Über die Autorin bzw. den Autor

Wendy Schlessel Harpham, is an internist in Dallas, Texas, where she lives with her husband and three children. She is the author of After Cancer: A Guide to Your New Life and Diagnosis Cancer: Your Guide Through the First Few Months.

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As anyone who has been diagnosed with cancer knows, surviving cancer is more than just killing cancer cells and getting through treatment. Patients must deal with the emotional, social, spiritual, and financial fallout of a cancer diagnosis. By helping survivors understand that they can't go back to where they were before cancer, Dr. Wendy Harpham liberates them to move forward to a different, "new normal." In a reader-friendly, question-and-answer format, Dr. Harpham (herself a cancer survivor) addresses a wide range of issues. Among them are understanding the medicine of reevaluation, follow-up, and prevention after treatment; dealing with the most common physical aftereffects of treatment; learning how to make decisions about work and school; relating to friends and family; helping children deal with parents' cancer; and coping with the practicalities of living wills and insurance.

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After Cancer

Perennial

Chapter One

Understanding the Medical Aspects of Recovery

Most of you would like to put your whole cancer experience completely behind you. You would like to say, "I had cancer, but it's all over now. I am, or soon will be, as healthy as I was before I got sick. I can go back to my routine medical care."

Can you really face your future by ignoring your history of cancer? Should you? Unless your doctors have given you a 100 percent guarantee that your cancer will never come back, you will have some concern about recurrent cancer. Depending on what treatment you received, your body will need to recuperate. And many treatments cause their own problems, in the short run or the long run.

Your health is not the same as it was before you developed cancer. Your knowledge about the vulnerability of your health is painfully changed. Believing that you are back to the way you were before cancer may save you immediate anxiety about possible future problems. But it would be at an enormous cost to you, emotionally and physically.

There are many reasons why you should continue learning about your cancer. In the short run, you can take steps to prevent or minimize problems, and thus maximize and speed your recovery. In the long run, knowledge allows you to take measures to help prevent future problems such as recurrent cancer (recurrence) or the development of a new type of cancer.

You have met the challenge of treatments. But your situation is like that of a marathon runner, whose efforts are not over at the end of the race. Successful runners are careful about their recovery. For days afterward they get extra fluids, nutrients, and rest. They know that it takes weeks to get their primed, but spent, bodies completely back to normal.

Given that an optimally conditioned runner has to make adjustments to recover from a race, imagine the needs of a competitive runner who sprains her ankle. She has to decide how to deal with her injury. She can ignore the injury and risk further injury while performing at less than peak performance. Or she can find out what to do to maximize and speed her recovery. This may mean slowing down or even stopping her training schedule for a while. If, after complete healing, some ankle weakness remains, she can act as if there were no problem, running in pain and risking recurrent injury. Or she can learn about modifications to make in her shoes, running style, training schedule, or running route that would allow continued, though changed, running..

Your cancer and treatment caused changes in your body that can take days, weeks, months, or even years to disappear. Some changes may be permanent. Like the runner, you will feel better and heal faster if you learn about the changes in your body and the ways to help yourself recover.

Many survivors who have completed treatment struggle with a sense of vulnerability and an urgent desire to do something to help protect their renewed health. Learning what you can do to stay healthy will allow you to regain a sense of control and will maximize your chance of staying healthy.

After cancer, you may feel bombarded by information about what causes, cures, or prevents cancer. Newspapers and magazines, books, and well-meaning friends and family offer frightening, exciting, confusing, and often contradictory messages. Knowledge can help you sort out useful facts from inaccurate or misleading stories.

Each year brings advances in the diagnosis and treatment of cancer. In the future, new options for screening, follow-up, and preventive measures for your type of cancer may be offered to you. Staying informed about your medical situation after cancer will make it easier for you to appreciate the benefits of these developments.

This chapter will help you to understand what is happening medically after your treatment is complete and to participate in your own care. It reviews the medicine of reevaluation, recovery, and long-term care after cancer. The text assumes that you have a working knowledge of the basics of cancer medicine as it applies to a newly diagnosed cancer, patient, "Diagnosis," "prognosis," "staging," "biopsy," and "scan" are all terms covered in Diagnosis: Cancer: Your Guide through the First Few Months.

Reevaluation

What Happens Now That My Cancer Treatment Is Completed?

• find out the status of your cancer. Is your cancer completely gone as far as we can tell? If your cancer is not gone, where is it?
• evaluate your current condition (your physical and emotional limits, both temporary and permanent). How are your kidneys? Lungs? Heart? Weight?
• make a decision about whether further treatment will offer any benefit in terms of maximizing control of your cancer now or decreasing the chance of its coming back
• begin to learn how to live most fully within any new limits
• learn what you can do to accelerate your recovery
• find out what you can do to prevent future problems, such as use sunscreen or undergo periodic colon tests
• begin the adjustment of changing from being a patient under active cancer treatment to being a patient with a history of cancer who is seen for checkups geared to the special needs of someone who survived your type of cancer
• begin your lifelong routine of cancer follow-up

What is Restaging?

Restaging is the evaluation after your treatment is completed, to determine

• how much cancer is left, if any
• whether there are any new areas of cancer

Now Is Restaging Done?

• talk to you about any symptoms or problems you are having
• examine you ("do a physical exam")
• order various tests and studies, such as blood tests, X rays, and scans, or bone marrow biopsies

Excerpted from After Cancerby Harpham, Wendy Schlessel Copyright © 2004 by Wendy Harpham. Excerpted by permission.
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