Exercise and Cancer Survivorship – The Next Step
If you have personally gone through cancer surgery/treatment, you will understand what I am about to share with you. At the end of active treatment, many survivors often have mixed emotions that range from relief that their treatment is over to anxiety about the future. After treatment, the “safety net” of regular, frequent contact with their health care team ends, leaving some survivors to feel alone and scared, in the absence of this source of support. Although some cancer survivors recover with a renewed sense of life and purpose, others may have physical problems, psychological problems, sexual problems, and fertility concerns (based on their age and health/fitness level prior to treatment). Those who have gone through cancer treatment describe the first few months as a time of change. It’s not really about getting back to normal, but really it is establishing what their “new” normal looks like. People often say that life has new meaning or that they look at things differently. Their new “normal” may include making changes in the way they eat, the things they do, and their sources of support (emotional and financial).
This article is an excerpt from the Module 1 Handbook in the Cancer Exercise Specialist Advanced Qualification course. Check out the free course preview.
Fear that the cancer will return (recurrence) is common among most cancer survivors. It may lead a person to worry over common physical problems, such as a headaches, coughs, and joint pain/stiffness. This is of particular importance to the Cancer Exercise Specialist. It is difficult to know what is “normal,” and what needs to be reported to the doctor. Always err on the side of caution by suggesting that your client visit their doctor if something is a concern, but make sure to keep it “light” and not to be an alarmist. Although many cancer survivors describe feeling scared and nervous about routine follow-up visits and tests, worrying that their cancer will come back, these feelings may ease with time. Although I am 35 years post-treatment, I still get worried over anything new or unusual. Whether it be a lump in my breast, a dry patch on my forehead, or a bloated belly, I assume that it is cancer. I know that I should not “go there,” but that is easier said than done. Despite being a bit of hypochondriac, I make sure to see the beauty in every moment of every day. I try to live each day as if it were my last, and I am not just saying that!
It is natural for someone to feel angry, tense, or even sad. For most people, these feelings go away or lessen over time, but some people’s emotions can become more severe and erratic. Exercise can play an important role in minimizing depression, but some may need to see their doctor for medication or therapy. You may want to suggest some complementary and alternative medicine options with your client. They can include a variety of different healing approaches that are often used to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease. This type of treatment is called “complementary” because it is used in addition to treatments prescribed by a doctor. It is imperative that your client discuss these options with their doctor prior to embarking on them (even if they are through with treatment). When a method is used instead of treatments prescribed by a doctor, it is called “alternative.” Some common alternative methods include visualization, relaxation, acupressure, acupuncture, massage, homeopathy (naturopathic medicine), vitamins and herbal products, psychotherapy, prayer, yoga, and other forms of exercise.
When active treatment is over, some survivors need different types of support than they had before. Some friends may become closer, while others distance themselves. Families can become overprotective or may have exhausted their ability to be supportive. Relationship problems that may have been ignored before cancer can surface. The entire family is changed by the cancer experience in ways they may not be aware of. When treatment ends, your client may expect life to return to the way it was before they were diagnosed with cancer. But it can take a long time to recover physically and emotionally. For some, the fear is so strong that they no longer enjoy life, sleep well, eat well, or even go to follow-up visits. What I love about being a Cancer Exercise Specialist is that I get to see the power of exercise and the affects it has on my clients. Even under the worst circumstances, I am amazed at the transformations I’ve seen; both physical and emotional. I have been given this great opportunity to empower fellow cancer survivors! I get to see/help them take back control over their body; even when they feel that it has failed them miserably. They have a renewed self-confidence and self-esteem. Even if their marriage is strained, or they are having financial challenges, their load seems to be lifted!
As time goes by, many survivors report that they think about their cancer less often. However, even years after treatment, some events may cause patients to become worried (as I mentioned earlier). Follow-up visits, symptoms similar to the ones they had before, the illness of a family member, or the anniversary of the date they were diagnosed can trigger concern. They may have scars on their body, loss of a body part or limb, weight changes, they may not be able to do some of the things they did before, chronic pain, and emotional scars from the entire cancer “process.” You will be a pillar of support for your cancer survivor client, perhaps a friend and confidant as well, but try not to play doctor or therapist. Suggest a support group or an individual therapist that your client can join or visit with. In general, survivors usually return to the doctor every 3 to 4 months during the first 2 to 3 years following treatment, and once or twice a year thereafter. At these visits, their doctor will discuss any side effects of treatment (those that are apparent as well as those that are not) and make sure the cancer has not metastasized to another part of their body.
The following programs or organizations provide helpful follow-up care guidelines for some cancers. You may want to share them with your clients:
Cancer.Net – American Society of Clinical Oncology has a series of follow-up care guidelines focused on breast and colorectal cancer. They can be viewed at www.cancer.net/patient/survivorship
Children’s Oncology Group Long -Term Follow-up Guidelines – Children’s Oncology Group offers long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers at www.survivorshipguidelines.org
Journey Forward – Journey Forward is a program centered on its Survivorship Care Plan. By using an online Care Plan Builder, the oncologist creates a full medical summary and recommendations for follow-up care to be shared with clients and their primary care providers. It was created by the National Coalition for Cancer Survivorship, UCLA Cancer Survivorship Center, Genentech, and WellPoint, Inc. Go to www.journeyforward.org
Life After Cancer Care – M.D. Anderson’s Cancer Center Web site lists follow-up guidelines for 15 different disease sites at www.mdanderson.org/survivorship, and click on “Follow-up Medical Care.”
Livestrong Care Plan – developed by Livestrong and the University of Pennsylvania, the Livestrong Care Plan gives individuals a specific survivor care plan, based on the information they enter the online program. Hosted at UP’s Web site, view at www.livestrongcareplan.org
Cancer Hope Network – Cancer Hope Network matches cancer clients or family members with trained volunteer cancer survivors who themselves, have undergone and recovered from a similar cancer experience. www.cancerhopenetwork.org
Cancer Care – Cancer Care provides telephone, online and face-to-face counseling, support groups, education, publications and financial and co-payment assistance. Professional oncology social workers offer personalized care, and all of their services are free of charge. www.cancercare.org
Cancer Support Community – CSC’s focus is to ensure that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community. www.cancercommunity.org
Walking Miracles Family Foundation – WMFF is a 501c3 non-profit that helps families and survivors of childhood adolescent and young adult cancer in WV