The transition from ‘patient’ to ‘person’ after cancer can be challenging. For the months of treatment, most patients are cared for, and aspects of their life controlled, by their oncology care team. For some this is comforting, for others it feels constricting and frustrating. But the treatment phase does end, and some patients find it difficult to transition back to life after treatment and what was once ‘normal’ life.
It is well accepted that life after cancer means finding a new normal. No one can go through the cancer experience and not be affected by it. Many come out stronger with a clearer perspective on what they want their life to be. Others struggle – perhaps because of lingering side effects of treatment or the development of new late effects. Or because they expect to be the same as they were before and aren’t.
One of the interesting effects of the cancer is the experience of post-traumatic or personal growth. This is fairly well described in the literature and refers to a transformative process resulting from the struggle that individuals face living life during and after a traumatic experience (like cancer and its treatments) (Tedeschi & Calhoun, 2004). Researchers (Jim & Jacobsen, 2008) suggest that this growth is evident in three areas:
- Enhanced relationships with family and friends,
- Better personal resources such as increased compassion for others, a more positive outlook on life, and greater spirituality, and
- Improved coping skills
It is thought that younger cancer survivors are more likely to experience this growth because their identity is more fluid and less fixed compared to older individuals. This growth does not happen magically; there needs to be introspection and contemplation of what one has been through. Studies with young adult survivors of osteosarcoma and breast cancer support this. In the first study (Teall, Barrera et al, 2013), survivors attributed their personal growth to the support they received during treatment and of the breast cancer survivors in the second study (Arpawong et al., 2013) 74% reported a changed sense of self and improved relationships with others after cancer.
So what does this mean? Paying attention to how one has changed after cancer may help to ease the transition from ‘patient’ to ‘person’. While there may be physical and emotional changes and challenges, it is also possible to experience personal growth and the benefits that flow from that experience. Noticing this is not going to happen without reflection about how the survivor has changed and grown. But the process of reflection may be therapeutic in itself and may open the door to increased awareness and inner peace.
Arpawong, T. E., Oland, A., Milam, J. E., Ruccione, K., & Meeske, K. A. (2013). Post-traumatic growth among an ethnically diverse sample of adolescent and young adult cancer survivors. Psychooncology, 22(10), 2235-2244.
Jim, H. S., & Jacobsen, P. B. (2008). Posttraumatic stress and posttraumatic growth in cancer survivorship: A review. Cancer Journal (Sudbury, Mass.), 14(6), 414-419.
Teall, T., Barrera, M., Barr, R., Silva, M., & Greenberg, M. (2013). Psychological resilience in adolescent and young adult survivors of lower extremity bone tumors. Pediatric Blood & Cancer, 60(7), 1223-1230.
Tedeschi, R., & Calhoun, L. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry., 15(1), 1-18.
Dr Anne Katz is a clinical nurse specialist and AASECT-certified sexuality counsellor at CancerCare Manitoba. She has written 2 books on the topic of cancer survivorship (After You Ring the Bell: Ten Challenges for the Cancer Survivor [Hygeia Media] and Surviving after Cancer: Living the New Normal [Rowman & Littlefield]) and 3 on cancer and sexuality.
“I am thrilled to be taking on this new role as editor of the Survivorship Section for CKN. Initially you will see regular commentary from me on key aspects of the survivorship experience that I hope will lead you to think about, talk about with your patients and care providers, and then explore further in your own reading and research. Coupled with this will be key references to new research findings in this exciting growth area of cancer care.”
Dr. Katz’ professional life is focused on providing information, education and counselling to people with cancer and their partners about sexual changes that can occur during and after treatment. But there is another important aspect to this work; Dr. Katz wants every cancer patient to be able to have a discussion about sexuality with their health care providers. And so she travels across North America (as well as Europe and the Caribbean!) teaching health care providers to ask their patients about this important part of quality of life.
If you’d like to know more about Dr. Katz and the work she does, or if you’d like her to come to your city or town, health care facility or doctor’s office, you can contact her by email.
“I am always eager to spread the word and break the silence.”