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Health Information
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Sunday, July 20, 2008
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Continuing To Care
for Your Health
What You Can Expect
After you have been
treated for cancer, you will have two ongoing health needs.
First, you'll want to take the health steps that doctors suggest
for anyone your age. Second, you'll have special needs for caring
for your body based on your type of cancer, treatment, and current
state of health.
Other long-term health needs for cancer survivors differ from
person to person. In addition to regular checkups, you may need
rehabilitation or home care. Some survivors may need help in
dealing with emotional or sexual problems, while others may
seek pain control therapy. And more cancer treatment sometimes
occurs. To get a good picture of your individual needs, ask
your doctor. He or she can let you know what you need to do
this year-and in the future-to take care of your health. The
following stories highlight some of the most common issues for
cancer survivors.
- "I had expected
that leaving the hospital after cancer treatment would be
the happiest day of my life. When that time came, though,
I was actually more afraid than happy. I felt very alone,
and I missed the support of being watched over and cared for
by the medical team. My social worker said that this was a
common reaction, but I remember that my family had a hard
time understanding it." -Jack C.
- "In the first
couple of years after my recovery, the thing I hated most
was going in for my checkups. Just seeing the hospital again
reminded me of a part of my life I'd rather have forgotten.
I had an almost physical reaction to the sounds and smells
of the place. But more than that, those visits reminded me
that I'd been sick and that my cancer might recur. In my daily
life, I'd kept those thoughts out of my mind.
- Fortunately, it's
better now. Maybe I've just gotten used to the routine, and
I also understand how important these checkups are to my health."-Janet
V.
- "I find I walk
a fine line between watching for signs of recurrence or long-term
effects of my radiation therapy and going overboard. I never
used to be like this, but it's hard not to be scared by changes
that might mean problems. My first doctor was not very sympathetic
about my concerns, so I found another doctor who is. She understands,
and she doesn't tell me 'it's all in your head.' " -Louise
F.
- "I'm in a support
group for cancer survivors, and we have people with all kinds
of cancers who've made all kinds of adjustments: living with
artificial limbs, ostomies, breast changes, energy loss, chronic
pain. But we all have one thing in common. At one time or
another we each have been so angry that this happened to us.
Before I joined the group, my anger was having as much of
a negative effect on my life as my disability. Talking about
it, and seeing how others cope, helped me put things in perspective."-Sacha
R.
- "When I think
about my cancer treatment, I almost feel like it began when
I left the hospital after surgery. Much of my care took place
at home-for a while my room looked like a hospital. Now I'm
back to the hospital some times for radiation therapy to control
my pain. I'm getting used to the fact that my cancer is more
like a lifelong, chronic disease that I need to manage than
something the doctors can 'cure' once and for all. "-Irene
L.
- "My family wonders
if it's a waste of time and money for me to get yearly checkups
for the colon cancer I had 15 years ago. But I feel that I'm
doing something important for my health."-Rhea S.
Briefs
Basics of Health
Care for Cancer Survivors
- Get regular checkups.
In general, people who have been treated for cancer return
regularly to the doctor every 3-4 months at first, and once
or twice a year later on. Ask your doctor how often you should
be rechecked.
- Be alert to signs
of a possible return of cancer and long-term effects of treatment.
Ask your doctor to explain what symptoms should be watched.
- Get tested as
needed for other cancers. Your doctor can tell you how often
you should have tests to detect breast cancer and colon cancer.
With early detection, these cancers often can be controlled.
- Have good health
habits: Eating right and getting enough sleep and exercise
will help you feel better.
Tips for Managing Your Care
- Keep accurate,
up-to-date records of all the medical care you receive for
cancer and other conditions. Future decisions about your care
may depend on how you have been treated in the past. If you
move or go to several different doctors, no one but you will
have your complete history.
- Do things you
enjoy, even if you don't feel perfect. Pleasure can be a powerful
tool for health.
- Work as a partner
with your doctors and other health professionals in your continuing
care. When you first were treated for cancer, you may have
taken an active part in making decisions about your care.
The same active role can help you take control of your long
term health needs. The two main steps are to ask questions
and give information to your caregivers.
ASK QUESTIONS
You need information to carry out your role in managing your
care. These facts are as important to quality of care as any
other aspect of treatment. With this in mind, no question you
have about your care is "dumb." Many people bring a tape recorder,
take notes, or ask a friend along to help them remember everything
that's said. It is also a good idea to bring a list of questions
when you visit your doctor. The following are some questions
you may want to ask:
- How often should
I have a checkup?
- What are the signs
of cancer's return or of long-term effects?
- How likely are
they to occur?
- What changes might
I see that are not danger signs?
- What kind of diet
should I have?
- What are my treatment
options for handling chronic pain, the return of cancer, the
long-term effects of therapy?
- What is the best
way to talk to you about my concerns? (By phone? At a special
appointment? At a regular visit scheduled in advance to run
longer?)
- Who else is available
to talk with me about specific problems (e.g. sexual concerns,
care instructions, general fitness)?
GIVE INFORMATION
Doctors need to know key facts about you to prescribe the best
treatments and help keep you involved in your care. Tell them:
- What medicines
you now are taking for all conditions (including over-the-counter
medicines such as aspirin or laxatives). Doctors need this
information to avoid problems when they give you a new medicine.
- About fears or
concerns you have, especially those that might be keeping
you from following treatment. Talking openly may help solve
the problem.
- About changes
in your lifestyle. Even changes that seem minor could affect
your treatment. For example, if you quit smoking you may need
a different dose of some medicines.
- How you are feeling.
Include danger signs you may have noticed as well as any other
changes that may be worrying you.
- About problems
you may have and how much the doctor tells you about your
cancer. You have a right to hear as much or as little information
as you wish.
Options
for Coping With Body Changes
Get help if you
need it.
- Ask your nurse
or the social worker at your hospital about homemaker services,
home health services, seminars and classes, rides to the hospital,
and other community aid.
Find out how to use
special tools to over come disability or discomfort.
- Mechanical aids
can replace many lost functions. Talk to your rehabilitation
professional.
Learn from others
who have the same problem.
- Ask your local
cancer support organization, social worker, or doctor's office
staff to put you in touch with other survivors. They can give
you practical tips to make your new situation easier.
Find ways to meet
your needs for intimacy.
- Most survivors
of any cancer can still enjoy sexual touching and sexual closeness.
- Talk to your doctor,
nurse, or therapist to learn proven ideas for solving problems.
Focus on your best
features.
- Make the most
of them with makeup, clothes, or accessories. Feel good about
yourself.
Find new shopping
sources for products that help you look better.
- Ask your local
cancer support organization, your social worker, and other
survivors for ideas and addresses.
Resources
ADDITIONAL READING
Cancer patients,
their families and friends, and others may find the following
booklets useful. They are available free of charge by calling
the Cancer Information Service (1-800-4-CANCER) .
- Chemotherapy
and You: A Guide to Self-Help During Treatment
Explains chemotherapy and addresses problems and concerns
of patients undergoing this treatment.
- Datos sobre
el tratamiento de quimioterapia contra el cancer
Introduces chemotherapy to Spanish-speaking persons.
- Eating Hints
for Cancer Patients
Provides recipes and tips that help patients meet their needs
for good nutrition during treatment.
- El tratamiento
de radioterapia: guia para el paciente durante el tratamiento
Provides an explanation of radiation therapy for Spanish-speaking
persons.
- Radiation Therapy
and You: A Guide to Self-Help During Treatment
Explains radiation therapy and addresses concerns of patients
receiving radiation treatment.
- Taking Time:
Support for People With Cancer and the People Who Care About
Them
Discusses the emotional side of cancer- how to deal with the
disease and to learn to talk with friends, family members,
and others about cancer.
- What Are Clinical
Trials All About?
Explains clinical trials (studies of new cancer treatments)
to help patients decide if they want to take part in a trial.
- What You Need
To Know About...
This is a series of booklets. Each provides information about
a specific type of cancer.
These booklets discuss symptoms, diagnosis, treatment, emotional
issues, and questions to ask the doctor about a number of
cancer types. Some are available in Spanish.
- When Cancer
Recurs: Meeting the Challenge Again
Explains the ways that cancer may recur and discusses types
of treatment and methods of coping with recurrence.
Magazines and Journals
- Hundreds of articles
on cancer are published each year. You can locate those that
appear in popular magazines and journals in the Reader's
Guide to Periodical Literature, which is available in
most public libraries. If you need help using the guide or
finding an article, ask a librarian.
- You can find articles
published in over 3,000 health-science journals by looking
in Index Medicus. Medical libraries, most colleges
and universities, and some public libraries carry this resource.
- You also can locate
cancer-related articles published in technical journals by
using or having access to the National Library of Medicine's
(NLM) MEDLARS program. MEDLARS, in turn, provides access to
CANCERLIT, a computerized database system which contains almost
1 million citations and abstracts of articles on cancer from
technical literature published since 1963.
- Librarians in
medical libraries and in libraries at nursing schools can
retrieve information stored in MEDLARS. However, if you or
your doctor want to get information using your own computer
system, you can contact NLM at the following address or telephone
number:
- MEDLARS MANAGEMENT
SECTION
- National Library
of Medicine
- 8600 Rockville
Pike
- Bethesda, MD 20894
- (301) 496-6193
- (800) 638-8480
- Your local library
also may be able to do a computer information search. If it
belongs to the Federal Library System, you may be able to
borrow government publications.
ADDITIONAL RESOURCES
-
Looking Good
- Some people who've
had cancer treatment must adjust to a new body image. Cosmetic
aids, such as artificial limbs or wigs, may help boost self-confidence
as well as provide physical comfort. After a mastectomy, for
example, a woman may wear a breast form to give shape and
weight to where her breast was removed. Patients who lose
hair due to chemotherapy may wear wigs.
- If you are a woman
interested in making the most of your appearance, contact
the Look Good, Feel Better program through local American
Cancer Society offices or at 1-800-395-LOOK.
- If you are over
65, have had a mastectomy and want reconstructive surgery
or a prosthesis, you may want to contact your local Medicare
office. Medicare covers either of these if necessary due to
a mastectomy. The coverage is the same in all states.
- If you plan to
buy a cosmetic aid, you may want to contact your local American
Cancer Society unit, which may have a list of stores that
sell them. The unit also may maintain a "wig bank," a collection
of wigs that are given free of charge to cancer patients.
Or call the Cancer Information Service at 1-800-4-CANCER,
which may have a list of local stores that sell the product
you need. And check with your insurance company. Some policies
cover some cosmetic aids.
- These books
on cosmetic aids also may be useful:
- Looking Up: The
Complete Guide to Looking and Feeling Good for the Recovering
Cancer Patient, Suzy Kalter. McGraw-Hill: 1987- Provides tips
(with photos) on hair care, wigs, makeup, and exercise. (Out
of print; check your local library to find a copy.)
- Buyer's Guide
to Wigs and Hairpieces. This 2-page summary is available,
as well as additional literature as needed. Contact Ruth L.
Weintraub Co.lnc., 420 Madison Avenue, Suite 406, New York,
NY 10017, (212)838-1333.
- A full-color catalogue
of wigs for medical purposes is available nationwide. Contact
Jacques Darcel, 50 West 57th Street, New York, NY 10019, (212)753-7576.
Sexual Concerns
- Cancer and cancer
treatment may affect sexual relationships. Although treatment
for cancer sometimes causes sexual problems, often a patient's
or partner's feelings about cancer and sex can make a difference.
Your doctor, nurse, or social worker may be able to help.
They also may be able to help you find a sex therapist who
helps couples understand their sexual problems and suggests
ways to deal with them. The following association can provide
names of sex therapists in your area:
- American Association
of Sex Educators, Counselors, and Therapists (ASECT)
Suite 1717
435 North Michigan Avenue
Chicago, IL 60611
(312) 644-0828
If you write ASECT, be sure to include a self-addressed, stamped
envelope and a $3.00 handling fee.
- The American Cancer
Society has two publications on sexuality that may be helpful:
- Sexuality and
Cancer: For the Woman Who Has Cancer and Her Partner
- Sexuality and
Cancer: For the Man Who Has Cancer and His Partner
Contact your local unit or the national office at 1-800-ACS-2345
to get copies.
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