Remember, if you find it impossible to get the information you want from your practitioner, there are alternatives. Every patient is entitled to a second (or third, or more) opinion. This may be from doctors or any other type of practitioner. You may quite happy with your practitioner’s experience and technical skill but find that he or she is no good at communicating. This is sufficient reason to ask for another opinion. If the problem is with a medical specialist, you may be able to get the information through the doctor who referred you, or ask to be referred to another specialist. The referral can be from your local doctor or the first specialist. After seeing the second (or third, or more) practitioner(s) you are entitled to choose whichever one you prefer for your continuing care. You can always go back to the first one if you wish. Don’t feel silly about doing this if, in the end, that is what you prefer.

This sounds easy on paper but, of course, we all know it’s not. It takes courage and determination to ask for a second opinion. Many practitioners will try to talk you out of it because it is inconvenient—they may even see it as insulting. Stick to your guns. You are that important. You deserve the best. You’re not there to protect your practitioner’s ego.

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How Can I Ask for Help Now, after Treatment, When I Asked for So Much during Treatment?

You may feel that it was acceptable to ask for help, support, and attention during cancer treatment but that now you should be taking care of your own needs. On the contrary, physically and emotionally you are still experiencing the effects of treatment. In many ways you bear the brunt of the experience after treatment is completed.

Cancer treatment and recovery must be considered one long process toward health. The cancer treatment was the dramatic part of the process to get you well again. Your body still has to recover physically from the cancer and the treatments. Your emotions and spirit still have to recover from the trauma and changes. The dramatic part of making a clay statue is the painstaking molding and carving. The passive last step of heating the statue in the kiln is critical in creating a lasting artwork. Making the batter and baking the cake take the most time, but icing the cake transforms it from a food to a celebration.

Physical and emotional recovery after cancer treatment is a demanding, energy-consuming process. An analogy is the case of mountain climbers who, after reaching the summit, expend great care and energy in descending; without this expenditure of effort their successful ascent might be followed by disaster. Your recovery after treatment is part of your path to wellness that began with treatment.

After you complete your cancer treatment, you deserve help and support during recovery at least as much as you did during treatment.

What If I Feel the Urge to Help Other Cancer Survivors?

Helping someone else

• makes you feel that something good is coming out of your experience

• is one way to give back for the help you received

• gives you a sense of control over cancer

• allows you to save someone else a few of the hardships you may have experienced

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Enormous progress has been made in understanding and relieving acute and chronic pain due to noncancerous conditions. Many of the approaches are applicable to pain due to cancer or its treatment. A vital starting point is to get the facts about the source of your pain. Find out whether anything can be done with medicine, surgery, or other therapy that can correct the physical problems that are causing your pain. While your pain is being evaluated, and certainly after its cause has been identified, take steps to get the pain under control.

Work with your doctors to find the safest medicine for relieving your pain. In most cases, it is best to take your pain medicine around the clock until you are consistently pain-free. Studies have documented that people in pain who take pain medicine only “as needed” require more total medication and experience less satisfactory pain control than people who are taking regularly scheduled pain medicine. With the pain under better control, you can work with your doctor on physical activities that may help alleviate the pain.

Many people with uncontrolled pain develop poor physical habits that cause additional problems. For instance, favoring a painful arm can cause secondary weakness and stiffness in the limb. Uncontrolled pain also leads to poor psychological habits. If chronic pain leads you to avoid outings and social contact, you deprive yourself of the companionship and distraction that are so valuable in the transition to your new life after cancer.

The chief function of pain is to draw attention to a problem so that you can take measures to fix it. Nothing is gained and much is lost by enduring pain without investigating its source, or after having the source explained. Many physical and behavioral postures that reduce pain may prolong its duration, prevent healing, and cause further problems.

Your mind possesses the power to help diminish your sensation of pain. Learn about biofeedback and relaxation techniques. Effective relaxation will reduce pain caused by muscle spasm affecting the injured organ. In addition, a state of relaxation will so diminish the perception of pain that the pain, even if unchanged, becomes more tolerable. Learn how to divert your attention away from your pain. The more you focus on your pain and the more you arrange your life around your pain, the more your pain will have control over you.

Your mind can help through rational problem solving. Evaluate how your pain is affecting your activities and your interactions with other people. Find a way to get around the limits currently imposed by your pain so that you can resume your activities and normalize your interactions. You may need outside help to figure out ways to compensate for limitations, such as that offered by occupational therapists, physical therapists, physiotherapists, orthopedists, and support groups.

What If Many Questions, Fears, and Worries about My Cancer Have Resurfaced?

At the time you were first diagnosed, there were many questions, fears, and worries. Once the decisions about therapy were made and you began your treatment, you could put aside questions and concerns about the medium- and long-range future to some degree. After treatment you are again faced with many small and big decisions and uncertainties. You have to confront the reality of the changes that happened during treatment but that did not affect your life during treatment.

During treatment you may have had physical pain, but you focused on getting through your treatments. Having survived, you now fear ongoing or worsening pain.

If you are single and your treatment rendered you sterile, you may have been too ill during therapy to desire to socialize or worry about infertility. Now that you are getting well again, you may experience concern about the effect of your infertility on your social relationships. You may experience grief over your lost fertility now or later, even though the actual loss occurred during treatment.

Another source of renewed questions, fears, and worries is an insecurity that the posttreatment tests missed something. You may want reassurance that the treatments did indeed work and that they are all the treatments you will ever need. Even if everything goes perfectly and all your tests look good, the best you can be told is that you are fine right now. After treatment you reenter the world of judgment calls, multiple right choices, and great uncertainty.

How Can I Lessen These Worries?

The key to managing fears and worries is becoming informed and acting on your knowledge. Find out as much as you can about your situation, weigh all of your options, and then follow what feels right for you. After the decision has been made that no further therapy is needed, put all of your energy into getting and staying well.

There comes a time when you must trust the test results, trust your doctors, trust your decisions about therapy, and decide to put the issue behind you.

If you do not trust the test results or your decision that your therapy is complete, you need to find out why. Then pursue a route that will provide information and decisions that you can trust. If you feel that you will never trust any test results or any doctor’s advice, it is time to speak with a counselor skilled in the issues of the cancer survivor.

In order to be emotionally healthy, you must be able to trust.

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What Can I Do If I Feel Confused?

Things you can do to diminish your sense of confusion include

• prioritizing your responsibilities, then attending to the most important, most immediate ones

simplifying your questions and concerns (writing them down may help you clarify them)

• getting, or having someone help you get, more information, so that you can find satisfactory

answers to your questions (if your questions all end up being unanswerable or if you cannot prioritize your responsibilities, you will benefit from outside guidance in forming your questions and organizing your priorities)

• getting help from friends, family, and your health care team

Confusion is a symptom like pain, fatigue, or blurred vision. Do not be embarrassed about being confused. Let your nurse, doctor, and family know. Bringing attention to your confusion will

• minimize the risk to your health

• minimize the risk that people will misinterpret your actions

• help clarify the confusion

• avoid preventable delays in your recovery

What If Things Seem Unreal after Treatment Is Completed, As They Did When I Was First Diagnosed?

In the realm of everyday events, our subconscious is ready to accept what we experience, so we perceive our experiences as real. When events or emotions are intense or extraordinary, and our subconscious is not yet ready to integrate the information, we perceive them as unreal. They become real with time, as the subconscious develops a readiness to accept the reality.

During cancer therapy you spent weeks or months suppressing the feared outcomes, and you rehearsed in your mind life after treatment. The heightened emotions that accompany being reevaluated, coupled with end-of-treatment physical effects, can make any news seem unreal, even good news.

During treatment you spent a lot of time focused on your treatments, hospitals, and doctor visits, and in an environment such as the doctor’s office where having cancer is the norm. As you spend more time in settings where most people are well (school, work, shopping malls), the apparent contrast between you and those around you will make things seem unreal. This sense is heightened by your feeling different in a place that used to be familiar. This is similar to when you visit a former home or your old school. Everything looks familiar, and yet it feels different because you are different.

It can take days to weeks for things to seem real again. If it is taking longer than you think it should, or the feeling is lasting longer than a few weeks, get some outside guidance.

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How Do I Keep Up with Advances Related to My Type of Cancer?

If you feel comfortable reviewing medical information, call the Cancer Information Service to obtain the latest information about your type of cancer. The service has access to medical databases and the Internet.

Read the science and health sections of various newspapers and magazines. However, be careful, because sometimes the reporting is inaccurate or misleading. Subscribe to newsletters or journals for cancer survivors. Be sure to differentiate advertising from reporting.

At your checkups review any questions or new findings from your readings. Ask your doctor whether any new development or information related to your cancer situation has appeared since your last visit. It will be impossible for your doctor to remember what you may have reviewed at prior visits, so repeat the last “news” you had been told and then see whether anything new has developed since then.

How Do I Know Whether the Articles I Read in the Newspapers and Magazines Are Valuable for Me?

Cancer issues make good news. You will see many articles having to do with your cancer—the risks, the incidence, new treatments. Some questions to consider when reading include the following:

•Was the work done at a reputable cancer center?

•Was the work done in the test tube, with animals, or with humans? You cannot draw any conclusions about your situation on the basis of test tube or animal studies.

•Was the work double-blind placebo-controlled? In double-blind placebo-controlled studies neither the patients nor the researchers know who was getting real treatment and who was getting a placebo (a substance having no medicinal value, such as a sugar pill). These studies, in general, give more reliable results.

•Was the work subsidized by an impartial source, such as the National Health and Medical Research Council, or by a drug company with a vested interest?

•Was the treatment being recommended by an impartial scientist or by a potentially partial party, such as a drug company?

If something looks interesting or important to you,

•share the information with your oncology nurse or doctor, and have him or her get back to you about it

•call the Cancer Information Service for advice or more information about the news item

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