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Life After Cancer A Roadmap for Cancer Survivors

Life After Cancer
A Roadmap for Cancer Survivors

Once you are diagnosed with cancer your life has been changed forever. Now that you have gone through successful treatments and achieved a remission or cure, you still may live with fear of a recurrence, a new cancer, latent side effects, comorbid diseases or the possibility of functional disability, emotional changes, and even death.

Your attitude, your philosophy of life, and how you manage your health care needs can make a big difference in how you cope, recover and live.

Perhaps one of the most important factors in your favor is that cancer forces you to face your own mortality. Survivors of cancer graduate to a new life keenly aware of how fragile life is and are ready to fight to preserve it. The many realities and potential consequences related to your cancer and therapy can best be addressed with a team approach, including your medical team, family, friends, community resources, and, most importantly, yourself.

The Cancer Survivorship Program provides knowledge and education, health promotion and guidance to survivors, families and friends, with a special emphasis on programs for better health through nutrition, exercise, and supportive care to improve quality of life and prolong survival.

The booklet contains information, recommendations, and resources to help guide cancer survivors toward a healthier life.

Problems facing cancer survivors include:
Physical deconditioning
An unhealthy diet
Emotional, psychological and social challenges
The potential for recurrence, new cancers, side effects from therapy, and comorbid diseases (including infertility, sexual dysfunction, osteoporosis, pain, obesity, and fatigue)
Financial expenses for treatment and care
Maintaining health insurance or obtaining new health insurance
Work and employment issues
A crucial guide for all survivors, a Survivorship Care Plan Summary from your treating oncologist includes the medical history, a brief review of therapy, a list of potential side effects, and future recommendations for follow-up care. It is for use by all doctors and nurse specialists involved in your clinical care, and is updated periodically to reflect new treatments, screening results, and other aspects of patient care. Medical follow up is necessary for twenty or more years to monitor the possibility of late side effects from therapy (e.g., damage to heart, lung, kidneys, bone marrow, and reproductive organs), recurrent cancer, or a new cancer. Through a Cancer Survivorship Program, you and your healthcare team can help devise and implement an organized preventive medicine program that includes screening and advice on ways to improve diet, increase exercise, and ways to obtain needed psychosocial support. This Roadmap for Cancer Survivors presents fundamental strategies and solutions for survivors, a basic outline of what you need to know about how to follow your anticancer therapy, and resources for dealing with workplace, insurance, and disability issues.

Through knowledge, exercise, a prudent diet and psychosocial support, one may also decrease the risk of cancer recurrence and reduce the risk of toxic cancer treatment-related side effects. Sections in this booklet on Nutrition for Healthy Survivorship and Benefits of Physical Activity provide information you can use to plan your lifestyle strategies.

Exercise has been found to reduce the side effects of cancer treatment. Survivors who exercise have less fatigue, less shortness of breath, less depression, less pain, less sleep disturbance, and fewer memory problems. In other words, survivors who exercise have a better quality of life.

The Guidelines for Better Health
1. Avoid weight gain (especially after menopause for women).
Try to maintain a healthy weight by balancing the amount of food calories consumed with the calories expended through daily life activity, physical exercise and eating a healthy prudent diet.
2. Increase fruits, vegetables, and whole grain foods. Reduce dietary fats, saturated fats, and trans fats.
3. Exercise at least one-half to one hour a day - for example a brisk walk.
4.Consume minimal alcohol - limit use to a maximum one drink per day for women, two per day for men.
5. Don't use tobacco in any form.
6. Avoid excess sun exposure, use sunscreen to help prevent skin cancer.
7. Adopt an osteoporosis prevention program.
8. Use available information on cancer prevention to improve your survivorship.

The section on Surviving the Emotional Impact of Cancer provides information about support resources and strategies to help achieve peace of mind and spirit, addressing problems such as fear of not being in control of one's life, anxieties, depression, cognitive changes, distress from the diagnosis and treatment, and worry about a recurrence or a new cancer or death.

Sections on Survival with Side Effect Control, Treatment Side Effects and Solutions, and Common comorbidities that Affect Survival provide information on lifestyle choices and strategies for prevention and control of potential comorbid conditions, reduction of the risk for cancer recurrence or development of a new cancer.

Each person has an inner strength, which he or she must call on to help deal with a cancer diagnosis and treatments and to live and cope with the disease and all its associatedproblems. Support programs have been very successful in helping survivors develop the coping skills they need to live with and through their cancer.

Both psychological and physical support are becoming more available and are very important and helpful in relieving the physical and emotional consequences that may develop for cancer survivors.

It is important to maintain a positive fighting spirit with faith, optimism and hope which can make a major difference in your will to live, quality of life, and survival.

We hope that the knowledge and recommendations in this booklet will help survivors adopt a healthier lifestyle to attain a better health outcome, quality of life and a longer survival after a cancer diagnosis and treatments.

These guidelines can help you maintain your health and live longer with better quality of life.
We wish you a better survival through better health!

I shall not pass through this world
But once

If, therefore be any
Kindness I can show

Or anything I can do.
Let me do it now,

Let me not defer it or neglect it,
For I shall not pass
This way again.

                                      -Stephen Grellet

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First appeared January 20, 2008; updated August 2, 2008; reviewed 2010-12-14