Tag: Cancer

Patient vs. Survivor: The Impact of a Label

(Photo by Joshua Hoehne on Unsplash)

The first devastating realization I had following my breast cancer diagnosis was that I was now a cancer patient. In my mind I immediately went from “happy-go-lucky, fitter-than-average” to “sick beyond belief”.

Except that nothing physical had changed. But my mindset had. And when I found out that my triple-positive tumor was going to require chemo, I knew that everyone else was going to be aware of my hairless, frail status.

Cancer. Patient. I imagined myself pathetic and scrawny, walking around hunched over in a hospital gown with light shining off my bald scalp. Sounds dramatic, huh?

How do your labels affect you?
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Recently, however, I learned that there’s been a change in the language surrounding those individuals who have been diagnosed, are undergoing treatment for or have finished cancer treatment. The word “patient” as it relates to someone’s status has been supplanted by “survivor” much earlier in their cancer experience.

This is curious to me because I went through a mini identity crisis after I was done with chemo and radiation–I thought that only then could I start calling myself a (hopeful) cancer survivor. But I was a bit anxious about doing so, because I didn’t know whether I truly deserved that title. I thought that I needed to have some special designation before I qualified as a survivor.

These days, the survivor label is given when you receive a diagnosis. The idea is that while initially we didn’t know your status, now that we’ve confirmed your tumor, you are going through the experience of surviving the disease. As stated on the Cancer.net site, “When people talk about ‘survivorship,’ they are usually referring to navigating their life experiences and challenges resulting from their cancer diagnosis.” Read more about how ‘survivor’ is used here.

This sounds a lot better to me than using the term “patient”. By referring to myself as a patient when I didn’t have any reason to–meaning no physical symptoms–I was imagining myself sicker than I really was, which increased my anxiety levels. That made my entire experience worse and it didn’t have to. I did that to myself (‘cept that I was only using the common labels of the time).

How are you choosing to define yourself?
(Photo by Brett Jordan on Unsplash)

Instead of putting my energies into dealing with the side effects of treatment, I went down a dark hole.

Language matters! While there’s no doubt that cancer brings on stress and anxiety, terminology can make a difference in your cancer experience and that can either help or hinder you in the process.

So I urge you to consider the words you use to refer to yourself and pay extra attention to how that feels to you. You could be making yourself miserable without even realizing that you have some control over this.

Year 7 Mammogram in the Books

It’s enough to make me get a little cocky.

A few days ago I had my 7th yearly mammogram since my cancer diagnosis. Let me stress first, I am very aware of how fortunate I am. My appointment was early in the morning, my husband came with me (like he’s been doing, since he didn’t come during my diagnostic mammogram seven years ago) and I got a clean bill of health from the radiologist quite quickly.

I didn’t even feel those few minutes of hovering as I waited for the results. The technician had allowed my hubby into the mammogram room to wait with me, and he and I casually chatted so I didn’t notice the time pass.

Wow, things have changed.

‘Scuse me while I sit back and reflect on how fortunate I am for getting this far.
(Photo by Fuu J on Unsplash)

Every year, this feels different, cancer feels further away and I feel less “impending sense of doom” that I had in the first several years.

That’s why something like Kate Middleton’s announcement that she had started chemotherapy for cancer shocked me back to reality.

No matter how good I currently feel about my own situation, there are many reminders that cancer is still a terrible disease that doesn’t care who you are or what you have going on. And it’s still grabbing people and throwing them into treatment.

So much for my cocky attitude.

At times like these, I take a moment to reflect on gratitude for how far I’ve come and, as suggested by my oncologist, how much more life I have in front of me. I don’t think I would have ever felt this appreciation as deeply if I hadn’t gone through the soul-tearing experience that cancer is. Which is not to say that I’m glad I went through it, because I’m not.

Still reminders like Kate’s announcement help counter the selfish little feelings that I sometimes get when I see the free things available to cancer patients now and pout that those weren’t there for me. Yes, those are “human” feelings, but you know what, I can do without them.

Instead, it’s so much more fulfilling to bask in the golden hour sun, taking deep nourishing breaths, and shoo away the everyday concerns that disturb my sleep. At least I have the luxury of being able to busy myself with them, the bothersome little things, and know that I’m still around to have them be a bother.

White Paper: “Yoga Interventions for Cancer Patients and Survivors”

(Title image: Photo by Raimond Klavins on Unsplash)

I’ve been writing a lot lately about using yoga to mitigate cancer therapy-related side effects.

In this post, I want to bring your attention to the white paper entitled, “Yoga Interventions for Cancer Patients and Survivors” [Important: this links to the download page on the yoga4cancer website, *not* directly to the pdf itself]. It’s an evidence-based review of research regarding the benefits of a yoga practice in coping with negative side effects that afflict cancer patients and survivors, followed by recommendations for teaching yoga to this population.

This 24-page document (quoted directly from the paper’s abstract) “(1) provides a summary of research on the benefits of yoga for cancer patients and survivors, (2) highlights the most beneficial components of yoga for cancer survivors, (3) identifies barriers and solutions to the creation of accessible, evidence-based yoga programming, and (4) offers guidelines for developing yoga programs that best meet the unique needs of cancer patients and survivors.” [Again, this links to the download page.]

The white paper is written in non-technical language, distilling the research down into a form that doesn’t require a scientific background to understand. Additionally, editions are available in Spanish and Japanese, both available on the download page beneath the English version.

If you’d rather not download, you can read the English version below (or click the “download” button underneath the paper for a pdf):

yoga-interventions-for-cancer-patients-and-survivors_white-paperDownload

Unexpected News at my 7-Year Oncology Appointment

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A few days ago I had my seven-year post-diagnosis appointment with my oncologist. Seven whole years. And it was a weird conversation.

He said something that set me aback. He told me that he didn’t think I should worry about the cancer coming back. Essentially, I was cured (note: MY words, not his, but that’s the idea). [See bottom of post for disclaimer!]

He’s alluded to this before during previous appointments. But this time around felt different.

I’ve officially hit SEVEN!
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I returned home a bit confused. See, for the last seven years, I’ve been a full-on cancer survivor. Still holding on to the fear that at any moment, I would get those terrifying scan results back and–WHAM–I’m a cancer patient once more, back on that sickening rollercoaster ride through treatment.

As difficult as it was to accept that–even trying my best to live a healthy life–I had somehow been smacked down by cancer…now, I had a new problem. Reentering life as maybe not-so-much a cancer survivor anymore, but rather just a healthy, active postmenopausal woman with years ahead of her.

And that is a weird feeling.

For the first five years after my diagnosis, I was frustrated, even angry. Cancer was a devastating detour at a time when I was already struggling to find my way back into a career. Well, forget that. Derailed. I was bitter.

Eventually, I realized that while life sucked, it sucked for a lot of people and I wasn’t special in that regard. That was an important turning point in how I perceived my own role in my cancer story–it was humbling but also gratifying.

Humbling because my experience could have been so much worse. There were people whose treatment did not end well. I was incredibly fortunate, even when it felt like I’d been thrown in a sack and beaten with sticks. At least, I made it out.

Gratifying because early on I held myself responsible for getting cancer, even though I had literally done everything protective (lots of exercise, high fitness, plant-based diet, breastfeeding, not smoking, not drinking) that I could think of. I was desperate with frustration and helplessness about this. Letting go of that guilt was healing.

Feels like I’ve got the green light to hurry up and get on with the rest of my life now.
(Photo by Possessed Photography on Unsplash)

So the last two years have been more about understanding my perspective and then stepping out of it to view things more objectively. Mindfulness and meditation helped with that, which is why I often write about them here. But I hadn’t been ready to get out of the breakdown lane and drive myself back into mainstream life, in part fearful of the pain of having the expectation of cancer-free “normality” smashed to smithereens by a potential diagnosis.

Gradually, that’s changed. But this last appointment felt like getting shoved out the door by someone yelling, “YOU’RE OKAY, DAMMIT!” Here I am, standing and blinking in the sunlight, trying to make sense of exactly what that means for me now. Wow, after seven years, I can actually stop being afraid.

I don’t know if I even remember what that feels like.

Yes, I’m still going to refer to myself as a survivor, because it’s a part of my natural history. I’m never going to forget that experience and I continue to be driven by a need to support others going through this disease.

And if it does return? Well, at least I will have had a brief glimpse of life completely outside the notion of cancer.

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Of course, because we’re talking about cancer, the statements above call for level-headness in the midst of levity. While my oncologist feels that the chances of the same cancer coming back are low, the possibility for a brand spankin’ new tumor, breast or otherwise, never goes away. It happened once, it can happen again. But that’s life. I’ll take it.

“Moving Through Cancer”: A Short Film from ACSM

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I’ve been coming across a lot of interesting–and hopefully useful– videos. The one I’m posting here is presented by the nonprofit Fund for Sustainable Tomorrows and the American College of Sports Medicine, the latter being the organization through which I received my personal trainer certification almost 16 years ago.

This is a 20-minute film with a hopeful message!

The film, narrated by former Olympic figure skater and cancer survivor Scott Hamilton, showcases the stories of how survivors are using exercise to make themselves feel better and increase their chances for survival. It also shows how our knowledge about physical activity’s benefits during cancer treatment has increased, and the programs that have been created to help cancer patients become and stay active.

It’s amazing to see how within a decade or two the attitude about cancer and exercise has changed. Whereas individuals undergoing cancer treatment used to be told to rest as much as possible, now it’s understood that exercising through your treatment is one of the best ways to not only minimize associated side effects but also decrease the chances of cancer recurrence.

For me, exercising during my treatment was a way to feel normal when everything else felt out of control.

The current recommendation is aerobic activity for 150-300 minutes per week along with twice weekly resistance training sessions. And it’s best to do both types of exercise for a well-rounded program, if you can manage it.

But the most important thing to remember is that no matter what you do, doing something is better that doing nothing. Research has discovered the existence of myokines, hormones that are produced in the tissue of skeletal muscles. They are released during muscular contractions and seem to have anti-cancer properties, slowing cancer growth and spread. That is very exciting news!

Of course, exercise is not a cure, and there is no guarantee that if you are an avid exerciser you won’t get cancer or won’t have it recur. However, there’s a very good chance that physical activity will make you feel better and help you continue with life-saving treatments.

As E. Ronald Hale, MD, MPH, Medical Director of Radiation Oncology at Kettering Health states (from the video), “The best cancer treatment in the world is useless if you can’t get through the cancer treatment.” The side effects from cancer therapies can be debilitating, but getting out and moving will improve your quality of life and help you finish your treatment.

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It’s worth mentioning that the number of exercise professionals who have had additional training in working with cancer patients is growing, which means that cancer-informed trainers and yoga teachers are becoming easier to find. Now it’s the insurance companies that need to get on board.

yoga4cancer: Bringing the Benefits of Yoga to Cancer Patients and Survivors [VIDEOS]

(Title image: Photo by Zoltan Tasi on Unsplash)

In February 2022, I started a yoga teacher training program with a singular goal: to eventually teach yoga to cancer patients and survivors.

With its mix of physical postures (asanas), breathwork (pranayama) and meditation, yoga is ideal for someone going through the traumatic experience that cancer can be. Yoga can provide enough physical exertion to count as moderate exercise and the ability to help the practioner calm their mind, things that are so important for improving cancer treatment outcomes. However, classes must be designed carefully and taught thoughtfully.

Yoga4Cancer Q&A for Cancer Patients and Survivors (Yoga Alliance on YouTube)

Keep in mind, yoga teachers were yoga practitioners first. Many of them got really good at the practice, developed great flexibility and balance and gained respect for the tradition of yoga. But that doesn’t automatically make them appropriate yoga teachers for cancer patients, who need an instructor that understands the nuances of what cancer is and how treatment affects us.

A yoga teacher and breast cancer survivor by the name of Tari Prinster addressed that need by creating yoga4cancer (y4c), “an evidence-informed Oncology Yoga method tailored to address the specific physical and emotional needs left by the cancer and cancer treatments. The approach matches breath and movement to stimulate the immune system, improve flexibility & strength, reduce anxiety and boost overall well-being” (from the y4c website).

I’m planning to begin the y4c advanced 75-hour certification program (see informational video here) either later this year or early next. I’ve been so impressed by y4c’s emphasis on understanding the unique situation that cancer patients and survivors are in–it’s not just your garden variety beginner yoga class with “also for cancer patients” dressing. The program is well-thought out and comprehensive, and I’m so excited to embark on this next leg of moving closer to my teaching goal.

In the meantime, here is a selection of videos created by Tari and her instructors that are specifically geared for the mental and physical needs of cancer patients and survivors:

Yoga4Cancer Oncology Yoga for Cancer Related Fatigue (Yoga Alliance on YouTube)
Yoga4Cancer Yoga for Bone Loss (Yoga Alliance on YouTube)
Yoga4Cancer Yoga for Range of Motion (Yoga Alliance on YouTube)
Yoga4Cancer.com Yoga for Anxiety (Yoga Alliance on YouTube
yoga4cancer.com Yoga for Lymphedema (Yoga Alliance on YouTube)
yoga4cancer.com Yoga for Constipation (Yoga Alliance on YouTube)

Enjoy!

Effects of Diet and Exercise on Chemotherapy Tolerance and Efficacy: Research

(Title image: Photo by Hermes Rivera on Unsplash)

Many cancer patients complain of feelings of helplessness after their diagnosis, and I can certainly relate to that. As a result, I’m particularly interested in research that explores whether patients can gain control over the success of their treatments.

The most recent study I’ve come across includes breast cancer patients undergoing treatment at Yale and Dana Farber Cancer Centers.

This study appeared in the Journal of Clinical Oncology (Sanft et al., 2023). Researchers examined the effect of diet and exercise on “relative dose intensity” (RDI), which is the relationship between the amount of chemotherapy delivered to the patient compared to the standard amount prescribed. Low RDI means that there was a reduction in the chemotherapy the patient received and is generally associated with a poorer outcome. Dose reductions result from the patient’s difficulty in tolerating the drug.

The researchers also looked for “pathologic complete response” (pCR), which is “the lack of all signs of cancer in tissue samples removed during surgery or biopsy after treatment with radiation or chemotherapy” (definition from cancer.gov). This was for women receiving neoadjuvant chemotherapy, which is chemotherapy administered prior to surgery.

Yep, once again we come back to diet and exercise, even during chemo.
(Photo by Yulissa Tagle on Unsplash)

The subjects of this study were women recently diagnosed with stage I-III breast cancer, who either received the “usual care” or a diet and exercise intervention. Those in the intervention group received nutritional counseling with a focus on a plant-based diet. The physical activity included counseling and support for maintaining a home-based exercise program that included strength training (2x/week) and brisk walking (150 min/week of moderate intensity or 75 min/week of vigorous intensity).

What the research confirmed first was that the subjects in the intervention group were able to increase their exercise and diet quality, which showed that it was feasible to make lifestyle improvements even in the midst of chemotherapy.

However, in this study, the RDI for both groups (“usual care” and diet & exercise intervention) ended up being similar, but also quite high, which meant that women in both groups completed most of their treatment. The researchers noted that the study should be re-run with patients who were at greater risk of not being able to complete all their chemo to see how much of an effect improved diet and exercise would have, especially since exercise has been shown in other studies to have a positive effect on patient outcomes.

But a striking difference was seen for women receiving neoadjuvant (prior to surgery) chemotherapy in that the rates of pCR (disappearance of cancer in the tissues) were 53% for women in the intervention group versus 28% for women receiving usual care. That suggests that the intervention enabled the chemotherapy to be more effective.

There are many physical activities you can choose from–clifftop not required.
(Photo by Sigmund on Unsplash)

The researchers stated the following in summarizing their study: “Given that pCR is an accepted predictor of recurrence and mortality, our findings could provide oncologists with a supportive care intervention that affects the ability to potentially improve survival outcomes” (Sanft et al., 2023, J Clin Oncol). And this is very good news indeed.

The take-home message here is not surprising, and it’s good advice for life in general: no matter what your current lifestyle, prioritizing a healthier diet (emphasis on whole foods, plant-based, less processing, etc.) and engaging in regular cardiovascular and strength training exercise will improve your quality of life. It is always worth the effort.

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REFERENCE:
Sanft et al. (2023) Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study. J Clin Oncol, 41: 5285–5295. https://doi.org/10.1200%2FJCO.23.00871. [This paper is Open Access and can also be found in PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691793/]

February: A Great Month for a Diagnosis Reenactment

(Title image: Photo by Aaron Burden on Unsplash)

It’s February and that means it’s the start of “diagnosis season” for me. At this point in cancer survivorship, I don’t get as affected by everything that happened “on this date X years ago“. However, I have an oncologist appointment and my yearly 3D mammogram around this time, so I can’t forget what this month means.

You would think that since 2024 marks seven (!) years since my initial diagnosis, I’d feel pretty good about having made it this far past my treatment…and you would be right.

Seven years down and still going strong!
(Photo by Frankie Lopez on Unsplash)

I’m now living the feeling that I so desperately wished for seven years ago when everything felt devastating and out of control. My outcome, even with the many pesky moguls that I’ve had to clear, is something I’m so thankful for.

But of course, even as mellow and relatively unconcerned as I am now, there are little reminders of the rough and tumble past that unsettle me.

Like that point in my mammogram when the tech finishes up and leaves the room to consult with the radiologist, and all of a sudden I don’t feel great anymore. It’s maybe 5-10 minutes or so of sitting in a quiet room all by myself, wrapped up in that bathrobe-y gown made out of fabric that seems like it should be less scratchy, trying to focus really hard on the tropical ocean video that they have playing on the tv screen on the wall.

No matter how warm the room is, there is a cold spot in the pit of my stomach. The hospital does its best making the surroundings seem inviting. Really they try. But it’s kind of hard to mellow out the echo of an impending sense of doom.

Same goes for every time my oncologist says something like, “Hmmm, should we do another chest MRI?” No, no we should not. That’s about 45 minutes of being stretched out like superman on a surface that’s clearly meant for a woman much shorter than me, while getting my ears blasted.

In case you’ve never taken a ride in the tube, this is what it’s like. Don’t forget your earplugs. Bonus for chest MRIs: you’re lying on your belly with your arms stretched past your head for almost an hour, giving you plenty of time to reconsider your life choices.

My husband says the MRI sounds like a broken dot matrix printer. I think if your printer is making sounds like that, it’s time to evacuate the building.

Ah the memories. But again, I am talking about this from the vantage point of seven years away. It is nicer being up here above the fray. It also gives me a great view of the potential rollercoaster disaster that this season could become, if my scans go south.

But seven years into this, I’m betting it probably won’t. So far, so good.

Benefits of Mind-Body Fitness Classes for Cancer Patients: A Preliminary Research Study

If you needed yet another reason to turn to meditative exercise practices in the course of cancer treatment, here it is.

A recent, unpublished study that was presented at the 2023 ASCO (American Society of Clinical Oncology) Quality Care Symposium, entitled “Virtual Mind–Body Fitness Classes Show Unexpected Benefit in People with Cancer” (Mao et al., 2023), examined the effects of virtual mind-body fitness classes on visits to urgent care or unplanned hospitalizations for cancer patients who were in active treatment and were dealing with moderate or greater fatigue.

While mind-body practices are already recommended for cancer patients to help deal with the symptoms of treatment and its emotional fallout, the results of this study illuminated specific benefits. Those patients who had been assigned to the group given access to virtual live mind-body and fitness classes (called Intergrative Medicine at Home, or IM@Home) had fewer hospitalizations and shorter hospital stays, in addition to fewer visits to urgent care, compared to those subjects who were only given access to pre-recorded online meditation resources (Enhanced Usual Care, or EUC).

It’s not surprising that mindfulness benefits cancer patients, although it’s striking how those benefits manifest themselves.

This study was run at the renown Memorial Sloan Kettering Cancer Center (MSKCC) with 200 cancer patients randomized into the two groups (IM@Home and the stan, which makes the design more solid and increases confidence in the results. Nonetheless, as the lead author Dr. Jun Mao (Chief of Integrative Medicine at MSKCC) stated in the National Cancer Institute’s Cancer Currents blog, “I do want to caution that the current trial was designed as an early-phase trial, so we would like to do a larger study with longer follow-up to confirm our results before we are completely confident in the findings.”

A larger study is currently in the works. Dr. Mao would like to explore whether these classes help patients follow through on their treatment plans, and if so, whether these patients also live longer.

The IM@Home group’s classes included a variety of classes (again, quoted from Cancer Currents blog): “Some of the classes taught participants movement-based activities such as yoga, tai chi, and dance therapy; other classes taught meditation-based practices, such as music therapy and mindfulness.” It is already known that exercise during cancer treatment can reduce fatigue, but the researchers felt that part of the success of this study was due to the participants’ ability to choose the level of exertion based on how they were feeling at the time of the class.

Looking forward to further research on the ways that we can support cancer patients physically, emotionally and spiritually!

As Dr. Mao pointed out, more directed research on this must be done before drawing specific conclusion, but this was a very valuable pilot program, the results of which would not surprise those of us who have made use of various exercise modalities, particularly those with a mind-body angle, for calming ourselves during our cancer journeys.

The more this subject is studied, the greater the chance that cancer centers focusing on whole-patient treatment will be offering such classes to their patients. COVID taught us that there are ways to make classes accessible to people with limited mobility or conditions that may prevent physical travel to classes.

While I believe that attending mind-body oriented classes in person is ideal, this study illustrated that even virtual opportunities can have significant benefits for the patient.

It’s worth pointing out that of the 200 study participants, 91% were female and 77% were white. That is not a diverse spread and reflects the typical clientele at your average yoga studio (based mainly on my personal observations), with the exception being that the average age of these study participants was 60 years. I would be willing to bet that less-represented groups would benefit greatly from the stress relievers offered here and I hope that the researchers expand their subject pool to balance out the participants in their future study.

Regardless, these are intriguing results that underscore the important of mind-body focused classes, and exercise in general, in the well-being and improvement of cancer patients. This study joins a growing list of research that is changing the way that we look at managing cancer treatment side effects.

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REFERENCES:

Reader-Friendly
Windstead, E, Virtual Mind–Body Fitness Classes Show Unexpected Benefit in People with Cancer, Cancer Currents, December 15, 2023:
https://www.cancer.gov/news-events/cancer-currents-blog/2023/mind-body-fitness-cancer-side-effects

Research Study Abstract
Mao, JJ et al., Effect of virtual mind-body fitness program on reduction in unplanned hospitalizations among patients undergoing active cancer treatments: A pragmatic randomized clinical trial, presented at 2023 ASCO Quality Care Symposium, October 28, 2023:
https://meetings.asco.org/2023-asco-quality-care-symposium/15514?presentation=227485#227485 (note: click on “Abstract 473” on right side panel for abstract text)

“Left Behind”: An Unanticipated Side Effect of Cancer

(Title image: Photo by Denys Argyriou on Unsplash)

Apologies because this might sound like a rant but this topic has been on my mind a lot lately.

When you’re diagnosed with cancer, you learn about the many side effects of treatments.

You will be informed about the physical and even psychological effects that cancer patients deal with, but there are also considerable financial repercussions. Patients may struggle with hospital bills: some lose their insurance coverage, others might never have had any to begin with, those who have coverage may find that it’s insufficient. It’s not uncommon to hear how cancer has driven survivors and their families into bankruptcy.

On top of that, cancer can do a number on your career aspirations for years to come.

Money issues are one of the side effects of cancer that don’t get a lot of airtime…but really should.
(Photo by Alexander Grey on Unsplash)

In case you think that it’s uncool to complain about one’s career in the face of having survived cancer, let me get this out of the way: being a cancer survivor is a privilege. I’ve written before about how acutely aware I am that I have lasted longer than many cancer patients.

But as the effectiveness of cancer treatments improves, the number of cancer survivors increases and long-term repercussions become a more and more serious consideration, particularly how they affect ongoing quality of life.

For people who are still working out their careers, cancer can derail progress because it plants a huge stop sign in their path.

Think of going into the chemo infusion room: the days leading up to it entail appointments, port placement, purchasing supplies (anti-emetics, anyone?) and in general prepping for being out of commission about a week.

It’s not the time to focus on stressful work deadlines (and most sincere condolences to any patient who has to do that!).

Ironically, as much as I feared infusions, they actually gave me an excuse to focus on myself instead of worrying about everyone else. I posted about that here somewhat sadly that chemo allowed me to rest without feeling guilty.

It was at that point that I’d realized I’d been pushing myself, always expecting more and not feeling like I was measuring up. Chemo gave me a break from that. Which was good…kind of…

But after chemo and radiation came endocrine therapy, so just as I was winding down from one set of side effects, up popped another.

Right? RIGHT?
(Photo by Drew Beamer on Unsplash)

And all those plans I’d had for myself were put off again and again. Career goals seemed more out of reach because my timeline had shifted.

Well, I’m not stupid, so I changed my career goals. Makes sense, right? Cancer provided a different perspective on things and motivated me in another direction.

But in the wake of cancer treatment, I feel like I’m walking in cement shoes…if it’s not one thing it’s another. I got off aromatase inhibitors (early) and then realized that I was having memory and focus issues. Whether Cancer Related Cognitive Impairment (CRCI) or menopause-driven brain fog, all of a sudden I’m dealing with something else.

It feels as though the train to prosperity has left the station and I was just a little too late to catch it.

Great.

Right now I’m looking at sky-rocketing costs-of-living in a part of the country that literally got expensive around me. Instead of moving up in the world, my family and I are desperately searching for less pricey housing which will put us in worse conditions and a longer commute to work.

And at age 57, when most of my friends are looking at enjoying retirement in the years to come, planning for what they’ll do in their golden years, I’m trying to reeducate myself, shifting into a career that doesn’t make much use of previous work experience.

And it feel exhausting. Sometimes I want to cry.

I want to believe this, I really do. But I don’t think that there’s a reward for surviving cancer beyond simply surviving cancer.
(Photo by Nik on Unsplash)

Yes, I’m happy to be alive. But no, this was not the way I thought things would go. When initially I was told that I had a decent chance of surviving for five years, that was all I could think about. In fact, that was all that mattered.

I wasn’t thinking about the fact that if I managed to live through this, I’d still need to find a way to make a living. And the interruption that was cancer could do a number on that.

At this point, I need to stress that my intention is *not* to try to scare cancer patients into dreading survivorship. Goodness knows, there are enough things to navigate within the cancer experience as relate to the usual treatments that will take your energy and attention.

I wish nothing less for you than 100% remission and many years ahead to enjoy your “survivor” label.

At the same time, I encourage you to remain present and mindful of the fact that you might have to pivot if you’re not already well-established in your career. If things start to change in a direction that’s southward of what you expected, be patient and readjust your expectations. Nuture acceptance and keep an eye on how you can put yourself in a good position to meet the future. And be kind to yourself.

I’m still working on it.