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    Dealing with an illness like cancer can change your relationships with the people in your life. It is normal to notice changes in the way you relate to family, friends, and other people that you are around every day—and the way they relate to you.

    This section talks about some of the issues cancer survivors face in relating to family members, partners and dating, friends, and coworkers after treatment.

    Family

    Even though treatment has ended, you may face problems with your family. For instance, if you used to take care of the house or yard before your treatment, you may find these jobs too much to handle after treatment has ended. Yet, family members who took over for you may want life to go back to normal and have you do what you used to do around the house. You may then get angry because you are not getting the support you need.

    Other times, you may expect more of your family than you receive. They disappoint you, and it can also make you angry. For one woman, it was a family member's lack of support during her treatment. "Never once, not a card, not a phone call, and I have a hard time looking at her today."

    You may see your role as taking care of others, not being taken care of, yet you may need to depend on others during this time. You may resent it and get angry at those who are just trying to help. You may not know how to talk to your children or grandchildren about your cancer.

    gruberfamilyWhen treatment ends, families often are not prepared for the fact that recovery takes time. In general, your recovery will take much longer than your treatment did. Survivors often say that they didn't realize the time they needed to recover. This can lead to disappointment, worry, and frustration for everyone. Families also may not realize that the way the family works may have changed permanently as a result of cancer. They may need help to deal with the changes and keep the "new" family from falling apart.

    Now that I've had cancer, what do my family members need to know about their risks?

    You may fear that passing your genes on to your children means they will get cancer. One woman felt guilty about getting cancer and what it might mean for her family. "I have a daughter, and I'm sure she's blaming me for putting her [at] risk."

    It is important to know that most cancer is not passed down through families. Only about 5 to 10 percent of the most common cancers (such as breast, colon, prostate) are inherited. In most of the families that have inherited cancers, researchers have found relatives who may have had:

    • Cancer before they were 50 years old
    • Different kinds of cancers
    • Cancer in two of the same body parts (like both kidneys or both breasts)
    • Other risk factors for cancer (such as colon polyps or skin moles)

    If you think that your cancer may be inherited, talking with a cancer genetic counselor can help answer your questions and those of your family. He or she can also help you and your doctor decide on the medical care that you and your family might need if a genetic link is found. Genetic testing can determine if the cancers that occur in your family are due to genes or to other factors.

    Dana-Farber Cancer Genetics and Prevention Program 

    Getting help with family issues

    Some family members may have trouble adjusting to changes or feel that their needs are not being met. Your family may want to deal with issues such as these on its own, or you may want to consider getting outside help. Ask your doctor or social worker to refer you to a counselor or therapist. An expert on family roles and concerns after cancer treatment can help your family solve its problems.

    Tips: Dealing with family issues

    How do you cope with family issues? Here are some ideas that have helped others deal with family concerns:

    • Let others know what to expect of you as you heal—and what not to expect. Do not feel you must keep the house or yard in perfect order because you always did in the past. Let people know what you can and cannot do.
    • Give yourself time. You and your family may be able to adjust over time to the changes cancer brings. Just being open with each other can help ensure that each person's needs are met.
    • Help your children (or grandchildren) understand that you were treated for cancer. Children of cancer survivors have said that these things are important:
      • Being honest with them
      • Speaking as directly and openly as possible
      • Allowing them to become informed about your cancer and involved in your recovery
      • Spending extra time with them
       

    With your permission, other family members should also be open with your children about your cancer and its treatment.

    Partners and dating

    Body changes and concerns about sex can affect the way you relate to your partner or how you feel about dating. As you struggle to accept changes yourself, you may also worry about how someone else will react to scars, ostomies, sexual problems, and loss of fertility. Sexual problems can make feeling close even harder. Even for a couple that has been together a long time, staying connected can be a major challenge at first. It may be a comfort to learn that very few committed relationships end because of ostomies, scars, or other body changes. Divorce rates are about the same for people with and without a cancer history.

    If you are single, you may wonder how and when to tell a new person in your life about your cancer and body changes. Fear of being rejected keeps some people from seeking the social life they would like to have. Others do not want to date and prefer to be alone but may face pressure from friends or family to "be more sociable."

    Getting help with partner and dating issues

    If your concerns about sex or dating persist, think about seeing a sex therapist or a counselor. He or she may be able to help you work through personal issues and prepare you to talk with your partner or a new person in your life.

    Tips: Talking to your partner about your sexual needs

    How do you talk to your partner about sex after cancer treatment? Here are some ideas that have helped others:

    Tell your partner how you feel about your sex life and what you would like to change. You might tell him or her:

    • What is happening with your sex life
    • Your thoughts and beliefs about why your sex life is the way it is
    • How it makes you feel—for example, scared, lonely, sad, or angry
    • What would please you or make you feel better

    This approach avoids blame, stays positive, and gives your significant other a better sense about how you are feeling.

    Tips: Dating after cancer treatment

    How do you start dating after cancer treatment? Here are some ideas that have helped others:

    • Start by working on other areas of your social life besides dating and sex. Make an effort to see friends and family. Try a new activity. Join a club. Take a class. These activities can increase your comfort level in being around people.
    • Make a list of your good points. Focus on what you bring to a relationship.
    • Try not to let cancer be an excuse for not dating or trying to meet people.
    • Do not tell a new date about your cancer right away. Wait until you feel a sense of trust and friendship, but do not wait until you are about to have sex.
    • Practice what you will say to someone if you are worried about how you will handle it. Think about how he or she might react, and be ready with a response.
    • Think about dating as a learning process with the goal of having a social life you enjoy. Not every date has to be a "success." If some people reject you (which can happen with or without cancer), you have not failed.
    • Remember that not all dates "worked out" before you had cancer.

    Work

    Research shows that cancer survivors who continue to work are as productive on the job as other workers. Most cancer survivors who are physically able to work do go back to their jobs. Returning to work can help cancer survivors feel they are getting back to the life they had before being diagnosed with cancer.

    Some cancer survivors may find themselves changing jobs after cancer treatment. If you decide to look for a new job after cancer treatment, remember that you do not need to try to do more—or settle for less—than you are able to handle. If you have a résumé, list your jobs by the skills you have or what you've done rather than by jobs and dates worked. This way, you don't highlight the time you didn't work due to your cancer treatment.

    Whether returning to their old jobs or beginning new ones, some survivors are treated unfairly when they return to the workplace. Employers and employees may have doubts about cancer survivors' ability to work. For more information on your legal rights, see Employment and Legal Rights.

    You have no legal obligation to talk about your cancer history unless your past health has a direct impact on the job you seek.

    Tips: Handling problems at work

    Decide how to handle the problem.

    • What you want to do?
    • Do you still want to work there?
    • Are you willing to take action to correct a problem?
    • Would you rather look for a new job?

    If necessary, ask your employer to adjust to your needs.

    • Start by talking informally to your supervisor, personnel office, employee assistance counselor, shop steward, or union representative.
    • Ask for a change that would make it easier for you to keep your job (for example, flex-time, working at home, special equipment at work).
    • Document each request and its outcome for your records.

    Get help working with your employer if you need it.

    • Ask your doctor or nurse to find times for follow-up visits that don't conflict with your other responsibilities.
    • Get your doctor to write a letter to your employer or personnel officer explaining how, if at all, your cancer may affect your work or your schedule.
    • Contact your local cancer support organization, groups for disabled workers, or the local bar association for names of qualified lawyers who specialize in antidiscrimination law.

    Friends and coworkers

    The response of friends, coworkers, and/or people at school after your cancer treatment can be a major source of anger, grief, or dismay. Some people mean well, but they do not know the right thing to say. Maybe they just do not know how to offer support. Others do not want to deal with your cancer at all, even though it is still a daily challenge for you. "When you say the 'C' word, it just turns [some people] right off, and [they] will mumble something and ... walk off," one survivor said.

    Friends' and coworkers' seeming lack of support may be because they are anxious for you or for themselves. Your cancer experience may threaten them because it reminds them that cancer can happen to anyone. Try to understand their fears and be patient as you try to regain a good relationship.

    Many survivors say that acting cheerful around others for their comfort is a strain. "I do not want to smile any more," one melanoma survivor said. "You do not have the energy to put up with that." A prostate cancer survivor noted that: "You know if you complain sometimes, for some people, it turns them off. So I try not to do that."

    As survivors sort out what matters most, they may even decide to let some weak friendships go to give more time to the strong ones. One brain cancer survivor found that after cancer, "You really know how many true friends you've got. And they do not stop calling just because they hear you're in remission. They really love you and think something of you." A kidney cancer survivor found that, "Letting weak friendships go was hard, but I also got support I did not expect from people at work and in church."

    On the job or where you volunteer, people may not understand about cancer and your ability to perform while recovering from treatment. They may expect you to "slack off" or think that your having had cancer means you are going to die soon. Sometimes, fears and lack of knowledge result in unfair treatment.

    Getting help with issues involving friends and coworkers

    If you find that a friend or coworker's feelings about cancer are hurting you, try to resolve the problem with that person face-to-face. If such efforts don't help in the job setting, you may want to get help. Your manager, shop steward, company medical department, employee assistance counselor, or personnel office may be able to change coworkers' ideas, procedures, or the way your job fits in with others' to lessen problems.

    When hurtful remarks or actions get you down, talking to a friend, family member, or counselor may help you deal with it. But if coworker attitudes get in the way of your doing your job, it is a problem management needs to address.

    Relating to others

    Tips: Relating to others

    How do you relate to other people in your life after cancer treatment? Here are some ideas that have helped others:

    • Accept help.
      When friends or family offer to help, say yes, and have in mind some things that would make your life easier. In this way, you will get the support you need, and your loved ones will feel helpful. "When I first started treatment, I had a lot of help," said one colon cancer survivor. "So I felt bad asking my friends for more help when my treatment ended. But I still really needed it, so I let them know."
    • Address any problems that come up when you go back to work or school.
      Your supervisor (or his or her supervisor), teacher, or coworkers may be able to help those around you understand how you want to be treated as a cancer survivor. If problems with others get in the way of your work or studies, you may want to talk with your bosses, your union, the company's Human Resources department, or the school's Student Affairs office.
    • Keep up contacts during your recovery.
      Friends and coworkers will worry about you. If they find out about your treatment and progress, they will be less anxious and scared. Talk to them on the phone or send email. When you are able, have lunch with friends or stop in for an office party. Your return to work or other activities will be easier for you and others if you stay in touch.
    • Plan what you'll say about your cancer.
      There is no "right" way to deal with others about your illness, but you do need to think about what you'll say when you're back on the job. Some cancer survivors don't want to focus on their cancer or be linked in people's minds with the disease. Others are very open about it, speaking frankly with the boss or other workers to air concerns, correct wrong ideas, and decide how to work together. The best approach is the one that feels right to you.

    Source: U. S. National Cancer Institute, Facing Forward Series: Life After Cancer

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