Cancer Survivors: Managing Emotions After Cancer Treatment

Since the 1980s, doctors have tried to describe the stages cancer survivors normally go through. Most divide them into a version of the three stages described below:

Acute Survival (Living With Cancer) – Covers cancer diagnosis and any subsequent treatment. During this time, patients will undergo treatment and may be invited to participate in a clinical trial to study new cancer treatments. Sometimes services are offered to patients and their caregivers to address emotional, psychological and financial problems.

Prolonged survival (transient cancer): Post-treatment period during which the risk of recurrence is relatively high. Many patients are relieved that treatment has ended, but are concerned that they will not visit the oncologist regularly. During this stage, patients often visit the oncologist two to four times a year, depending on their circumstances.

Permanent survival (living after cancer): survival after treatment and long-term. Although two out of three survivors declare that their lives have returned to normal, a third affirms that they continue to have physical, psychosocial or economic problems. During this stage, most survivors are cared for again by their GP. Ideally, they have developed a long-term follow-up plan with the oncologist for their regular doctor to implement.

Social and Emotional Repercussions of Cancer

In addition to the physical effects of cancer, survivors experience psychological, emotional, and spiritual consequences. Many of them affect quality of life and can manifest many years after treatment. Here are some of the most common problems cancer survivors face:

Fear of Recurrence

Many survivors live in fear that the cancer will return at some point. In some cases, a major event, such as the anniversary of the diagnosis or the end of treatment with the oncologist, can trigger these feelings. Fear can be good if it encourages you to discuss your health changes with your doctor, but it can also cause unnecessary worry. Knowing your own body will help you distinguish between normal changes and more serious symptoms.

Pain

Grief is the natural result of loss. In cancer, losses refer to health, sexual desire, fertility, and physical independence. To overcome your pain, it is important to experience all of these feelings. Support groups and psychological assistance can help you deal with these problems.

Depression

It is estimated that 70% of cancer survivors experience depression at some point. Depression can be difficult to diagnose in cancer survivors, since the symptoms are very similar to the side effects of cancer treatment, such as weight loss, tiredness, insomnia, and inability to concentrate. In a 10-year follow-up study, symptoms of depression have been found to be associated with shorter survival, so seeking treatment for depression is essential.

Body Image and Self-esteem

Cancer survivors who have suffered amputations, disfigurements, and loss of organs such as the colon or bladder often have to overcome their problems to relate to themselves and to others. A negative body image and low self-esteem can affect the survivor’s ability to maintain relationships with their partner, which will have important consequences on their quality of life. Good communication is essential to maintain or regain intimacy after cancer. Consult a doctor if problems persist.

Spirituality

Many survivors feel that life takes on new meaning after cancer and renew their commitment to certain spiritual practices or organized religion. Research indicates that spirituality improves quality of life through a strong social support network.

Survivor’s Fault

Some people feel guilty about surviving cancer when others don’t. You may be wondering “Why me?” Or reevaluate your goals and ambitions in life. If you have a prolonged feeling of guilt, a psychotherapist, a member of the clergy, or a support group can help you express your feelings.

Relations

Possibly the biggest challenge cancer survivors face is how others react to their disease. Friends, coworkers, and family members may feel uncomfortable when discussing the diagnosis of cancer. They can keep silent, avoid you, or pretend that nothing has happened. Others may use humor to try to distract you and not think about your situation, instead of offering to talk about your problems. Cancer can be a long-lasting disease, so it is essential to overcome communication barriers.

Social and Work Life

Social and professional reintegration can be accompanied by many fears: concern about being exposed to a higher risk of infection, lack of enough energy to reach the end of the workday and anxiety about not being able to think clearly due to the so-called “neurological impairment by chemotherapy “or memory loss. In overcoming a life and death situation, many cancer survivors feel alienated from people who have not had the same experience and turn to other survivors for support and friendship.

You may be reluctant to reveal to your bosses and colleagues that you are receiving cancer treatment for fear of being treated differently or even losing your job and health insurance. This creates an atmosphere of uncertainty that contributes to emotional stress. Again, honest communication with your colleagues will help you overcome these feelings.


About the author: Diane H. Wong is copywriter at write essay for me service. Besides, she is a professional nutritionist. So she is going to start writing her own blog. It can help her share her knowledge with others.

10 Ways of Thriving After Cancer

First and foremost, “surviving” cancer is amazing. After all, cancer is one of the deadliest diseases in the world! So, if you are a survivor, you are indeed worthy of praise. 

There are many types of cancers out there. One thing that they all have in common is that they are a result of uncontrolled growth of abnormal cells anywhere in a body. Early detection of cancerous growth results in a good prognosis as there is nearly no definitive cure for any form of cancer at its late stages.

Again, whether yours was at its late-stage or not and you survived, you are a winner! At this point, you should hold no reserve about cancer resurfacing and instead THRIVE. 

Now that you have survived cancer, the next step is reintegration back into society and doing the best you can to thrive while doing so. 

1. Battle your fear & anxiety head-on 

Long after getting cleared of cancer, survivors have to fight an emotional battle of fear and anxiety. No matter what the medical reports say about their health status, there is the seemingly never-ending fear of the cancer returning. 

This emotional turmoil is insurmountable and almost never avoidable unless you normally just have a strong will. You must quench this fear so that you can thrive.  A chat with your doctor is vital. Disclose whatever concerns you have about your health. Your doctor may even schedule frequent testing and care plans to make you feel better. 

2. Be devoted to your physical therapy sessions 

Cancer is usually for the long term. So, when the health providers eventually manage to get rid of all the cancerous growths, you may be left with a physical limitation like immobility. Such a physical limitation may make life less enjoyable, thus your doctor’s statutory recommendation for physiotherapy.

 Be dedicated to treatment sessions and work closely with the physical therapist as well as your loved ones. Don’t be afraid to ask for continued support as you heal.

3. Try a new hobby 

Don’t rush to get back to your old self before cancer. Try to enjoy the process more by finding new sports or leisure activities that fill your time. 

So, instead of getting mopey and worrying over cancer resurfacing, try knitting for a change, go golfing, try swimming! There is nothing too small or too big to try, and the main goal is to get you taken by any activity other than sitting down and getting paranoid. 

4. Consider returning to work

A defining part of getting reintegrated back into society after cancer is a career. If you were working before cancer, going back to work can help redefine your life. 

If you weren’t, try finding a new skill or going job-seeking. This gives you a sense of normalcy, but even better, it occupies your time! Remember, one of the most important ways to thrive after a battle with cancer is to not dwell on the past and simply enjoy the moment. 

5. Find intimacy with your loved ones 

There is nothing better than speaking to people who genuinely love you. Such emotional talks are sure to renew your confidence and help you build strong emotional support. If you are dating or married, it’ll help a great deal to bear your thoughts before your partner. Keeping it all inside won’t help and may even make you distant from them. 

6. If possible, start exercising

Numerous benefits accompany exercise. These range between boosting your physical endurance to giving your mental health a much-needed boost. 

Aside from that, nothing beats that sense of accomplishment that comes with completing an exercise session every day. Before starting an exercise regime, tell your doctor; and you may have him refer you to a physical therapist with knowledge of care for cancer survivors like you. 

If you are strong enough to exercise independently, start small with home workouts and build your way up to going for a walk at the park and then the gym. 

7. Make A List of Your Fears

This is on emotional terrain. Write down your deepest fears about life after cancer or what you think may prevent you from enjoying this new phase. This may include fear of the cancer returning, fears about your health overall, concerns of satisfying your partner in bed like you once did, fears of losing your job or doing poorly at it, and many more others. 

No matter how many they are, penning these fears down on paper can help you tackle them. After writing, you may even discover that some of these are so insignificant and shouldn’t be any trouble. Either way, you are tackling these problems head-on. 

8. Let go of the past 

This is an essential task if you want to thrive following a battle with cancer. Letting go of the past may be harder for people who have been fighting bouts of cancer over a significant number of years, but there is indeed nothing better than finding a new you. 

Cancer puts a dent in your mental health, so it may pose a challenge to let go of your history. If this is you, speaking to a counselor or even your doctor will be beneficial. 

9. Accept that there are going to be bad days 

It is a part of living to have good and bad days. As a cancer survivor, you can’t escape this, and you may even be more vulnerable, having battled one of the world’s deadliest diseases. As you strive to get back to normalcy, you have to realize that not every day will be good and that the process may be a lot harder than you expect. 

An optimistic attitude and never giving up are crucial to overcoming the dismay or depression that may set in when you’re not successful at something you try to do. You can also create a backup plan for such days e.g., take a walk with your partner, go to the cinema, etc. 

10. Share your experience with support groups 

There is nothing like working closely with people who have had similar experiences with you. Whether they are still battling cancer or not, speaking to others about your own experience surviving the disease will give them a ray of hope. It will equally do you a lot of good. 


Resource links: www.aicr.org, www.curetoday.com, www.inovanewsroom.org

Helping Cancer Survivors Sleep

This blog was originally published by Cancer Today by Cheryl Platzman Weinstock, here.

A clinical trial comparing acupuncture and cognitive behavioral therapy found that they are both helpful for people who are experiencing sleep problems after cancer treatment.

​Photo by Marjot​ / iStock / Getty Images Plus

PEOPLE WHO HAVE BEEN DIAGNOSED with cancer often face sleep problems stemming from the physical effects of cancer treatment as well as psychological or spiritual concerns related to the diagnosis.

A randomized clinical trial published April 9, 2019, in the​ Jo​urnal of the National Cancer Institute​ compared cognitive behavioral therapy for insomnia (CBTi) and acupuncture in patients who had completed treatment for a variety of cancers. Study results showed that participants assigned to the CBTi group experienced a greater reduction in insomnia severity over the course of the study compared with the acupuncture group. However, survivors treated with acupuncture also experienced meaningful improvement in their sleep.

The researchers assigned 80 patients to receive CBTi from therapists trained in the technique over the course of eight weeks. CBTi has previously been shown to be effective in improving sleep in cancer survivors. The therapy works in part by modifying unhelpful beliefs about sleep and providing relaxation training. Patients are also asked to limit their time in bed and use it only for sleep and sexual activity. Another 80 patients were assigned to receive acupuncture over the course of eight weeks. Participants in the study were 62 years old, on average, and had completed active cancer treatment.

The researchers asked the participants to fill out a questionnaire asking about insomnia symptoms both before and after receiving treatment for insomnia. Patients reported significant improvements after receiving either CBTi or acupuncture, both when surveyed immediately after their course of treatment for insomnia and about three months later.

“While overall we found that there is a statistically significant benefit of CBTi over acupuncture, the difference is actually small,” says Jun Mao, chief of integrative medicine at Memorial Sloan Kettering Cancer Center in New York City, who led the study. “I certainly think both treatments produce clinically meaningful outcomes and they persist.”

When they looked more closely at subgroups of patients, Mao and his research team found that CBTi was only significantly better than acupuncture at reducing insomnia for males, white people, people who had graduated from college and people without significant pain. For other groups, the two treatments had a similar effect.

Poor sleep can have a variety of effects, including increased pain, depression and fatigue, says Sandra Mitchell, a research scientist and program director in the Outcomes Research Branch at the National Cancer Institute in Rockville, Maryland, who was not involved in the study.

Although Mitchell says she believes additional studies are needed to look at the long-term effects of acupuncture and CBTi management, she says, “This study yields important and clinically actionable results that patients and providers can utilize in a shared decision-making approach.”

Weidong Lu, lead oncology acupuncturist at Dana-Farber Cancer Institute in Boston, says today many patients with insomnia are first put on medications, which can cause side effects. “I think it’s best starting patients on nonpharmaceuticals for mild- and moderate-level insomnia. Severe, long-term insomnia probably needs a combination approach” that includes drugs and other therapies, such as acupuncture and CBT, says Lu, who was also not involved in the study.

The trial was supported in part by the Patient-Centered Outcomes Research Institute (PCORI), a nongovernmental organization funded through a trust established by the Affordable Care Act to carry out research guided by patients and caregivers.

Jodi MacLeod of Collegeville, Pennsylvania, was one of the patient partners who provided input into the design and execution of the clinical trial. She was diagnosed with stage II breast cancer in 2004.

After treatment, “the expectation was that I would return to being a normal stay-at-home mom, but my insomnia was really disruptive,” she recalls. Her sleep problems led to mental fog and fatigue. Eventually, MacLeod’s husband rearranged his work schedule to help take care of their three young children.

“Back then, in 2005, insomnia and cancer wasn’t well researched and recognized. I actually thought it was my fault,” says MacLeod of her difficulty in sleeping.

MacLeod met Mao in 2006 when she enrolled in a study he was conducting at the University of Pennsylvania in Philadelphia on acupuncture and cancer-related joint pain. When Mao was ready to do his PCORI-funded research on cancer and sleep, he reached out to MacLeod for her help.

Among other contributions, MacLeod and her fellow patient advisers helped decide what questions the study would seek to answer, shape inclusion and exclusion criteria for the trial and recruit a diverse group of patients to participate, as described in a 2017 paper​ that MacLeod co-authored.

“It is satisfying and empowering to know that we’re leaving the cancer waiting room better than we found it,” says MacLeod. “Cancer patients now don’t have to go through what I did, because now there are effective insomnia treatments available.” 

Cheryl Platzman Weinstock is a journalist who reports on health and science research and its impact on society.​

A Cancerversary Reflection

This blog was originally published by I Had Cancer.com on July 23, 2019, by Catherine, here.

This month marks the five year anniversary of my first cancer diagnosis, and three years since my stage IV diagnosis. Statistics say that I’m at the upper limit of my predicted survival (2-3 years), so it looks like I’m bucking the trend. I have a strange mixture of emotions. On one hand I feel like celebrating, but on the other hand I feel quite drained – emotionally and physically. It’s hard work living with cancer.

I’m tired of traveling to Manchester every three weeks for treatment. I’m sick of feeling guilty when I eat a dessert or drink one too many glasses of wine. I’ve had enough of slathering on cream to try to keep the skin on my hands and feet from cracking. I’m fed up with scans, blood tests, cannulas, and putting up with the indignity of being poked and prodded by strangers. What I wouldn’t give for just a few months of freedom from the shackles and restraints that my cancer diagnosis entails.

Recent years have seen a huge rise in cancer life expectancy. Medical advances in immunotherapy, genetic profiling, artificial intelligence and advanced imaging are just a few of the areas that are significantly impacting that survival rate. It is now estimated that 2.5 million people in the UK alone are living with cancer and over 15 million in the US.

Despite this growing population, there is so little awareness and understanding of advanced-stage cancer and its emotional and physical burden. I’ve lost count of the number of times I’ve been asked when my treatment will be finished. When I explain that I’ll be on treatment forever, people look shocked and embarrassed. There is a general perception that cancer is something you have, and if you’ve caught it early and fight hard enough, you beat it. Versions of this story are churned out with every awareness campaign, accompanied by coloured ribbons and sponsored runs.

I’m not saying that we should stop these campaigns – it is important to highlight the symptoms of cancer and encourage people to be vigilant – but society needs to become aware of the daily challenges people living with cancer face in our attempt to live a ‘normal’ life.

Most of us will be on treatment forever – treatment that often comes with debilitating side effects. Many of us are unable to work, or are struggling through pain and fatigue to hold down a job so that we can afford to feed and clothe our children. Normal life plays second fiddle to the endless cycle of medical appointments. And every single one of us has a constant mental battle to overcome the fear of an uncertain future.

I’m exceptionally grateful that, five years on from my original diagnosis, I’m still here and relatively healthy. But it is exhausting having to keep conjuring up the inner strength to overcome the physical and emotional daily challenges of a cancer diagnosis for such a long period of time.

Sorry for the moan, it’s quite out of character. I’m usually a proud person, preferring to keep my struggles and insecurities private, but I feel quite strongly that there is simply not enough understanding or practical support for the millions of people in this country and around the world in my position.

Globally we are making huge advances in our ability to kill off errant cancer cells, but we have long neglected the wider emotional, physical and financial needs of the people whose lives we’re extending.

I long for a time when society has a better appreciation of the challenges cancer survivors face and can start creating an environment that better supports the needs of our growing population.

Presentation Tips for Patient Advocates: Developing Effective Speaking Skills

As a patient advocate you may be invited to speak in public about your cause, and while some of you will relish this opportunity, many others will find it daunting. According to the National Institute of Mental Health, 74% of people suffer from speech anxiety. Surveys show that the fear of public speaking ranks as one of the most common phobias among humans. There’s even a name for it – glossophobia – the fear of public speaking. Whether you are daunted or excited by the prospect of speaking in public it pays to have a plan in place to communicate effectively.  For a presentation to impact an audience and be memorable, you must structure the content, design the slides, and use public speaking techniques effectively. Next time you are asked to deliver a presentation, follow this step-by-step guide designed to help you become a more confident, prepared, and persuasive speaker.

STEP ONE: PREPARE YOUR TALK

Good presentation skills begin with thorough preparation. Here are seven tips to help you prepare for your next talk.

1. Decide what you want to say. What is the purpose of this talk? What do you want your audience to know, feel, or do after they have heard you speak? Your presentation should have a purpose, something that the audience walks away eager to do. Write down your core message in one or two clear sentences. Include a call-to-action (CTA) detailing exactly what should happen next. If you find that you have several messages you would like to deliver, challenge yourself to focus and simplify your message. Once you have a clear focus for your talk, you can then group your other ideas around it.

2. Know your audience. Who will be coming to your talk? Why are they coming to listen to you? What do they already know about the topic you will be speaking on? Find out as much as you can about your audience so you can better speak to their interests and in the language they are most familiar with.

3. Do your research. Do you want to present facts and figures in your talk? Are there any research studies you could incorporate to make your core message stronger? Use online tools like Symplur, the Journal of Internet Research (JMIR), and Google Scholar to help you with your research.

4. Structure your presentation. Now it’s time to put your key messages and research points together in a structured way. Having a structure is a helpful roadmap to keep you on track and to allow the audience to follow along with your points. Start with astrong opening, for instance, share some compelling statistics, outline a current problem, or share a memorable anecdote. If you feel comfortable sharing a personal story, this is one of the most effective ways to get your audience to pay attention. Stories leave a lasting impression on listeners. Patient advocate Martine Walmsley points to the importance of sharing your patient story because the story “behind the diagnosis is a side researchers and clinicians don’t usually see. Don’t assume they already know those details.” (Read Why Your Patient Story Matters for more tips on how to tell your patient story). Healthcare consumer representative and patient experience consultant Liat Watson advises patients to speak from the heart. “People want to connect with you and your story”, she says, “Share like you are sitting around the kitchen table”.

Next, organize your main points into an order that will make sense to your listeners. Reflect on your key points and how you might emphasise them.  Finally, determine the take-home lesson (CTA) you want to close with and how you will convey this to your audience. Your CTA should transmit a sense of urgency. Why is it important they hear your message and act now?  What will happen if they don’t act?

5. Add visual interest. If you decide to use slides in your presentation aim to create highly-visual slides with minimal text. Never cram information onto your slides. Instead, present one idea per slide so the audience can process each point fully before being presented with another idea. By presenting only one point at a time the information is easier to understand, and the audience is less likely to experience information overload.  Avoid excessive use of bullet points, not only do they contribute to the phenomenon known as Death by PowerPoint, but they are also proven to be an ineffective method of communication for presentations. Take care when choosing fonts for your presentation– how you present your text is an important factor in making your slides clear and compelling.  Type Genius is a useful tool to help you find the perfect font type and which fonts complement each other.

For a change from the usual PowerPoint presentation, consider using an alternative such as Keynote (for Mac) Prezi or Haiku Deck. Whichever tool you decide on, your slides should be visually engaging.  Make good use of diagrams and charts and find some compelling images to hold your audience’s attention. When choosing an image make sure it is high resolution so that it will still look pleasing to the eye when it is blown up to full-screen proportions. Don’t be tempted to use an image you have sourced from a Google search unless the image is licensed “Creative Commons”. Instead look for images on sites such as Foter, Pixabay, and Unsplash, all of which gives you access to a bank of high resolution free-to-use photos. As a general rule of thumb, stick to one image per slide – anything more than that simply looks too cluttered.  If you want to add text to a background image, choose a background with plenty of “whitespace” which will allow the text to be read clearly. If your image is lacking whitespace, try applying a blur effect or a gradient fill when you want to add text to your background.

6. Stand and deliver.  Rehearse out loud using whatever slides, notes, or props you plan to use during your talk. Don’t simply practise by sitting at your desk clicking through your slide-deck; stand and deliver your talk as if you are doing it in front of an audience. Work on your voice intonation and emphasis, flow and transitions, and practise controlling filler words, like “ems” and “ahs” (Toastmasters Internationalpoints out too many fillers can distract your audience). Crohn’s disease patient, Nigel Horwood, who has spoken to a large audience of nurses at Kings College Hospital, London, UK, recommends reading your talk out loud when you are practising. “I find that simply reading through what I have written doesn’t pick up the likes of over used words or even ones that are missing. Much better to hear it being read,” he has written in his blog Wrestling the Octopus.

Modulate your speaking voice to a lower pitch (if you can do so without sounding unnatural); the deeper the pitch of your voice, the more persuasive
and confident you sound. In “The 5 P’s of Powerful Speaking for a Memorable Speech”, professional speaker Pam Warren points out that “in public speaking clarity and tone are far more important than volume in that they imply authority, a certain gravitas and above all, confidence.” When speaking on certain points you may want to stress their importance, so practise the power of the pause – a slight pause before you’re about to say something important.  Take a printed copy of your text and make marks, such as a forward slash (/) or use color coding in your paragraphs to remind you to pause at key points in your talk.

The most important thing you should practise is the opening of your talk. Focus on conveying a strong, confident start which will set the stage for everything that follows.  Time your presentation using a stopwatch, or one of the many free countdown timers available online. After practicing a few times on your own, ask a friend to listen to you. If you don’t want to do this, video or audio record your presentation so you can play it back and see how you might improve on delivery.

7. Final preparations. Make sure you have a good night’s sleep the night before your talk and have your clothes freshly pressed and ready on hangars. Back up your presentation to a flash drive (or the cloud), pack a plentiful supply of business cards and handouts (if you are using them). Health consumer advocate Melissa Cadzow recommends making it easy for people to follow up with you after your talk, by having a dedicated business card for your patient advocacy work. She also recommends including information on your LinkedIn and Twitter profiles and providing an email address in your presentation slides.

 

STEP TWO: DELIVER YOUR TALK

It’s the day of your big presentation. Plan to arrive early so you can familiarise yourself with the room, meet the technical team, check your slides are working correctly, and practice using the microphone.

When you take to the stage, resist the urge to begin speaking straight away. Take a few moments to ground yourself – set your feet slightly apart, toes pointing towards the centre back of the room (this gives you balance and is the most secure and comfortable way to stand when talking).  Pull your shoulders back and down – this allows your chest to expand, so you have more breath when you begin to speak.  Make eye contact and smile at your audience which will help to relax you if you are feeling nervous.
When you begin to speak, do so slowly and clearly to give your audience time to absorb your words. Remember to take full breaths between sentences.

Dealing with presentation nerves: Feeling anxious or being nervous before a big presentation is normal. If you feel nervous, focus on the fact that your audience wants you to succeed. They are on your side. You were chosen to speak and you are the expert they have come to hear. There’s no need to tell them that you are feeling nervous – people probably won’t even notice if you don’t mention it.  Whenever you feel those first signs of nerves such as a racing heart, sweaty palms and shallow breathing, bring awareness to the physical sensations, take some deep breaths and anchor yourself by touching something physical, such as a table or the slide advancer, or push your weight into your toes and feet.  It’s perfectly natural to feel nervous, but try to focus your attention away from your nervousness and concentrate instead on what you want to say to your audience. Recognize that nerves are a signal that this is something that matters to you. Turn your nerves into enthusiasm and passion for your topic.

 

STEP THREE: AFTER YOUR TALK

Spend time after the presentation to reflect on how things went. Ask yourself (or others) what you thought went well and what could have been better? Take some notes on which techniques worked to help calm your nerves, which stories resonated with the audience, and how you answered any questions in the Q&A.  The purpose of this exercise is to become a better presenter the next time you are asked to give a talk, by putting the lessons you learn each time into practice. Take every opportunity you can to practise speaking in public. Not only is it an important way to get your message out into the world, but mastering the art of public speaking is a wonderful way to boost your personal and professional confidence.


Editor’s Note: For another creative presentation design tool, please check out Canva.