Q. I had a post-cancer check-up recently and it is all clear. My doctor says it was caught early and I should do well. This was great news so why do I feel so down?
Dr Nina replies: Cancer is a word that rings fear in most. Hearing the word in reference to yourself or a loved one causes a cascade of emotions that can take months and years to overcome. The treatment itself can be long and arduous and recovery is not always guaranteed. It is no wonder that up to one in four of those diagnosed with cancer will experience some form of mood change.
Cancer care is improving all the time. Patients are usually very well informed about what to expect during treatment but the after effects aren't always so well described. Nearly every patient I see who has gone through cancer treatment experiences some form of mood change afterwards. This is most common in the days and weeks after they have been given the all-clear. I refer to this as the "post-cancer adjustment reaction". The diagnosis of cancer brings its own stress. The body goes into fight or flight mode, releasing all the stress and energy hormones it can. The days, weeks and months that follow are filled with hospital stays and appointments, chemotherapy and radiotherapy treatment - sometimes complicated by infections or further physical ills. Patients often get through this time on a wave of adrenaline that helps them cope.
The check-up that brings the good news of cure should be a happy day but the calm that follows often is the time where the true emotional impact of the previous months takes its toll. Feelings of anger, depression, guilt, anxiety, fatigue and a sense of dread are all really common. Many have made promises to themselves that life will be different once cancer ends, and if this doesn't happen, even more guilt can set in. Physical scars and change may bring emotional turmoil and adjusting to the new you can take time.
It is important to recognise that you are not alone with these emotions. Tell your family and friends how you feel. Talk to your GP. Engage a professional counsellor. Connect with cancer support services such as ARC House or others. Connect with other cancer survivors at peer group meetings or on social media. They will know how you feel and can be a great source of support and advice. Learn how to practice mindfulness; it can help greatly.
Don't put too much pressure on yourself to physically bounce back straight away. Focus on a healthy lifestyle. Eat well. Drink plenty of water. Don't rely on alcohol as a stress release. Gently return to exercise. Walking and yoga may be easier on the body and really helpful to the mind. Enquire about a post-cancer rehab class. This will help improve your strength and your confidence in your abilities. Get plenty of restful sleep. This heals body and mind. Remember, treatment likely ran for six months to a year. Healing takes time too. The good news is the majority of people do get back to themselves and today more cancer survivors are leading full and happy lives. Mental and physical recovery is possible.
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