medical update

Transitioning from Patient to Survivor
Nancy Payeur, MSW, RSW Regional Clinical Coordinator
Patient & Family Counselling Services BCCA - Vancouver Island Centre

Over the past several years, our provincial team of counselors and social workers, as well as many other staff within the BC Cancer Agency, has become very aware that patients and their families frequently struggle with transitions back to post-treatment living. In other words, patients need to find a way to get back to their new normal after their treatments end.

Away from the structure, the routine, the support of the cancer care team and without the clear focus of getting through treatment, patients after treatment can find themselves blindsided by intense emotions such as anger and confusion and even clinical depression and sadness. Many patients report that they see themselves in a kind of limbo. They ask the question - now what? Some women end up feeling very isolated and set apart from their peers, afraid they will continue to be immobilized by fears of the cancer returning. This is no way to live!

When former patients talk to us about what has helped them make the transition from patient to survivor certain themes emerge.

Dealing with Fear of Recurrence

For many, dealing with fears of recurrence is overwhelming. For those that come to some peace or resolution about living with this fear, it seems that action may be the best antidote for anxiety. Those patients tell us that they try and take control of those factors over which they have some control (diet, exercise, stress management) and try to let go of the rest.

One breast cancer patient, initially diagnosed over ten years ago, notes that Every day there is a moment when I think about the cancer. Then I get on with my day. I refuse to let those fears stop me from living my life. If it happens, I'll deal with it then. Others say you face it, accept it, name it and then that takes some of the power away. It also helps to connect and talk openly with other cancer patients who understand your fears because they've been there too.

Getting Clear on Life's Priorities

Many patients tell us that cancer has given them permission to clean house, to clear the clutter in their lives, both literally and figuratively. Some end unhappy relationships, change careers that no longer fit, disengage from activities they no longer find rewarding, or simply vow to be more selective in how they spend precious time and energy.
The bittersweet gift of cancer is to perhaps value life more intensely and to be committed to not wasting a moment. We see many survivors begin to pursue those juicy heart-felt moments: time with grandkids, with partners, travelling, being creative, puttering about in the garden - whatever is treasured and joyful.

Taking Charge of Personal Wellness

While everyone varies in how much medical information they need, want and find helpful, many cancer patients become self-educated experts on their cancer. Once treatment is over, many want to create their own program for wellness. They want a sense they are doing something productive to take control of their overall health and well-being. Many pursue a variety of complementary and alternative therapies (i.e. yoga, reiki, massage, energy work). As well, physiotherapy, nutrition and exercise programs can help to gain both physical and emotional comfort - a sense of control.
Connection and Support

Often survivors tell us that they have a renewed appreciation of their relationships with friends and family. While certain friends and family members may have disappointed them or been unable to provide meaningful support due to their own fears, those who stay connected with the cancer patient may find their relationship deepen through the process. There is an intimacy that develops in standing side-by-side with someone as they go through a cancer diagnosis, treatments and the transition to survivor.

Making Sense, Finding Meaning

For some women there is immense comfort in drawing on personal spiritual beliefs. This may include a sense that everything in life happens for a reason and that there is a higher purpose to our lives. Perhaps even cancer has some lessons to teach us. Astonishingly, there are those individuals who tell us that cancer has been a blessing and has made them appreciate life and their loved ones so much more than they ever would have. Of course, other patients and survivors may disagree with that positive perspective as that may not be their truth. Everyone is individual.

Even without a sense of spirituality, though, our most resilient patients tell us they feel they have been given a second chance at living their lives and they want to do so with gusto. Carpe diem seize the day becomes their motto!

These are some of the messages and strategies for transitioning to survivorship which people have shared with us over the years. It is clear that all patients want to move forward into living the best quality life possible, no matter what the future may hold - to be a survivor, thriver!

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