Managing the Emotional Effects of Survivorship

You may be prepared for the possibility of managing the physical late effects of cancer treatment, but be aware of your ongoing emotional feelings as well. Mental and emotional health are an important part of the transition into survivorship. It is impossible to predict how survivorship will affect you because it is different for everyone, but many survivors admit to being surprised when they feel stress, depression, anxiety, guilt and/or fear rather than feelings of jubilance and relief.

Be gentle with yourself as your body and mind heal after cancer because a variety of intense and unfamiliar emotions may linger. Ask your doctor about the time needed for emotional healing. Be prepared to seek help if the feeling of being “off” doesn’t go away and if your emotions hinder your daily life. Various supportive care resources and services are designed to help you through this phase, including counselors and therapists with expertise in working with people living with cancer.

Following are common emotional effects you may experience after treatment ends. All are valid, understandable and even expected for cancer survivors, but they can become serious if ignored. Therefore, an important part of survivorship involves acknowledging your emotions — both the good and the bad.

Anxiety about your future can begin as soon as treatment ends and can continue until it is addressed. Moderate to severe anxiety is often treated with medication, therapy or a combination of both. Explore relaxation techniques, such as meditation, muscle relaxation, yoga or guided imagery. Peer-to-peer cancer support volunteers can offer insight into what to expect, and they’re often available by phone or online.

Depression is a psychological reaction to your situation as a whole. Certain ongoing treatments or maintenance therapies, such as chemotherapy or hormone therapy, can also cause or contribute to depression. Many cancer survivors do not talk to their doctors about it because they think depression is “expected,” but it can, and should, be treated. It’s extremely important to talk with your doctor about feeling hopeless, helpless, “numb” or worthless. If these feelings last more than a few days or if you have thoughts of death or of attempting suicide, seek medical attention immediately.

Doubt can lead to confusion and questions about the meaning of life and its purpose. Some people find strength in support from family, friends, the community or spirituality. It may also help to talk about your feelings with a counselor or support group.

Fear can continue after treatment because of the possible risk of a recurrence or secondary cancer. Making long-term plans may become difficult because every ache and pain triggers a concern that cancer has returned. Develop a comprehensive follow-up care plan to help calm these fears. Do your best to stay focused on the present.

Guilt may occur if you blame yourself for getting cancer because of actions you did or didn’t take, if you feel you’ve been a burden to loved ones or if you wonder why you survived when others with similar conditions didn’t. Talk with a therapist about these feelings. You might find that you can lessen your guilt by giving back to the cancer community. Helping others can provide a sense of purpose and well-being that can help take away blame you may be placing on yourself.

Scanxiety is the anxiety you may feel before having scans or tests to monitor your disease and while you’re waiting for the results, and it’s real. It can affect your ability to eat, sleep, work and more. Because your follow-up care requires frequent monitoring, it’s very important to find ways to manage it. Stay busy with activities you enjoy. Exercise daily, if possible. Call your doctor if your scanxiety prevents you from carrying out your daily activities.

Stress is the physical, mental and/or emotional tension that results from an adverse or demanding circumstance, such as cancer. It’s common for you to feel stress as you transition from patient to survivor, but watch for signs of post-traumatic stress (PTS). It can occur any time after treatment. Although PTS is not as severe as post-traumatic stress disorder (PTSD), the symptoms are similar. They include feeling defensive, irritable or fearful; inability to think clearly; difficulty sleeping; avoiding people; and losing interest in life. Survivors with PTS need early treatment, which may include medicines (antianxiety drugs or antidepressants), crisis intervention techniques (relaxation training and support groups) or cognitive behavioral therapy.


The Role of the Caregiver After Treatment Ends

Once your loved one with cancer transitions away from their primary treatment schedule, your role as a caregiver also transitions. You will begin to adjust back to your previous lifestyle from before treatment began. Such a change can bring surprising emotions with it. It’s possible that more intense feelings may emerge because you may now have more time to process what’s happened. If you find the emotions are ongoing or overwhelming, consider talking with your own doctor or a mental health specialist. It is common to remain worried that your loved one’s cancer will return. Attending post treatment follow-up appointments is both important for the survivor and the family/caregiver. Many people experience what is sometimes referred to as “scanxiety” as follow-up tests are conducted. Try to adopt the attitude that you’ll have time to worry later if you hear concerning news, and otherwise proceed as normal even when the time for these tests come around on your calendar. Don’t be surprised if your loved one, or even yourself, find a desire to arrange priorities differently from before the diagnosis. Getting back to normal is great, and enhancing normal is good, too.

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