• Your Emotions after Treatment

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    Just as cancer treatment affects your physical health, it affects the way you feel, think, and do the things you like to do. Besides causing many emotions that may surprise you, the treatment may actually change the way your brain works. Just as you need to take care of your body after treatment, you need to take care of your emotions.

    Each person's experience with cancer is different, and the feelings, emotions, and fears that you have are unique as well. The values you grew up with may affect how you think about and deal with cancer. Some people may feel they have to be strong and protect their friends and families. Others seek support from loved ones or other cancer survivors or turn to their faith to help them cope. Some find help from counselors and others outside the family, while others do not feel comfortable with this approach. Whatever you decide, it is important to do what's right for you and not compare yourself to others.

    Here are some common feelings other people have had after cancer treatment.

    Fear that cancer will come back

    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. Even years after treatment, this fear may always be in the back of their minds.

    For some, the fear is so strong that they no longer enjoy life, sleep well, eat well, or even go to follow-up visits. "If I get it again, what am I going to do?" one woman said. "I never thought I'd make it through the first time." Of course, not everyone reacts this way. As one survivor put it, "[Cancer] is just part of life, and we always have hope."

    As time goes by, many survivors report that their fear of cancer coming back becomes less, and they find themselves thinking less often about their cancer. However, even years after treatment, some events can cause you to become worried about your health. These may include:

    • Follow-up visits
    • Anniversary events (like the date you were diagnosed or had surgery or ended treatment)
    • Birthdays
    • Illness of a family member
    • Symptoms similar to the ones you had when you found you had cancer
    • The death of someone who had cancer
    • Personal reminders. For example, one person said he used to go to a particular restaurant during chemotherapy because the milkshakes they served were the only thing he could stand to eat. After treatment, he found he had to stop going to the restaurant because it reminded him of treatment and made him "sick to his stomach."
    Tips: Coping with fear of cancer returning

    How do you cope with fear of cancer returning? Here are some ideas that have helped others deal with fear and feel more hopeful:

    • Be informed.
      Learning about your cancer, understanding what you can do for your health now, and finding out about the services available to you can give you a greater sense of control. Some studies even suggest that people who are well informed about their illness and treatment are more likely to follow their treatment plans and recover from cancer more quickly than those who are not.
    • Express feelings of fear, anger, or sadness.
      Being open and dealing with their emotions helps many people feel less worried. People have found that when they express strong feelings like anger or sadness, they are more able to let go of these feelings. Some sort out their feelings by talking to friends or family, other cancer survivors, or a counselor. Of course, if you prefer not to discuss your cancer with others, you should feel free not to. You can still sort out your feelings by thinking about them or writing them down on paper.
    • Work toward having a positive attitude, which can help you feel better about life now.
      Sometimes this means looking for what is good even in a bad time or trying to be hopeful instead of thinking the worst. Use your energy to focus on wellness and what you can do now to stay as healthy as possible. Don't blame yourself for your cancer. Some people believe that they got cancer because of something they did or did not do. This is usually not true—and you should not dwell on feeling this way. Remember, cancer can happen to anyone. You don't need to be upbeat all the time. Many people say they want to have the freedom to give in to their feelings sometimes. As one woman said, "When it gets really [bad], I just tell my family I'm having a bad cancer day. I ... cancel all my appointments. I go upstairs and crawl into bed."
    • Find ways to help yourself relax.  
    • Be as active as you can.
      Getting out of the house and doing something worthwhile can help you focus on other things besides cancer and the worries it brings.
    • Control what you can.
      Some people say that putting their lives in order makes them feel less fearful. Being involved in your health care, keeping your appointments, 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.
    socialworkersFeeling stress

    When you were diagnosed, you may have put certain issues aside for a while, such as concerns about family, work, or finances. Now that treatments are over, these issues may begin to resurface just when you are tired and may feel that there is already too much to handle.

    Many cancer survivors also worry that stress may have played a role in their illness. It is important to remember that the exact cause of many cancers is still unknown. No research shows that stress causes cancer, but stress can cause other health problems. Finding ways to reduce or control

    Tips: Reducing stress

    Many survivors have found activities like the ones below useful in dealing with cancer and their worries after treatment ends. Ask your doctor, nurse, social worker, or local cancer organization about taking part in activities like these.

    Exercise
    Exercise is a known way to reduce stress and feel less tense—whether you've had cancer or not. As one man put it: "I can feel down a little bit, and it is a fine line with depression, but when I walk 45 or 50 minutes in the fresh air, I feel like I can take on the world sometimes." See your doctor before making an exercise plan, and be careful not to overdo it. If you cannot walk, ask about other types of exercise that may be helpful.

    Dance or movement
    People can act out their feelings about cancer in classes using dramatic and/or dance-style body movements. Other class members talk about the issues the "performer" was trying to express.

    Sharing personal stories
    Telling and hearing stories about living with cancer can help people learn, solve problems, feel more hopeful, air their concerns, and find meaning in what they've been through.

    Personal Stories 

    Music and art
    Even people who have never sung, painted, or drawn before have found these activities helpful and fun.

    Dana-Farber's Creative Arts Program 

    Depression and anxiety

    After treatment, you may still feel angry, tense, sad, or blue. For most people, these feelings go away or lessen over time. For up to one in four people, though, these emotions can become severe. The painful feelings do not get any better, and they get in the way of daily life. These people may have a medical condition called depression. For some, cancer treatment may have contributed to this problem by changing the way the brain works.

    rosenblattandblockGetting help for depression

    Talk to your doctor. If your doctor finds that you do suffer from depression, he or she may treat it or refer you to other experts. Many survivors get help from therapists who are expert in both depression and helping people recovering from cancer. Your doctor also may give you medicine to help you feel less afraid and tense.

    How do I know if I need help with depression or anxiety?

    If you have any of the following signs for more than two weeks, talk to your doctor about treatment.

    Emotional signs:

    • A sense of being worried, anxious, blue, or depressed that doesn't go away
    • Emotional numbness
    • Feeling overwhelmed, out of control, shaky
    • A sense of guilt or worthlessness
    • Helplessness or hopelessness
    • Irritability and moodiness
    • Difficulties concentrating, or feeling "scatterbrained"
    • Crying a lot
    • Focusing on worries or problems
    • Not being able to get a thought out of your mind
    • Not being able to stop yourself from doing things that seem silly
    • Not being able to enjoy things any more, such as food, sex, or socializing
    • Finding yourself avoiding situations or things that you know are really harmless
    • Suicidal thoughts or feeling that you are "losing it"

    Body changes:

    • Unintended weight gain or loss not due to illness or treatment
    • Insomnia or increased need for sleep
    • Racing heart, dry mouth, increased perspiration, upset stomach, diarrhea
    • Physically slowing down
    • Fatigue that doesn't go away; headaches or other aches and pains (These may also be caused by cancer treatment; see Fatigue.)

    Memory and concentration

    quot;I tell them it is a 'senior moment,' but I notice I have a lot more of them now, and I'm sure [treatment] had something to do with it," one 70-something survivor noted. "Not being able to concentrate the way I used to is the worst effect for me," a younger survivor added. "I worry about how it will affect my work."

    meyerandtrenuloResearch shows that one in four people with cancer reports memory and attention problems after chemotherapy. More research is needed to learn what causes these changes.

    These effects can begin soon after treatment ends, or they may not appear until years later. They do not always go away. If a person is older, it can be hard to tell whether these changes in memory and concentration are a result of treatment or of the aging process. Either way, some feel they just cannot focus as they once did.

    Research is just starting to explore who may develop problems with memory and concentration. It seems that people who have had systemic chemotherapy or have had radiation to the head area are at higher risk of having these problems. People who have had high doses of chemotherapy may be particularly affected by memory problems, but even those who have had standard doses have reported memory changes.

    Working with your doctor or nurse on memory and concentration problems

    Your doctor can help you with memory and concentration problems. Talk with him or her if:

    • You think a medicine you are taking could be causing or adding to your problem.
    • You think you suffer from depression or anxiety. These problems can affect attention, concentration, and memory.
    • You are going through menopause. Some memory and concentration problems can be related to menopause.
    Tips: Improving memory and concentration

    Cancer survivors have found many ways to help improve memory after cancer treatment. See if any of these ideas work for you:

    • Get a notebook or pocket calendar and use it to plan your day. You can write down each task, how long it will take, and where you need to go. Plan the whole day, including night hours. Keep it simple, and be realistic about how much you can do in a day.
    • Put small signs around the house to remind you of what you need to do. Use them to remember tasks such as: 1) take out the trash; and 2) lock the door. Hint: use only two or three signs. If you have too many, you may ignore them.
    • Group long numbers (such as phone numbers and ZIP codes) into "chunks." For example, the phone number 812-5846 can be repeated as "Eight-twelve, fifty-eight, forty-six."
    • "Talk yourself through" something you need to do to help you stay focused. When doing a task with a number of steps, such as cooking or working on a computer, whisper each step to yourself.
    • Learn relaxation skills. Learning how to relax can help you remain calm even in stressful moments. Managing stress better can improve memory and attention.
    • Before you go to family events or work functions, practice saying important information that you want to remember, like names, dates, and key points you want to make.
    • Repeat what you want to remember. Saying it a couple of times can help your mind hold on to the information.

    Dealing with body changes

    Some body changes are short-term, and others will last forever. Either way, how you look may be a big concern after cancer treatment. People with ostomies after colon or rectal surgery are sometimes afraid to go out. They may feel shame or fear that others will reject them. They may be afraid they will have an "accident" and feel embarrassed. Others do not like people being able to see treatment effects like scars on the head or neck, skin color changes, loss of breasts or limbs, weight gain or loss, and hair loss. Even if your treatment does not "show," your body changes may trouble you. Feelings of anger and grief are natural. You have lost your "old body" and, with it, your sense of self.

    Feeling bad about your body can also lower your sex drive, and the loss of or reduction in your sex life can make you feel even worse about yourself. "Mentally, it was strange," one prostate cancer survivor said. "You're worried about your 'man thing.' It may be on the back of your mind ... but it is always there." Women also have this concern. "I felt like I was half of a woman," one ovarian cancer survivor noted.

    Changes in the way you look can also be hard for your loved ones—and this can be hard on you. Parents and grandparents often worry about how they look to a child or grandchild. They fear the changes in their body will scare the child or get in the way of their staying close.

    Tips: Coping with body changes

    How do you cope with body changes? Here are some ideas that have helped others:

    • If you find that your skin has changed color from radiation, ask your doctor or nurse about ways you can care for your skin and if the color will change over time.
    • Find new ways to enhance your appearance. A new haircut, hair color, makeup, or clothing may give you a lift.
    • If you choose to wear a breast form (prosthesis), make sure it fits you well. Your health insurance plan may pay for it.
    • Tell yourself that you are more than your cancer. Know that you have worth no matter how you look or what happens to
    • Mourn your losses. They are real, and you have a right to
    • Focus on the ways that coping with cancer has made you you in life. Stronger, wiser, and more realistic.

    Feeling angry

    Many people find themselves feeling angry about having cancer or about things that have happened to them during their diagnosis or treatment. They may have had a bad experience with a health care provider or with an unsupportive friend or relative.

    Tip: Feeling less angry

    Hanging on to anger can get in the way of your taking care of yourself, but sometimes anger can energize you to take action to get the care you need. If you find yourself feeling angry, find a way to use that energy to help yourself.

    Feeling alone

    After treatment, you may miss the support you got from your health care team. You may feel as if your safety net has been pulled away and that you get less attention and support from health care providers now that treatment is over. You also may feel that only others who have had cancer can understand your feelings. Feelings like these are normal any time you leave people who mean a lot to you.

    It is also normal to feel somewhat cut off from other people—even family and friends—after cancer treatment. Often, friends and family want to help, but they don't know how. Others may be scared of the disease.

    Tips: Feeling less alone

    What can you do to make yourself feel better during this lonely time? Here are some methods other people have found helpful:

    • Figure out how you can replace the emotional support you used to receive from your health care team. Think about:
      • Asking one of your nurses or doctors if you could call sometimes. Your call could help you stay connected and help you feel less alone. Even just knowing you can call them may help.
      • Finding support services offered over the phone or Internet.
      • Finding new sources of support for your recovery. Friends, family, other cancer survivors, and clergy are a few ideas.
       
    • Think about joining a cancer support group. In a cancer support group, people who have had cancer meet to talk about their feelings and concerns. Besides airing their own issues, they hear what others have gone through and how other people have dealt with the same problems they are facing. A support group also may help members of your family cope with their concerns.

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

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