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By Alanna Kennedy

Mindful Support

Find help managing psychological challenges after treatment

By Alanna Kennedy


As you finish your last treatment, it may seem like it’s time to breathe a sigh of relief. Yet for many survivors, new concerns arise. According to a report published by the Institute of Medicine (IOM) last fall, many people face psychological challenges as they transition from patient to post-treatment survivor.

It’s important to remember that being worried about recurrence is a normal fear, says Steven Palmer, a researcher and assistant professor of clinical psychology in the psychiatric department at the University of Pennsylvania in Philadelphia. When survivors return to the hospital for their first follow-up scans, many are “sucked back through a tunnel to the day of diagnosis,” adds Mona Taylor, an oncology social worker who is the director of outpatient oncology services at the Loran Smith Center for Cancer Support in Athens, Ga.

In addition to anxieties about recurrence, survivors often experience post-treatment fatigue and long-term effects of their treatment. Those physical conditions can have psychosocial ramifications, affecting a survivor’s self-image and daily functioning, says Taylor.

There are several options for survivors who need help managing various levels of anxiety and depression. As they exit treatment, the IOM recommends that all survivors prepare survivorship care plans to manage their physical, emotional and practical needs beyond treatment (see “What Now?” CR, Spring 2006). As part of the plan, you can ask your oncologist about psychosocial services available in your community.

Support organizations such as the American Cancer Society and the Wellness Community can also help you find support resources. You may want to attend a workshop or a support group for survivors. These groups can give survivors a sense of normalcy and provide opportunities to share experiences and resources, says Taylor. Another option for survivors is internet-based support groups. “Research suggests that online and internet-based support groups can be very helpful,” says Palmer.

While it is typical to feel afraid and vulnerable at this stage, some survivors also develop more serious depression and anxiety. According to the recent IOM report, major depression and depressive disorders occur at least four times more frequently in cancer patients than in the general population. “Most people experience distress,” says Palmer. “The fear of recurrence tends to resolve itself over time, but if the fear continues to grow and interferes with everyday life, the patient should feel empowered to seek professional help.”

Be sure to talk to your doctor about any fears or concerns you may have. Your doctor can use screening tools to identify whether you are exhibiting symptoms of a more serious problem. The social work department found in most hospitals is another resource for patients to inquire about referrals for psychologists, psychiatrists and group support. Individual counseling is often very helpful, adds Taylor.

Not all of the psychological effects cancer survivors experience are negative. The IOM report found that survivors often have an “enhanced appreciation of life.” After treatment, many survivors are ready to make changes that they had contemplated for a long time. In this case, says Taylor, “the cancer becomes a catalyst for making new changes and transformation to a life better lived.”  CR Endbox