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Colorectal Cancer: Post Treatment 6 Months +: Emotional Well Being: Stages II,III,IV


It is a myth to think that you can put cancer behind you with no emotional aftermath. The severity of emotional swings generally lessens over time, but can surface at unexpected times.

Emotions To Watch For:

  • It is common to feel anxiety or even panic about whether colorectal cancer will come back (known as "fear of recurrence"). This is particularly to be expected when a medical checkup is scheduled or you get any physical symptoms such as a cold. (Survivorship A to Z provides information about how to get through the often anxiety provoking period of waiting for test results).
  • It is not unusual to feel out of place or alone in a world of healthy people. It is likely that colorectal cancer caused you to look at death, perhaps for the first time. The experience may have changed your perspective and what is important to you.
  • People don't give you room. People who do know about what just happened expect you to be joyful and happy about eliminating cancer.
  • Watch for signs of depression. Depression is not unusual - especially during the first 24 months after the end of treatment.  Depression is usually treatable.
  • Any of the other emotions you experienced during treatment may resurface periodically.

Expect Anxiety Before Medical Appointments

  • Most people report being anxious in the days and hours before medical appointments and exams, especially those that are made as a result of a call about symptoms.
  • If you call with a question about a symptom, and the office takes the symptom seriously, keep in mind that the office is just playing it safe.
  • To help cope, consider techniques noted in How To Cope With Fear Of An Upcoming Appointment With A Doctor, Techniques For Coping With Stress
  • It may help if you take a friend with you to appointments.  (A friend also helps raise questions during appointments and recall what is said afterward). At the least, let friends know you are anxious before appointments and would appreciate their checking in on you. For information about friends who go with appointments with you,,including who to choose and who does what, see Patient Advocates..
  • NOTE: Prior to medical appointments, you can help make effective use the time if you:
    • Keep track of your symptoms. See Survivorship A to Z's Symptoms Diary to help. (With the click of a button, an easy-to-read graph is created that you can take with you to the doctor.)
    • If tests are likely to be ordered during the appointment, find out if you can schedule them ahead of time. This way you can discuss the results when you are with the doctor instead of over the telephone. This technique also avoids an additional stressful waiting period.

How To Cope With Ongoing Emotional and Social Needs

  • Use whatever coping mechanisms you used to get you through treatment and other difficult life experiences.
    • They worked before. They are likely to work again.
    • A few examples of what has worked for other people may help trigger thoughts about what has worked for you in the past:
      • Kristy irons naked.
      • Jamie cleans when she starts to feel overwhelmed by emotion.
      • Terri created a corner of her home that felt sacred. Such a apace may only have a candle or some fresh flowers. She spent about 10 minutes a day being there - taking deep breaths, giving herself pep talks, and saying prayers.
  • Do what you can to keep a positive attitude. To learn how, click here.
  • Share your emotions. Don't keep emotions bottled up. Some of the ways to express emotions include:
  • Make contact with another person who has gone through a similar cancer experience about the same time you did. (A colorectal cancer buddy)
    • If you were treated for cancer 10 years ago, the experience was likely different than the experience of a person who was treated 5 years ago and from a person treated today.
    • You can find other long term survivors through a variety of sources including:
      • A national disease specific nonprofit organization, such as Colon Cancer Alliance, offsite link, tel: 877.422.2030 or The American Cancer Society: offsite link or 800.ACS.2345.
      • The Cancer Support Community (formerly Gildas Club Worldwide and The Wellness Community). See: offsite link.
      • The ACOR long term survivors list connects people with similar cancers online. See: offsite link Click on "Mailing Lists." Then, under "Survivorship," click on "Long Term Survivors."
      • Your cancer center or possibly staff in your cancer doctor's office.
    • Young men and women: Check out the following organizations devoted to young people with cancer:
  • Writing And Creative Activities
    • Experience indicates that expressing emotions through writing or other creative activities helps people cope.
    • There is no right or wrong way to write or to be creative. You don't need to show your writings or creations to anyone if you would prefer to keep them private.
    • If you haven't kept a journal before, Survivorship A to Z provides tips. Click here.
  • Support Groups
    • Consider joining a support group of people who are post treatment for about the same amount of time you are.
    • If you finished treatment five years ago, you won't likely find much support in a group of people who just completed treatment.
    • Many cancer centers have support groups for longer term survivors. Or you can find a support through the resources noted above about making contact with another person.
    • In addition to emotional support, groups are a great source of practical tips and information.
    • The length of time to stay in a group depends on the individual. You will know when it is time to stop. When you feel that way, give the group a few more sessions to be sure.
    • You can find colorectal cancer support groups through the following non-for-profit organizations which are listed in alphabetical order:
    • For self help groups see: Self Help Groups.
    • If you are a young man or woman, other sources include:
  • Consider joining or starting a self help group.
    • A self help group is a support group that is led by members of the group rather than a professional.
    • Keep in mind that the information you see or hear may not be accurate. Verify all information before acting on it.
  • Consider volunteering with a group of volunteers.
    • For instance, Colon Cancer Alliance, Tel.: 877.422.2030.
  • Go on line to an online chat room.
    • If you join a chat room, keep in mind that information there may be wrongVerify all information you learn from a chat room or bulletin board before acting on it.
  • Consider getting a pet
    • Studies indicate that pets are good for your emotional health. As noted in our medical care section, pets may possibly even be good for your physical health
    • The pet doesn't have to be a dog or cat. Look for a pet that fits your lifestyle and budget. Our article, Pets 101 not only tells you how not to get sick from your pet, it also includes such practical information as how to travel with a pet and whether to get pet insurance.
  • Do something life affirming
    • People who have lived through colorectal cancer suggest doing something life affirming such as planting a tree, or perennials in the spring, or bulbs in the fall.
    • Start a project that will take a long time to complete.
    • Some men and women even go back to school. (You cannot be discriminated against because of your health history. To learn more, see: Americans With Disabilities offsite link provides college scholarships to current and former cancer patients.)
  • Turning to religion or spirituality can help.
    • Clergy men and women are good listeners, and are often trained at helping with emotional issues. As a general matter, you do not need to be a practitioner or a member of a religion to speak with a clergy person of that faith.
    • There are many paths to spirituality. The right path is the one that works for you - whether it's through religion, new age thinking or your individual belief.
    • To help find the meaning of the experience, click here.
  • Medication or Professional Help
    • Talk with a professional mental health therapist who has experience working with people after cancer treatment if any of the following happen: 
      • You feel like you're getting stuck emotionally.
      • You have trouble sleeping.
      • You are frequently teary or upset for no reason.
      • Your weight continues to fluctuate.
      • You lost interest in your usual activities and friends.
      • You fixate on your cancer experience.
      • You think you need it.
    • Check your insurance to see if mental health is covered. If it is, what are the limitations and restrictions?
    • NOTE: Especially during the first year after treatment, it is not unusual for anxiety and fear of recurrence to surface before doctor appointments and while waiting for test results. This type of anxiety may continue for a very long time. There are techniques available to help you through these periods. See: Anxiety And How To Cope With It, How to Cope With Fear Of Recurrence

Decide How To Define Yourself

  • It becomes important how you define yourself. The word "survivor" means different things to different people. The word(s) you use help you process what has been happening and where you are. The word(s) also help define you in the world. Keep in mind that you are a person who had colorectal cancer. Colorectal cancer was and is not your life. It is not your life today. It is worth taking a look at You Are Not Your Sally Fisher.
  • If you need help, consider speaking with a professional therapist, or a clergy person.

If You Completed Treatment Less Than Five Years Ago

  • Do not be surprised if every cough, flu-like symptom, or pain that is similar to the pain you felt before treatment triggers the thought that your cancer may have returned.
  • The transition after treatment takes time. Dr. Julia Rowland, a noted psycho-oncologist, suggests that the time to a return of a feeling of normalcy is generally about the same as the time between the first diagnosis and end of treatment. If that period was 18 months, expect at least 18 months to recover.
  • Emotional swings will likely be less and less over time.
  • If there is a Cancer Support Community in your area, check it out. (The Community is a result of a merger of Gildas Club Worldwide and The Wellness Community). The Cancer Support Community offsite link provides a community of cancer survivors with a like experience.

If You Completed Treatment More Than Five Years Ago

  • 5-year survival rates are used by medical scientists as a simple measure that allows them to compare outcomes of different treatments. They are also used by doctors to discuss a patient's prognosis in general. 5-year survival has no medical significance as such. However, surviving 5 years after treatment is an encouraging landmark. The longer you survive, the better your chances of remaining cancer free.
  • If fear of recurrence comes back, keep in mind that if colorectal cancer does recur, the medical treatments and handling of side effects have evolved since you had your treatment. You survived it once. You can do it again. (Also keep in mind that fear is only a thought. Thoughts can be changed).
  • Do not be surprised if other emotions unexpectedly surface periodically.

If Your Colorectal Cancer Was Not Eliminated

  • Do not be surprised if you feel overwhelmed occasionally. There may even be periods of obsessive worry, sleeplessness, and lack of concentration. 
  • Experience indicates that it is particularly helpful to reach out to other people in a similar situation, preferably through a professionally guided support group. Also consider making contact with a cancer buddy in a similar situation. 
  • If emotions interfere with life, reach out to a mental health professional with experience in helping people cope with a life changing health condition. 
  • For information about advanced colorectal cancer, click here

NOTE: If you work, if you want to be considered to be "disabled" so you can obtain disability benefits under programs such as Social Security Disability Insurance (SSDI) or a private policy, keep in mind that an emotional condition such as depression can be disabling as well as or in addition to a physical condition such as breast cancer. Be sure to tell your doctor about symptoms of depression and ask that he or she make a note in your file "just in case."

For additional information, see:

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