurrence is a reality for many people. The goal is to let that reality be your springboard to living well. What changes could you make in your life to help decrease your risk of recurrence? Change your diet to one rich in fruit, vegetable and whole grains? Engage in regular stress management like walking, gentle yoga or meditation? Cut back on your alcohol, or switch from soda to water and green tea? Don’t let the fear of recurrence stop you from living well – instead, let worry motivate you to make healthy changes that will help keep cancer away (and improve your mood, sleep and energy level, too).
Should I change my job?
John had thought about changing his job because cancer made him realize “life does not last forever and things might change at any time.” He dedicated some time to thinking about what he really wanted out of his life and realized that he’d get more satisfaction from a career that is more service-oriented. Given his insurance benefits and financial situation, he decided to stay in his current occupation for now, but he signed up for evening teaching classes at a community college. His plan is to do some volunteer tutoring at a local middle school then decide if he will make a career change to teaching. John actively decided not to let cancer stop him from a fulfilling career – he decided to use his experience with cancer as a springboard to actively think about and plan for meaningful work. Should a cancer experience stop anyone from searching out their dream job? Absolutely not. The whole reason to fight cancer is to go on living as well as possible.
How do I control my worry about the next set of labs and CT scans?
Because there is a reality to cancer recurrence, there is going to be worry before coming into the cancer center for labs and scans. There may be some poor sleep, irritability, trouble concentrating too. Stress management skills are critical during this time. Plan ahead, do not schedule big meetings, complex projects or time with difficult relatively in the days before the appointment. Take time for yourself; eat well, get outside, buy fresh flowers, see a funny movie, listen to your favorite music, or have lunch with a friend. Talk to yourself in a helpful way; “I have managed this before, I can do it again. I will deal with the results when we have them, there’s nothing I can do about it now. For now, the best I can do is focus on today.” Yes, the worst case scenarios will go through your mind, that is just how are minds are wired. Let those thoughts come, notice them, take three long, slow deep breaths, and then let them go again. Repeat your helpful thoughts. John decided the best way to tolerate his return to the cancer center was to make plans for a fancy fish dinner the night before the appointment, “I’d much rather think about the ocean and seafood than lymphoma.”
Some people experience horrendous daily anxiety related to their cancer experience. The worry may stop them from leaving the house or wanting to spend time with family and friends. Anxiety about recurrence may be part of a mental health problem like clinical depression or post-traumatic stress disorder. Talk to your doctor about the intensity and frequency of your fear. Treatment with talk therapy and/or medication can help alleviate the clinical depression or post-traumatic stress disorder and diminish the cancer worry to a manageable level.
