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You've survived cancer- now what?


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http://www.webmd.com/cancer/features/yo ... r-now-what

You've Survived Cancer: Now What?

People who have fought cancer and won may expect to go back to their ordinary lives. But life after cancer can be anything but ordinary.

By John Casey

WebMD FeatureAlthough public health experts like to point out that overall rates of death from cancer have not budged, some cancers are a lot more survivable than others. More than ever, a diagnosis of cancer today isn't necessarily the death sentence it may have been a 20 years ago.

"For some adult cancers, the survival rate can be as high as 70%," says Lindsay Nohr, executive director of Fertile Hope, a nonprofit group that educates cancer patients about how treatment may affect their ability to have children. "For some pediatric cancers, the cure rate can be even higher."

The simple goal of survival for many cancer patients becomes so all-encompassing that many survivors are badly under prepared to a return to everyday life.

Life After Survival

"People should have information about the psychosocial issues that they're going to face when they walk out of the hospital door," says Susan Nessim, founder of Cancervive, a group that aims to assist people who have experienced cancer deal with return to normal life. She also is author of Can Survive: Reclaiming Your Life After Cancer.

"Your relationship to everyone around you is going to change," says Nessim, who is a survivor of rhabdomyosarcoma, a childhood cancer of the muscles, which she developed in 1975 at age 17. "You may find yourself cutting off relationships that aren't working. You may want to change jobs because you've had this meaningful, life-changing experience.

"Once you finish treatment, people start moving away from you because they assume you're fine now," she says. "I was often was told, 'You look great, you've got your hair back, so just get on with your life.' But it's not that easy. Many of us are not prepared for the fact that everything isn't going to be what is was."

Beyond the difficulties of cancer treatment lie the more mundane problems of life as a survivor. Many cancer survivors have trouble keeping health coverage.

"It's common for a cancer survivor's health insurance premium to go up so high they can't afford coverage," says Nessim. "Or certain scans or procedures won't be allowed under the plan, so in one way or another, they get cut out of coverage."

Survivors may have substantial medical bills to pay down, and some employers are reluctant to hire someone who has had cancer because of fears the person will not physically be able to handle work.

"All types of discrimination may be faced by survivors," Nessim says. "Sometimes people return to work to find that their job is gone or they've been shifted to a lower position. They may find themselves loaded down with travel assignments in an effort to get rid of them. Employers know the bounds of the Americans with Disabilities Act, and they can be very savvy about how to get around hiring people who have had cancer or other major health problems, such as AIDS."

The Fertility Issue

Of the problems faced by cancer survivors, damaged fertility is one of the least understood, says Fertile Hope's Nohr. The side effects of radiation, chemotherapy, or surgery can leave a person infertile.

"I would estimate that only 10% of oncologists even discuss the fertility issue with female patients who are under 45 before treatment," she says. "That is a big, big problem. Cancer patients are much more empowered now than they have been in the past, getting second opinions and researching their treatment options, but many patients don't understand that some cancer treatments many leave them unable to have children."

Cancer patients can take special fertility-saving measures before treatment. adult and adolescent males can make deposits in a sperm bank for future use. Prepubescent boys can have testicular tissue frozen to preserve sperm.

For women the issues are more complex. A woman's fertility-saving measures depend entirely on her cancer treatment and her particular physiology. Eggs can be extracted and frozen, as can embryos. From there, the measures become increasingly tailored to an individual woman's needs.

"That's why all women cancer patients who have the potential to bear a child need to see a reproductive endocrinologist before cancer treatment begins," says Nohr. "Oncologists do not know enough about fertility. They tend to be not well educated about these issues, and that's why women need to be very proactive and think farther down the road to protect their fertility if possible."

That's also, says Nessim, why a survivor support group is so important.

Talk Therapy

"To have a group of survivors you can talk to is so vital," she says. "You learn from their experiences and mistakes. Once you finish treatment, your issues are dealing with everyday life. You may not be comfortable talking with cancer patients who are currently in treatment if you're worried about how you're going to keep your job or paying bills or feeling depressed."

Talking with other survivors about survivor issues is what makes all the difference, says Nessim.

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I just accept that this is the new me, and some priorities, plus the way I view many things, will never be the same. It's one more thing to grow from.

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Hmm, that is a good question. Dx in Jan 03 SCLC ext and have had clean scans since Jul 04. 2 Hip replacements (each side) and memory side effects from brain radiation. Here is what I have found:

1. After submitting several job applications I never even receive a thank you for applying. Why? they look up your name in google search and mine pops up about Lung Cancer. I wonder how fast they click the off button?

2. Decided I would go back to my old job breaking and training horses. Against doctors advice with hip replacements. Well guess what? I have made more money breaking horses than I ever had. Seems I have a better understanding of patience now. Gee go figure after waiting all that time in a doctors office and in a hospital bed.

3. I have had a dream of riding a what we call a finished cutting horse. 2 weeks ago a customer of mine asked if I would like to train and show his finsihed cutting horse stallion.

This horse has won several events and I could not believe I would get this opportunity. This past weekend I went and competed in the American Cutting Horse Competion. When I cut my first cow and dropped my hand to let the horse work on his own it was God filling my dream I started over 20 years ago. I had the ride of my life that horse cutting and working that cow. I didn't win any money but I won my life back.

4. Lung Cancer is the worst thing I think but I want you all to know that however short or long your time is never give up on your dream. It's that dream that wakes you up in the morning and puts you to sleep at night. If my cancer comes back it won't matter, I have had a beautiful life.

God Bless all of you and until we meet again, Happy Trails.


PS: Have another cutting horse show this new weekend so wish me luck for Friday and Saturday. I am riding for all lung cancer people from now on. And yes when I see someone smoking I go and tell my story. The real facts of the torture from smoking.

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Love the story! I only wish I had a dream like that to fulfill! Maybe I do and it will become obvious once treatment ends...In the meantime, I am getting ready to put in my vegetable garden and looking at options for "what's next?"

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I loved the story AND the photo.

You have given a lot in your posting, and I intend to change "something/anything" to give our lives some zip.

Can't climb on a horse (not just my hips, but the entire body :shock: )- nor cut a cow, but can move forward in small ways that make a difference.

Thank you for the upbeat posting. You have motivated me.


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Thanks for posting this Katie, it really made me think. I have cut people out of my life, because the relationships weren't working. They were great relationships as long as I was the one that was giving, but when the tables were turned and I needed support a couple people were not there for me at all. One friend tryed to get me to see their point of view, "But Dana they are probably very upset about your dx and are having a hard time handling it". Sorry too bad, so sad. I betcha they were "handling" my dx a heck of a lot better then I was! WOW! Just reread this! I had no idea I was that angry! WOW!

Something positive about it is I don't put off doing stuff for myself like I used too. Example: I am a total dog person, but haven't had a dog for 8 years. I keep putting it off, "now isn't the right" syndrome. So on my birthday this year, in March, I went and bought a puppy. That's her picture. She is half golden retriever and half doberman. She keeps me busy and laughing! Instead of me sitting around wondering "what if" all the time, I'm busy trying to keep up with Brin!


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