June 3, 2015 | by Ellen Alperstein
As cancer treatments advance and outcomes improve, so does the ability to help survivors adjust to post-treatment life. Here, Joanne Mortimer, M.D., vice chair of medical oncology and director of the Women’s Cancers Program at City of Hope, explains how survivors can cope and, ideally, thrive.
1. Communicate your concerns
Cancer patients are worried about a lot of things, and superior treatment addresses the whole patient, not just the tumor. City of Hope launches that superior treatment through the use of Support Screen, a biopsychosocial questionnaire that “identifies the variety of problems patients have in addition to cancer,” Mortimer said. Virtually all patients worry about dying, and the pain of cancer, but some also worry about the effect on their finances, their fertility, how they will manage transportation to the treatment clinic …
Support Screen is administered through the supportive care program, whose social workers are trained to tame the elephant in the room: emotion.
“Patients are emotional about their disease,” Mortimer said, “and talking to a doctor when you’re emotional isn’t always the best use of the limited time physicians have.” The questionnaires are processed in real time, so by the time the patient enters the exam room, the doctor has been emailed with its results, and knows the patient’s concerns.
2. Develop your powers of perspective
The emotion of cancer can be overwhelming, but it can be disarmed somewhat by knowing how the human mind responds. Mortimer has defined three stages common among people diagnosed with cancer:
“The transition … is difficult. People are apprehensive, because there’s no test to tell if they’ve been cured — only time will tell, and that’s hard to live with, waiting. Nobody does that well.”
“The outside world takes advantage of them,” Mortimer added, “because there’s money to be made from fear and hope.” Some businesses promote hormone-free milk and organic food to cancer survivors, never mind that there’s no scientific data to support their benefit for this population.
City of Hope teaches survivors to compartmentalize; to learn the difference between what they can affect and what they can’t. “We encourage patients to focus on what they can control,” said Mortimer, “such as a healthy lifestyle.”
3. Understand your place in the process
“The appreciation of survivorship science is new, and information about long-term complications is recent,” Mortimer said. “Now we have the luxury of being cured. But because survivorship is a new field, doctors need help from patients to understand it.”
Taking a page from the Communicate book, Mortimer advised survivors to talk about their post-treatment symptoms. For example, breast cancer patients “should not assume the physician knows all the complications of your chemotherapy. Talk about it if you’re worried about the loss of your fertility; if you should freeze your eggs.”
In younger women, breast cancer treatment causes early menopause, which, Mortimer said, “doesn’t just mean the loss of fertility, it makes you older. Patients assume doctors know they have problems with hot flashes, vaginal dryness, loss of libido ... But they should discuss these things, because they can be treated.”
4. Move your body
Apart from understanding how a cancer diagnosis messes with your mind as well as your body, Mortimer offered a single, concrete prescription for survivors: “Don’t gain weight. And continue to exercise.”
Her active breast cancer patients do better, she said. And recent studies indicate that weight control also seems to benefit colon cancer survivors. It makes sense for cancer survivors in general, Mortimer explained, because fat cells are metabolically active, and such activity encourages tumor growth.
The wrench in the works for breast cancer survivors is that menopause retards metabolism, which puts them at higher risk of gaining weight.
But exercise can increase metabolism, and according to Mortimer, “People who exercise, who become athletic even if they weren’t before their diagnosis, do best. Aggressive, healthy exercisers develop good coping strategies and that helps with anxiety; helps to get their head in the right place.”
Learn more about becoming a patient or getting a second opinion by visiting our website or by calling 800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.