Starting over Living with cancer is a time of challenges and changes. When you’re re-establishing yourself after weeks or months of cancer treatment, don’t expect things to be the way they were before. Instead, focus on finding a ‘new normal’.
Feelings When treatment finishes, the routine contact with your care team will come to an end and the visits from family and friends will probably start to drop away. You may feel less ‘sick’ now that the cancer has gone and treatment is over, but you probably don’t feel all that well. Feelings of fatigue, depression and even pain are very common in the first few months after treatment. The regular attention is gone, but you may still feel like you need some extra care and support.
Be kind to yourself It’s unrealistic to think that you’ll just pick up where you left off. Take it slowly. Bit by bit you’ll feel yourself getting fitter and stronger. Day by day you’ll feel more confident about starting work again or getting back into socialising. Don’t rush things – and don’t let anyone rush you either.
Communicate Your family and close friends may try to help you by involving you in everything that’s going on and reminding you to stay positive and start moving forward. If that bothers you, just remember that their intentions are good. Be honest and tell them that you still have a lot to deal with, emotionally as well as physically, and that perhaps you need to move a bit more slowly.
Make no comparisons Everyone who has been through treatment has different things to think about. Their concerns for the future will vary depending on what kind of cancer they had, how it was treated, what side effects they had to deal with, what their financial situation is, who they have to support them and so on. You’re not recovering any faster or slower than anyone else. Your responses aren’t better or worse. The way you’re processing things is right for you and your unique set of circumstances.
Talk to someone If you feel that the people around you are pressuring you to move on, or that they don’t understand your ongoing concerns, or that they simply have run out of energy for listening, then you could benefit from talking to a counsellor. Ask your GP to put you in touch with someone or call the Cancer Council Helpline on 13 11 20.
Relationships The last few months or years have been a challenge for the people around you, too. They’ve had to take on responsibilities and cope with feelings that were never part of the relationship before you had cancer. Once your treatment has finished, it’s understandable that those people may feel like it’s their chance to focus on their own needs or at least to take a break from their carer role.
Give it time You may feel out of sync with those closest to you. You may sense that they’re anxious to move forward while for you the transition to life after cancer is more of a struggle. This is a time for patience and tolerance on all sides: it’s very likely that those bumps will smooth themselves out with time.
Changing priorities Your experience may have caused you to question your goals and your direction. Don’t forget that those closest to you have also gone through a life-changing experience and may well be reassessing their priorities, too. Those changes could cause friction in your relationship, or they could strengthen it.
Being with kids You may be particularly sensitive to your children’s need to get back to ‘normal’. Being honest and open with them is going to make them feel more secure than if you exaggerate how well you feel and then make promises you can’t keep. If you’re too tired to muck about with them, ask them if there’s something they can do on the bed or the couch while you have a short rest. Being close to you is what matters most to them.
Getting work and money back on track You may find that it takes months or even years to get your career and your finances back to where they were before you had cancer. The recovery could be particularly slow if you choose to go back to work on reduced hours, or if you decide not to go back to work at all. Try to focus on making slow and steady progress.
Can I get help to return to the workforce? If your cancer or cancer treatment have affected the kind of work you can do, you can turn to CRS Australia (formerly the Commonwealth Rehabilitation Service) for help. This government-run program will help you identify what your vocational options are, work with you to get the training you need (including apprenticeships and on-the-job training) and support you through the job-seeking process. CRS Australia may also be able to help you with a return to work program, which involves assessing your capacity to work and negotiating suitable duties at the workplace. For more information on how CRS Australia can help you, including eligibility for services, go to www.crsaustralia.gov.au or call them on 1800 277 277.
Check the benefits You may be entitled to various government payments or allowances which could help you get back on your feet financially. To find out more go to www.centrelink.gov.au or call the Centrelink Customer Service Centre on 13 27 17.
Look into a lump sum Many superannuation policies incorporate total and permanent disability (TPD) insurance. If you can prove that you’re unable to return to your old job or to find work in any similar position, you may be eligible for a disability lump sum or a disability pension (usually paid monthly). This money is quite separate from the superannuation you have accrued during your working life. Follow up with your superannuation fund to see if your policy has TPD insurance. Disability claims can be complicated and can take a long time to process; you may need to get help from a lawyer.
Redo your budgets Returning to work at reduced hours or not at all will impact your finances. You may need to reassess your household budget and your financial goals. If you accessed money from your superannuation fund, you may want to rebuild your nest egg. This could be a good time to speak with a financial counsellor; for contact details, see “More help” below.
Don’t be intimidated Under the Fair Work Act, it is illegal for an employer to reduce your hours, terminate your employment or adversely affect your working conditions on the basis of your cancer or cancer treatment. If you believe you have been disadvantaged, get in contact with the Fair Work Infoline on 13 13 94 for advice on what action you can take.
Living better Evidence is mounting that having a healthy weight and a reasonable level of fitness actually improves your chances of avoiding a recurrence of cancer. Keep up those healthy lifestyle changes you started during your treatment and hatch some new ones, too.
Get started If you’re feeling frail or if you’ve never really been active before, you should start slowly. Think in terms of a more active lifestyle. Instead of emailing someone at work, hop up and walk over to their desk. Walk to the local shops instead of driving to the nearest shopping centre. Take the stairs instead of the lift or escalator. And keep track of your efforts with a pedometer. Your goal should be around 10,000 steps a day.
Bump it up Once you’re feeling really well, you can aim to stay fit by doing at least an hour of moderate exercise or just 30 minutes of vigorous exercise every day. Moderate exercise includes brisk walking, steady swimming and cycling. Vigorous exercise includes jogging, fast cycling, rowing, aerobics and sports like netball, football and basketball.
2&5 Get in the habit of having two serves of fruit and five of vegetables every day. A serve is roughly a handful.
Up the fibre Start eating less fat and more fibre. The simplest way to boost your fibre intake is to replace white bread and white rice with wholegrain bread and brown rice.
Reduce red meat Red meat can be a valuable part of a healthy diet, but don’t overdo it. Aim for a single serve (that’s around two chops or half a cup of mince), three to four times a week. The rest of the time lean towards chicken, fish and non-meat protein such as lentils and chickpeas.
Words to know
Total and permanent disability insurance an insurance policy that provides financial compensation when a permanent disability prevents you from earning an income
Things to ask
Am I going to find it difficult to get finance or insurance now? Your cancer should not affect your access to credit cards, mortgages or loans in the future. It may, however, affect your ability to get insurances that typically incorporate disability or death benefits including life insurance, travel insurance and income insurance. Some insurers may refuse to give you cover, others may charge a higher price than normal. If your insurance is managed through a group such as your employer or union, you may be automatically covered without being required to disclose any information about your health.
Am I depressed – or is this normal? You’re likely to feel quite elated about your recovery at times, and at other times quite downhearted about everything you’ve been through and all the changes you’ve had to endure. These highs and lows are to be expected and may go on for a year or more. However, if your low moods hang around for more than two weeks, you may be experiencing depression. If you have concerns, ask your GP to put you in touch with someone who can help, or call the Cancer Council Helpline on 13 11 20.
Expert's insight: Gill Batt Gill Batt from Cancer Council NSW explains that finishing treatment doesn’t mean that everything goes back to the way it once was. In fact, it’s probably time to define a ‘new normal’.
“There are two stages that people say are the most emotional times. One is when they get the diagnosis and they’re in that little bit of limbo before they start treatment, and the other is when treatment stops.
“While they’re in active treatment, they’re seeing a doctor all the time, they’re a cancer patient. There are constantly things to do, appointments and all that stuff. But when treatment stops and effectively you’re ‘well again’, you often feel a bit abandoned because up until then it’s all been about you.
“The people around you – the family, the friends, the work colleagues who have all gone through some very stressful times themselves – tend to think ‘That’s that. That’s over. Let’s get back to normal.’
“Maybe you’re looking more like yourself and the people around you want everything to be like it was before. But inside you have faced your own mortality, and often you feel very different from how you felt before.
“Talk to the people around you so that they understand that although you might look like you did before, you don’t feel like that. To get a better understanding of all this, maybe you could talk to a counsellor about why you feel the way you do.
“This can be a time when you make big life-changing decisions. You may decide you no longer want to do the nine-to-five, or you want to do something you have always wanted to do and you realise it’s now or never. Quite often there will be change. It’s quite a difficult time for you and the people around you as everyone adjusts to what we call the ‘new normal’.”
FOODcents www.foodcentsprogram.com.au Showing how you can save money by buying, growing and eating fresh food, with recipes.
Go for 2&5 www.gofor2and5.com.au Ideas for increasing your daily intake of fruit and vegetables, with recipes.
National Financial Counselling Hotline 1800 007 007
Photo by Nick Cubbin
KATE Kate battled through breast cancer and depression, but now has a more satisfying life and career.
Kate was 44 and mum to a toddler when she found a lump in her breast in 2004. She had six months of chemotherapy, then chemo medication, a lumpectomy and six weeks’ radiotherapy. Finally, with her cancer in remission, Kate made a career change.
“When I was diagnosed and started the treatment it was disastrous. I had just started a new job and my husband had just begun a new career. I became so sick from the chemo that I had to quit my job and my husband had to stop working to look after me. I ended up on a disability pension and my husband on a carer’s pension.
“My husband has been a fantastic support, but after the first full year of treatment I fell into a pit of depression. I was frightened for my life – the chemo almost killed me at one point – and frightened of ending up on the street. I felt lost and anxious and was obsessing about the cancer returning.
“It took a long time for me to start to bounce back, but after the trauma of the first three years, I began to have the energy, and opportunity, to head in a more positive direction. I found a place within myself to manage my fear of recurrence – living with this fear has become the new normal for me.
“Life before cancer had been a stressful juggle and the illness forced my husband and I to take time out and re-evaluate. My husband upgraded his IT skills at TAFE and has since found a better job. I’d been an art therapist and family therapist, but I couldn’t face it and instead went to art school. This led to grants and prizes, but art is no way to make a living, so now I work part-time training art psychotherapy students.
“In a strange way we are better off now than we were before. Going back to art has been something fabulous for me. I wish I’d done it earlier. It’s been great finding a way to manage as an artist and balancing a family. Despite moments of caution and despair, overall I’m much more positive about how things are going to pan out.”
Photo by Pip Blackwood
CHRIS BOYD Chris Boyd was just 20 when he was diagnosed with cancer in February 2009. It had a profound impact on his outlook.
After successful treatment, he decided to use what he had learned to set up Australian Youth Against Cancer*.
“I’d had a worsening pain in my right ear and head for months. A biopsy revealed an embryonal rhabdomyosarcoma in my nasopharynx – a head and neck cancer. Surgery was going to be too invasive so I had chemotherapy and radiotherapy. Four months later there was no visible trace of my tumour.
“Shortly after my diagnosis I left my job as a waiter at a sailing club and focused on the challenges ahead. Initially I was determined to persevere with my law degree [at the University of Technology, Sydney], but the combined treatment took such a toll that I couldn’t face the train journey into the city to study. Instead I spent two weeks in Vancouver with my girlfriend Faye and went back to uni for the next semester.
“Going through chemo is a struggle. Away from hospital I found myself a bit lost and in disbelief. But I had a very close group of friends at uni who were key to my recovery in those first few months, as were my family and girlfriend.
“In late 2009, I began to feel that my cancer experience was behind me. I started to reflect on my journey and realised that I wanted to get involved and help raise money for cancer research and treatment.
“I also decided I wanted to live life like I wouldn’t have dared to before. For years I’d wanted to kayak the Murray River. After talking with my mate Ian Bacon, we decided that in December 2010 we’d spend two months and 2600 kilometres kayaking the river to raise money for Lifehouse at RPA.
“I still feel the same as I did before and I believe it’s important to understand that cancer doesn’t change who you are. But cancer can teach you some very valuable lessons about life.”
* Go to www.ayac.com.au for more on Australian Youth Against Cancer.