Heal Your Whole Self After Cancer

The cancer may be gone, but why do you still feel ill?
By Julie Silver, MD

Imagine you go to the doctor for an annual physical… in general, you feel terrific. Yet during your examination, a screening test reveals that you have cancer. Although you don’t feel sick, you don’t need the doctor to tell you your life might end sooner than later without treatment.

One month later, you have had surgery and will soon begin chemotherapy. You’re in pain and the drugs that are supposed to help prolong your life make you incredibly ill. Three months later, your radiation therapy begins. Before you had cancer, you didn’t realize that radiation therapy is given every day of the week. You wonder how you are going to drag your beaten-down body to the hospital or clinic to get this daily therapy. Somehow, like millions of other cancer survivors, you make it through the worst of the treatments. Your oncologist tells you that your prognosis looks promising. But you feel worse than you have ever felt in your life.

According to recent research, the number one cause of distress in cancer survivors is their inability to function well. People generally seem to adjust to the fact that they have cancer, but they don’t adjust well to a life marked by disability. Why not?

Perhaps it is because cancer is virtually the only diagnosis in which patients are told to go home and figure out on their own how to heal. In nearly every other serious injury or illness, stroke or heart attack for example, people are offered rehabilitation. The same is true for individuals who have been injured in car accidents or have had hip replacements or a host of other serious health issues. But it has long been the practice to send cancer patients home after treatments—when they are sicker than they have ever been—and to tell them to “accept a new normal.”

A Paradigm Shift

There are more than 12 million cancer survivors in the United States alone, and they are, rightly so, beginning to be vocal about acquiring recovery help after cancer treatments. Sure, there are many things cancer survivors can do on their own to help themselves, but many want their doctors to prescribe the best treatments and to work with them holistically to facilitate healing. If you are a cancer survivor, here are a few questions to consider:

1. Am I candidate for cancer rehabilitation?

Yes, if you have any problems that you didn’t have before your diagnosis, especially if these problems interfere with your ability to function or with your quality of life, you are a candidate for cancer rehabilitation. Just a few of the possible side (and after) effects of treatments are pain, fatigue, weakness, sleep difficulties, and anxiety.

2. Will my insurance cover cancer rehabilitation?

Yes, insurance should cover costs if professionals with healthcare degrees and licenses in rehabilitation medicine offer the rehabilitation program. These include physiatrists (doctors), physical therapists, occupational therapists, and even speech therapists. Other team members’ services that your insurance will usually cover (if care is delivered in a healthcare setting) include nursing and mental health.

3. My hospital is developing a survivorship care plan—does this mean that I will be offered cancer rehabilitation?

Survivorship care plans are being developed throughout the United States and other countries. Any plan is only as good as the services it offers. So, you won’t necessarily be offered cancer rehab just because a plan is in place. If the services aren’t there to support the plan, they won’t happen.

4. How can I get referred to cancer rehabilitation?

Start by talking to your oncologist or primary care physician. Let him or her know that you think there is room for you to feel better with cancer rehabilitation. Ask about an appropriate referral. You won’t know what is available until you ask. Don’t skip this step—ask your doctor whether there are cancer rehabilitation services available to help you heal as well as possible.

Develop a Plan to Heal

Healing from toxic cancer treatments is ideally done as holistically as possible. While medications and other conventional treatments may continue to be necessary, much healing can be accomplished using therapies that support the recovery process naturally.

To develop a plan, there are two things that will help. First, set some attainable goals. For example, your goal may be to walk one mile a day at the local track, or that you will stop skipping breakfast and eat a nutritious meal in the morning. Then, once you develop a list of goals (three to five goals is a fine start), track your activities for three days. Every hour write down what you are doing and how you feel when you’re doing it. For example, note when you feel particularly tired or if you have pain, during what time, and during what activity.

This log of your daily activities will tell you a few things. You’ll be able to see whether what you do every day supports your goals. The lists should match up fairly well; for example, if your goal is to walk one mile at the track every day, but you never make it to the track because you are bogged down with chores and errands, then you might want to make an adjustment in your schedule. Perhaps you could go to the track in the morning before you begin your day. The main point here is that if you have healing goals, they need to take priority.

Your log will also tell you when you feel particularly tired or have pain. This will allow you to make adjustments that help alleviate your symptoms. For instance, if you have pain every morning around 11 and this correlates with time sitting at your computer, then perhaps you need to get up and move around more. You can be a detective and solve a lot of your own health problems by tracking your symptoms and activities.

Promote Physical Activity

Many cancer survivors feel so tired that they don’t want to move around much. The majority of survivors decrease their activity during treatment and this often continues for the rest of their lives. Ironically, to feel better, one of the best things that people can do is to keep active. An easy way to do this is to get a pedometer and track your steps. The goal for active, healthy people is 10,000 steps each day. If you are below this level and can safely bump up your activity level (talk to your doctor about this), set a goal to increase the number of steps you take a day.

Tap into the Mind-Body Connection

Every cancer survivor is worried; it is a part of the experience and there is simply no getting around it. It’s natural to worry about your health. But, the one thing that you can try and avoid is worrying about being worried. Don’t force yourself not to be worried; just accept how you feel. Go one step further and try to do things that decrease stress by participating in activities you enjoy. You can meditate, go for walks, listen to music, join a yoga class, or do whatever it is that relaxes you. Set a goal to do something relaxing every day to try and set your mind at ease as much as possible.

Sleep Well

It may be hard to sleep well during or after cancer treatments. There are a number of “sleep hygiene” techniques that can facilitate a good night’s sleep. Avoid caffeine after lunchtime and exercise or alcohol before bedtime to promote sleep. No one feels energetic unless they’ve had a good night’s sleep. So if you aren’t able to achieve this on your own, have a conversation with your doctor and explain why it is that you think you aren’t sleeping well (most people can pinpoint what keeps them awake, such as pain, hot flashes, or worry).

Take Supplements

Supplements taken during cancer treatment may or may not be helpful. Sometimes drug-herb interactions can be harmful—for example, certain herbs may make chemotherapy less effective. Therefore, it’s important to talk to your doctor during cancer treatment about all prescription and nonprescription medications, as well as supplements.

Gain Confidence

A cancer diagnosis is devastating and often makes people feel vulnerable. Take control of your healing to develop confidence in your body and spirit. Create a plan even with small goals—it can help you go a long way toward feeling better physically and emotionally.

 

Julie Silver MD, is a physiatrist (rehabilitation specialist), an assistant professor at Harvard Medical School, and a breast cancer survivor. She is the author of You Can Heal Yourself: A Guide to Physical and Emotional Recovery After Injury or Illness (St. Martin’s Press, 2012). For more information about Dr. Silver and her book, visit JulieSilverMD.com.