Health & Well-Being After Cancer Treatment

Social & Emotional Impacts of Cancer

In addition to the physical effects of cancer, survivors will experience psychological, emotional and spiritual impacts. Many of these affect quality of life and can show up many years after treatment. Here are some of the most common issues that cancer survivors may deal with:

Fear of Recurrence

Many survivors live in fear that their cancer will come back at some point. For some, a milestone event like the anniversary of their diagnosis or the end of care by their cancer doctor can trigger these feelings. Fear can be a good thing if it motivates you to discuss health changes with your doctor, or it can cause unnecessary worry. Knowing your own body can help distinguish between normal changes and more serious symptoms.

Grief

Grief is a natural result of loss. With cancer, such losses may include your health, sex drive, fertility and physical independence. To get past your grief, it's important to let yourself experience all these feelings. Support groups and counseling can help you work through these issues.

Depression

It is estimated that 70% of cancer survivors experience depression at some time. Depression can be hard to diagnose in cancer survivors because the symptoms are so similar to the side effects of cancer treatment, including weight loss, fatigue, insomnia and inability to concentrate. A 10-year follow-up study has found that symptoms of depression were associated with a shorter survival time, so it's crucial to seek treatment for depression.

Body Image & Self-Esteem

Cancer survivors who have experienced amputations, disfigurement and loss of organs like the colon or bladder often grapple with how they relate to themselves and other people. A negative body image and low self-esteem can affect a survivor's ability for intimacy with a partner, which has a major impact on quality of life. Good communication is essential to retaining or regaining intimacy after cancer. Seek medical advice if problems continue.

Spirituality

Many survivors find that life takes on new meaning after cancer, and will renew their commitment to spiritual practices or organized religion. Research suggests that spirituality improves quality of life through a strong social support network, adaptive coping, lessened depression and better physiological function.

The Department of Chaplaincy and Pastoral Education has resources to help patients and their communities find the support they need to cope with cancer and find a spiritual pathway to peace. Spiritual Self-Assessment 

Survivor Guilt

Some people feel guilty for surviving cancer when others don't. You may wonder 'why me?' or begin to re-evaluate your life goals and ambitions. If you suffer from a prolonged sense of guilt, a psychotherapist, clergy member or support group can help talk you through your feelings.

Relationships

How other people react to their illness is perhaps the biggest challenge faced by cancer survivors. Friends, coworkers and family members may feel awkward about discussing your cancer diagnosis. They may remain silent, avoid you or pretend nothing has happened. Others may use humor in an effort to take your mind off the situation, instead of being someone with whom you can discuss your issues. Because cancer can be a long-term illness, overcoming communication barriers early is crucial.

Life & the Workplace

Re-entering social and professional life can be accompanied by many fears: worry about being out in the world with an increased risk of infection; not having enough energy to get through a workday; and anxiety about not being able to think clearly because of "chemobrain" or memory loss. After struggling with life-and-death questions, many cancer survivors feel apart from peers who haven't had the same experience, and may turn to other survivors for support and friendship.

You may be reluctant to reveal that you are undergoing cancer treatment to your employer or coworkers 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, open communication with your colleagues helps get past these feelings.

Legal & Financial Impacts of Cancer

Few people escape the financial repercussions of surviving cancer. For patients who must self-pay, the cost of treatment for the first year alone can exceed $100,000. For patients with leukemia or lymphoma, that amount can reach $200,000 or more in the first year.

Even those with good health insurance have reported spending hundreds of dollars in co-payments for one cycle of chemotherapy in a treatment regimen that requires six cycles. Out-of-pocket medical expenses for these insured patients can average $35,000.

In addition, some insurance companies may not pay for cancer treatments that they consider experimental.

Patients who receive treatment outside their hometown or state face the additional costs of travel, lodging, meals and other living expenses.

If the patient is the major wage earner, family income may decrease or even disappear once vacation and sick time are used up. Benefits may be reduced or lost. As a result, survivors and their families can face significant debt.

Financial issues can continue long after treatment has ended. Some survivors are forced into early retirement, which may leave them without health insurance coverage or make it difficult to find another job with health, disability and life insurance benefits.

While this is an issue that has not been well addressed, here is a list of considerations that may aid survivors in dealing with the economic impacts of survivorship.

The American with Disabilities Act: Know your civil rights as a cancer survivor. The Americans with Disabilities Act makes it illegal to be denied a loan or other financial service based on your cancer history. The U.S. Department of Health and Human Services Office of Civil Rights has basic information to help you understand the rules and process your complaints.

Medical coverage: Explore Medicare and Medicaid.

Income alternatives: Look into Social Security disability income and supplemental security income.

Life insurance: Investigate if this can be an important source of cash or the basis for a loan. Keep your policy if you leave your job. Some life insurance companies offer an accelerated death benefit with a pre-death payment. Or you may be able to sell your life insurance policy to a company for a portion of its value.

Retirement plans: Find out if this could be a source of cash and a way to fund a disability. Read your benefits book so that you fully understand your plan. Funds may be available if you are still employed and meet the plan’s hardship provisions.

Managing your money: Make minimum payments on your credit card bills and keep the cards in your name only. Consider getting credit disability or credit life insurance on your card, if available.

Other important plans: Make sure you have a durable power of attorney, a living will and a regular will with a letter of instructions.