There are 16.9 million Americans living today who have survived cancer, according to the American Cancer Society. LaToya Williams is one of them. She was diagnosed with stage 3 breast cancer 13 years ago. Like other cancer survivors, Williams not only had to battle her disease, she also had to figure out how to live with it during her cancer treatment and after. "I have been on a learning journey over the past 13 years," says Williams, a New York City resident.
As early diagnosis and improved treatment options have allowed more and more people not only to survive cancer but to live long lives after treatment -- the ACS expects that number to jump to 22.1 million by 2030 -- the focus more often than not these days shifts beyond mere survival. Now, millions of people have to learn to live well with and after cancer.
"Cancer will pretty much deconstruct you to your breaking point. Then it teaches you how to live with it," says Williams, who actually changed careers after her treatment to work for the ACS, where she's now is a senior manager of cancer control strategic partnerships. "It took me about three years to talk about what I went through and have a grasp on it. The worst is behind me, now how do I find a sense of normalcy?"
A New Chapter Begins
The ACS says that when cancer treatment ends, "people begin a new chapter in their lives, one that can bring hope and happiness, but also worries and fear. No two people are alike. Each person has his or her own way of coping and learning to manage these emotions. It will take time and practice."
Life after cancer can include worries of long-term physical and mental health effects, financial concerns, relationship issues and the fear of the cancer's recurrence. All of these concerns, and others that may surface, are perfectly normal. The ACS offers these tips to help deal with this fear and uncertainty:
-- Stay informed. Learning as much as you can about your health and health care can help you feel more in control.
-- Put things in perspective. Understand and learn to accept that you have no control over whether your cancer recurs.
-- Don't judge your fears. Accept that they are normal, and learn to let them go.
-- Talk about your feelings with a friend, counselor or support group. Expressing emotions, rather than keeping them bottled up, helps many people feel better. "Don't hold those stages of grief in," Williams advises. "Connect with others who have been through it."
-- Focus on the present. The future is uncertain for everyone. Learn to find peace of mind, even when your life may be challenging.
-- Control the things that you can. Get back to as close to a normal life as you can. Be involved in your health care, and make the changes that you can affect.
Create a Survivorship Care Plan
"This is really key," says Dr. Arnold Baskies, a surgical oncologist who practices in southern New Jersey. "It is very important to be aware that, after treatment, you get a survivorship care plan."
In 2006, the Institute of Medicine (now the National Academy of Medicine) recommended that every cancer patient receive an individualized survivorship care plan. This plan should include guidelines for monitoring and maintaining the patient's health. It's required by the Commission on Cancer, a consortium of professional organizations working to improving survival and quality of life for cancer patients, says Baskies, who is also chairman of the ACS Global Cancer Control Advisory Council.
This plan should be created by one of your providers or someone at your hospital, and it should cover post-cancer health surveillance, exercise, nutrition, rehabilitation, mental health care and other aspects of your post-treatment life. But, Baskies says, "It can be problematic -- some hospitals have trouble providing that." So remember this important plan and advocate for its creation with your doctors. "Get that information, in one form or another," Baskies stresses.
Living Well After Cancer
You are not alone in your post-cancer life. Your doctors, health counselors, support groups, mental health care providers, spiritual leaders and others are ready, willing and able to help you find your way.
Nutrition is a common concern of cancer survivors. Cancer treatment can disrupt your eating for some time, and if side effects linger, talk to your providers for help managing the problem. Once side effects are controlled, eating well is critical to regain strength, rebuild your body and feel better mentally and physically. The ACS's tips for healthy eating after cancer treatment include:
-- Ask your doctors if you have any food or diet restrictions.
-- Work with a dietitian to create a nutritious and balanced eating plan.
-- Make sure your daily eating includes a variety of colorful fruits and vegetables, including citrus fruits and dark-green and deep-yellow vegetables.
-- Choose lots of high-fiber foods, like whole-grain breads and cereals.
-- Mix up your meals by trying new and different fruits, vegetables, low-fat foods or whole-grain foods.
-- Cut down -- or better still, cut out -- red meats and processed meats such bacon, sausage and deli meats.
-- Consume low-fat or nonfat milk and dairy products.
-- Avoid alcohol. Not drinking is best, but if you do drink, keep it no more than one drink per day (beer, wine or spirits) for women and two for men.
In addition, try to lose weight if you are overweight. "Obesity increases the risk of recurrence, and it is also a known risk for the development of cancer overall," Baskies says. Cutting calories and increasing your activity will help, but choose activities that you enjoy and will continue to practice. Before you start any new exercise or activity, be sure to check with your doctors first.
Health Care After Cancer
Cancer survivors need to stay proactive with their health care. That means seeing their doctors for years after treatment, sometimes for the rest of their lives. You will most likely be sick and tired of going to doctors and medical centers after the ordeal of cancer treatment, but follow-up care is critical for staying healthy long after your cancer is in remission. That means:
-- Regular follow-up visits with your cancer care team. They will check for any signs that your cancer might be recurring. If your cancer were to come back, the earlier it's found, the easier it is to treat.
-- Appropriate screening tests as recommended by your care team. Blood and imaging tests may be part of your follow-up and post-treatment care. They allow your care team to monitor your health and make sure you stay in remission.
The ACS also suggests that you keep copies of important medical records. If you need to see new doctors later in life, have the following on hand:
-- Copies of the pathology reports.
-- Copies of imaging test results (CT or MRI scans, for example), stored digitally on a DVD or flash drive.
-- Copies of surgery reports.
-- Hospital discharge summaries.
-- Lists of chemotherapy or other drug treatments, their doses and how long you took them.
-- Radiation therapy treatment summary.
-- Contact information for all your cancer care providers.