Survivorship, Your Way
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By Hester Hill Schnipper

Survivorship, Your Way

How should a cancer survivor behave? It's up to you

By Hester Hill Schnipper


It seems that survivorship is becoming a full-time job. During the first 20 years of my work as an oncology social worker—and at the time of my first diagnosis of breast cancer in 1993—a patient’s designated responsibility was getting through treatment and then slowly recovering both physically and emotionally. Newly ex-patients were encouraged to get enough sleep, gradually resume their usual work and home routines, and allow themselves plenty of excuses and even more slack. It was considered wise to avoid strenuous hikes, late-night parties and exhausting business travel.

Times have changed.

As increasing numbers of people have survived cancer and gone on to live long and healthy lives, more attention has been paid to survivors’ needs and the long-term effects of radiation and chemotherapy. This is good news. When we were all expected to die quickly, it didn’t much matter if we were couch potatoes or if chemotherapy drugs might result in health problems decades later. Certainly, most of us wish to be as healthy as we can—for as long as we can. Over the past several years, the medical world has begun to focus on this goal and has made many recommendations about the best ways to achieve it.

It is unfortunate that many non-medical people (such as your well-meaning family and friends) are likely to make a lot of recommendations, too. Each time there is news about the possible importance of exercise, diet or another lifestyle factor in reducing the risk of cancer recurrence, you are likely to hear from them. It is important, of course, to pay attention to what we are learning about how to stack the odds in our favor, but it is entirely up to you how you choose to live your life.

What is reasonable? What modifications might we make that are not driven by fear and can be sustained? And what can we say in response to all those directives from friends? Research that suggests physical activity and diet may improve cancer outcomes is new and not completely understood, but evaluating your exercise routine and food intake is a good idea for health in general. It’s just good sense. The research about alcohol becomes a bit more controversial. There are known health benefits to moderate (or less) drinking, and there are suggestions that alcohol may increase risk for some cancers. Here is a good example of something you must decide for yourself, taking into account how much pleasure you receive from wine with dinner versus the worry it may bring you. The same balance is true for virtually all specific diet suggestions. There is no evidence to support a true “cancer prevention diet,” and life is too short for most of us to eschew the joys of the table.

Dealing with friends’ suggestions can be difficult. We assume they have our best interests at heart when they insist we should eliminate stress from our lives, avoid anything containing sugar, or give up morning coffee. You need a few handy rejoinders for those moments. Try, “Cancer has taught me to really appreciate the pleasures in my life. That includes cookies (or lattes or wine).” Or try, “I know you are trying to be helpful, but I have talked with my doctor who assures me that we are doing everything necessary and possible to keep me healthy.” Finally, a really good response to virtually any awkward comment is, “Why would you say that to me?”

Enjoy your life. You’ve earned it.