Finishing Treatment: What Comes Next?, with Lidia Schapira, MD

July 11, 2007
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What to expect as you approach the end of your active treatment for cancer.

Transcript: 

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ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world's leading professional organization for doctors that care for people with cancer. In today's podcast we'll discuss what to expect as you approach the end of active treatment. This podcast will be led by Dr. Lidia Schapira, who is a medical oncologist at the Gillette Center for Breast Oncology at the Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School. She specializes in doctor-patient communication and the psychosocial care of people with cancer. ASCO would like to thank Dr. Schapira for taking the time to speak with us about this topic.

Dr. Schapira: Many of my patients want to know what to expect and want sort of a roadmap at the end of active treatment. This is a time that can be one of great anxiety because many people feel that they're not doing enough to actively fight their cancer. And they're also trying to recover perhaps from the side effects or late effects of the treatment they've had, usually chemotherapy, or surgery, or radiation,÷ or any combination of these. So it's a time of physical recovery. It's a time of anxiety. It's a time of excitement thinking about the future and sometimes of great worry. It's very important to try to have a bit of a plan for this. It may be very useful to ask the oncologist at the end of treatment to give you a summary of the treatments you've actually had and to give you an idea of what you can expect. How long it will take you to recover? What can you do if you're worrying about your symptoms or recurrence of cancer? Who can you turn to?

It's also very important to have an idea of what the time line is for the physical recovery, such as, when will you recover your sense of energy? Your sense of well-being? When will your hair grow back? All of these things need to be addressed. Some may recover quite quickly, and others may take a much longer period of time. The period during which you underwent your active cancer treatment may have caused some changes in your family life, in your work life, and you can't expect just to snap of your fingers and get right back to where things were before you had cancer. There may be an adaptation and what you may consider normal after cancer may be different. There may be a new normal. All of these things take patience, take motivation, take focus, and may take a little help.

ASCO: Thank you for this summary, Dr. Shapira. The last few appointments before treatment ends are good times to talk with your doctor about the help you need. These appointments should include time for you to raise any concerns you have above the future, discuss who'll be involved in your ongoing medical care, and provide you with necessary tools to help you in the period immediately after treatment and in the long-term. As Dr. Shapira mentioned, ask your oncologist for an end-of-treatment summary. Which should include the schedule of follow-up visits, recommended tests to monitor your recovery, and early signs that the cancer has returned. You should also discuss how to care for any long-term effects of treatment. For example, certain cancer treatments affect the density of people's bones. So some survivors will need to know how their bones will be monitored and cared for. Specific details on what to expect and what to watch for can provide an important sense of control during this transition period. In addition to monitoring your physical health, be sure to actively care for your emotional well-being.

Many survivors feel that support groups are useful in helping them move forward. Support groups allow people to share experiences and celebrate milestones. It also allows survivors to give and receive advice and support about mutual fears, including the common fear that the cancer will come back. It is important for people who are finishing treatment to be able to identify and understand their fears and talk about them, so they can sort through the available ways to address these concerns. Other people may find support from new hobbies or turning to spiritual advisors. It is also common for survivors to focus their energies into giving something back to the cancer community, because of their experience. The transition from the end of active treatment to survivorship can often raise new and renewed emotional and medical concerns for the person treated for cancer. The unique challenge facing survivors is how to celebrate the joys of the present while recognizing that their life may be forever changed by the experience of having cancer. This recognition should include identifying when and how to ask for the support they need after treatment ends. For more information on this topic contact your doctor or visit www.cancer.net. Thank you for listening to this Cancer.Net podcast.

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