Cancer Affects Daily Life and Well-Being

National Cancer Institute Bulletin | 10.17.2006

Survivorship Spectrum, Part II

Most cancer survivors look forward to resuming normal life after treatment, but burgeoning evidence suggests that for many the experience doesn't end with their last oncology visit. Survivors often deal with psychosocial issues that affect their school and work performance, finances, sexual health, and self-identity. The range and severity of these issues can vary based on the type of cancer a person has, their disease management, their age when illness occurs, and their personal characteristics.

Many times cancer survivors suffer emotional fallout from their disease. Dr. Gary Deimling, a researcher at Case Western Reserve University in Cleveland, notes that nearly half of all long-term survivors continue to have worries about recurrence or new cancers, or that symptoms they experience may be cancer related. There is also some concern that these worries are relatively strong predictors of depression.

Despite these obstacles, a positive attitude and self-identification can help survivors cope with the after-effects of cancer. Dr. Deimling notes that an individual's self-identification as a cancer survivor is associated with that person's level of optimism and self-esteem, and could promote better mental health outcomes.

Cancer survivors sometimes experience problems with sexual health, including a loss of desire for sex, impaired fertility, erectile dysfunction in men, and painful sexual intercourse in women. According to an article published in Hematology last year by Dr. Leslie Schover of the University of Texas M.D. Anderson Cancer Center, cancer treatment can "damage reproductive health in ways that are profound and often permanent. [But] interventions that prevent or reverse these problems will greatly improve the quality of life of our patients."

Dr. Schover recently listed a number of evidence-based interventions to address some of these effects - including cryopreservation of sperm, eggs, and embryos, as well as conservative surgical and hormone treatments - as a participating author of the American Society of Clinical Oncology's fertility preservation guidelines, which were published June 20 in the Journal of Clinical Oncology.

Often, cancer survivors face increased costs for medical care and personal expenses after cancer, such as those associated with transportation to and from treatment or lost days of work. Furthermore, dietary needs and lingering side effects such as fatigue, neuropathy, or cognitive changes may affect their performance at work or school.

"Work is particularly important for many cancer survivors because it provides income, health insurance, purpose in life, and even social relationships," said Dr. Carolyn Messner of CancerCare, a nonprofit organization that helps cancer survivors by providing free counseling, telephone and online support groups, education programs, and financial assistance.

"Returning to work represents a return to the routine that survivors were used to before they had cancer. Work reminds them that they can get back to normal activities." Also, Dr. Messner adds, survivors should pace themselves when returning to work and may require a workplace accommodation to manage long-term effects of cancer.

"The important message here is that cancer is often a life-altering and potentially traumatic event," explains Dr. Julia Rowland, director of NCI's OCS, "but we can make recovery easier by educating survivors on what to expect, giving them ways to manage stress, teaching them effective behavioral and coping skills, and directing them to resources that can help them not merely survive, but hopefully thrive after treatment."

 Copyright 2006 National Cancer Institute