Cancer

When It Simply Becomes Too Much…

When It Simply Becomes Too Much…

We all know that someday, we will all face death. A cancer diagnosis makes this realization personal, and often comes at a time that we would not have necessarily thought of our own mortality. As you reach the post-treatment phase, you may find that your priorities in life have changed and this may lead you to consider making changes in your life. You may be worried about your environment and what you put on or in your body as you continue to wonder why or how you developed the cancer. The people around you may not understand or even be open to talk with you about these changes. After so much focus on the treatment of your body and the cancer, you owe it to yourself to tend to your emotional needs and long-term goals. 

Emotional distress is real and can negatively affect your quality and quantity of life. But worrying about being stressed can have negative health effects on its own. 

Don’t be afraid to seek the help you need to heal from this journey. Most likely your cancer diagnosis started abruptly and forcefully pulled you away from life as you knew it.  The journey continues and now leaves you to pick up the pieces from this experience. It can continue to be overwhelming and even traumatizingat times.

Consider reaching out to the many professional services that are available to you within your community. One or a combination of interventions may sometimes be recommended (e.g. exercise, talk therapy and/or medications). Professional therapists are ready to help you process and make sense of your thoughts; to help you find new meaning and purpose, and to help you build new hopes and dreams.

Emotional Rollercoaster

Emotional Rollercoaster

“You have cancer…”

These words often result in what feels like an emotional roller coaster ride. Undoubtedly, you and the people around you will experience a wide range of emotions – fear, sadness, grief, anger, frustration, resignation, etc., and these emotions are likely to change rapidly and contradict each other. This ‘roller coaster’ may confuse and even overwhelm you and those around you.

For many, the ride begins with the first diagnosis; for others it may not manifest until much later when the realization of lingering or post treatment symptoms occur. For some, it may be the fear and/or uncertainty of cancer recurrence.

Regardless of when you experience these emotional extremes, it is important to recognize them as valid and to understand that they may interfere with your ability to function in your daily life- at work and at play- and even hinder your ability to tolerate your cancer treatment. Emotions play an integral part of our daily lives and our ability (or inability) to function at our best. Even our best efforts may find us unable to ‘shut down our mind’ and let our bodies get the rest that is critical to peak performance and optimal health.

Sometimes, a cancer diagnosis can also worsen pre-existing emotional problems or trigger memories to traumatic experiences from the past.

No two people handle stress in identical ways, yet there are some general guidelines that may help us all find some relief. Some suggestions to find relief are outlined in this link and briefly summarized below:

For most, the roller coaster will not significantly impact your ability to function and will pass as you become accustomed to your new ‘normal.’ Giving yourself permission to work through the emotions you experience will help your inner self to heal and regain your sense of self. However, for some, it might be time to reach out. If you experience emotions that ‘paralyze’ you in your daily living, if you experience feelings of overwhelming helplessness or hopelessness, or if you entertain thoughts of hurting yourself or others you need to reach out and ask for help. Talk to your physician, your loved ones, your clergyman; share with them what you are experiencing. Pick up the phone and call your local emergency number (in USA: call 911 or call/chat with the National Suicide Prevention Lifeline at 1-800-273-8255). Know that there are people out there who are standing by, willing and wanting to help you through this time.

Medication Adherence

Medication Adherence

Medication non-adherence is defined as not being able/willing to start, continuously take, or prematurely stop taking the prescribed medication.

A growing number of medications prescribed for a variety of cancer types are now being self-administrated at home, either by mouth or as an injection. These medications are taken to reduce the cancer recurrence risk and/or to treat cancer cancer.  These medications only work when they are taken as directed. Rough estimates for chronic diseases in general project that only half of all patients take their medications as directed. These same numbers also seem to include cancer medications. Additionally,  adherence to non-cancer medications for chronic disease may also drop in the first year following cancer treatment.

Reasons for non-adherence can be multiple:

  • Logistical barriers, such as access to a pharmacy, insurance coverage and affordability, and difficulties in obtaining refill requests.
  • Change in an individual’s belief of the benefits and risks of continuing cancer medications.
  • An individual’s ability to tolerate side-effects.

You may feel embarrassed to tell your doctor that you are not taking your medications in the manner they were prescribed. Keep in mind that everyone’s personal circumstances and drug kinetics differ. Cancer medication only works as well as you are able to take it, and not being able to follow your care plan may make you concerned about the cancer treatment’s ability to control the disease.

Life happens, and sometimes we all miss a scheduled dose. It is probably okay; check with your provider or the drug reference materials provided by your pharmacist to determine what you need to do (i.e. skip the dose, catch up on a dose, etc.). It is a great idea to make use of a daily pill box. It gives you visual proof of whether or not you have already taken, or still need to take your prescription.

If you find that you have consistent issues with not being able or willing to take your medications, then you should talk with your provider so that he (or she) can help you find a solution that works. Your provider may recommend remedies to allow you to tolerate it better, changes of the dosage, frequency, or delivery method of your medication, or even switch to another medication. It is never recommended that you experiment on your own by adjusting the dosage. Talk to your provider!

The power of suggestion can be strong! Sometimes, selecting a start date may allow you to prepare yourself physically, mentally, and spiritually and develop a positive and focused approach to a new treatment course.

Adherence to your medication regime is recognized as a challenge by the medical community. Finding the right solution is often a very individualized approach that requires open communication between you and your provider. Remember that these challenges are not unique to you alone and that  remedies that optimize medication adherence are being explored on many levels. If you would like to contribute, you may want to explore research studies available near you that seek to find interventions at the patient level that support medication adherence.

Who is a Cancer Survivor?

Who is a Cancer Survivor?

The definition of a cancer survivor remains debated. The National Coalition for Cancer Survivorship (NCCS) defines a cancer survivor as “An individual from the time of diagnosis, through the balance of his or her life”, and in their most recent version of their definition they include “impacted family members, friends, and caregivers”. Dr. Feuerstein (Editor of The Journal of Cancer Survivorship) proposed a working definition “From completion of primary treatment up to end-of-life”. Calls have been made to make the definition more transparent and be more respectful of persons who have lived past cancer.

Regardless of the definition you relate to, there is some good news! Medical advancements in cancer detection and treatment have made huge advancements in the last few decades, as described in the Pulitzer Prize winning book and documentary “Emperor of all Maladies”. These medical advancements have resulted in improved cancer outcomes and an ongoing increase in the number and longevity of many  persons with a history of cancer. Cancer researchers around the globe continue to work hard to allow ongoing improvements in cancer care and project positive outcomes (within the next ten years), as well as improving the quality of cancer survivorship care.  That means you can worry less and focus more on the things and people that are important and meaningful to you!

So what does this mean for you? For starters, seek and develop a good relationship with a primary care physician that you feel comfortable with and that will be your companion and advisor as you make the journey towards optimum health.

Lets get the conversation started! What is your definition of a cancer survivor?

Which Vitamin Source?

Which Vitamin Source?

Dietary Supplements and Mortality Rate in Older Women The Iowa Women’s Health Study (JAMA 2011)

Do Cruciferous Vegetables Really Fight Cancer? (NYT 2018)

Bottom line – until we know more and understand better, it may be preferable to get your vitamins from a large variety of dietary sources rather than pills (unless specifically recommended/prescribed by your health care provider).

What is Cancer Survivorship

What is Cancer Survivorship

As you enter the post-cancer treatment phase, you may….

  • “Look better”, but you likely still have more healing to do – physically, functionally – but also emotionally and spiritually. Being told “you have cancer” and having to put your life unexpectedly and urgently on hold to undergo life-saving treatments can be traumatizing.
  • Feel alone, since it may be hard for others to understand you, especially if they haven’t experienced it themselves.
  • Feel like you are riding an emotional rollercoaster.
  • Notice that your priorities in life are changing, perhaps even rearranging!
  • Find yourself trying to balance your health and healing while minimizing disruption to your home, work, and financial status.
  • Have lost trust in your body, wondering “what will happen next?”, and be searching for ways that allow you to heal and stay healthy.
  • Be uncertain and concerned about what the future may hold for you and for your loved ones.
  • Find yourself spending hours on “Google” trying to answer your many questions, only to discover that you have even more questions!
  • Yearn to renew your pre cancer self and embrace the feeling of wholeness that may have been lost in your journey.

This juggling can be overwhelming, confusing, and stressful. You may have a large team of health care providers, but you may not always know what to do or where to direct your questions, your concerns and your needs. Your providers may not always have the time to work with you in finding the answers that you need, or the specific skills to support you and as a result, you may feel lost or abandoned in your journey.

Even though the field of cancer research and treatment field has made huge advancements towards the prevention, diagnosis, and survival of cancer patients over the last few decades, the post-treatment phase has been relatively undervalued and under-explored until recently. But the “times they are a changing” and that means good news for survivors, caregivers, and providers as well.

As a first step, to facilitate the transition of cancer survivors into the post-treatment phase [From Cancer Patient to Cancer Survivor: Lost in Transition (IOM 2005)], large organizations such as LIVESTRONG, National Coalition for Cancer Survivorship, Office of Cancer Survivorship at National Cancer Institute(https://cancercontrol.cancer.gov/ocs/), and American College of Surgeonshave identified the following five essential elements and recommend that providers incorporate these elements as an integral part of the post treatment care plan:

  • Surveillance (watch for cancer recurrence)
  • Screening (for new cancers)
  • Assessment and management of the effects of cancer treatment(s)
  • Adoption of positive health behaviors
  • Care coordination between health providers

These areas represent only the first steps to assuring successful survivorship for both patients, their families and health care providers; more improvements in cancer survivorship continue to emerge as recognition of the post treatment phase evolves.

This informational site hopes to help you to navigate your unique survivorship journey and to empower you to regain control and better care for yourself.