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AFTER CANCER: FOLLOW-UP

You are a cancer survivor. Although you would like to put your cancer totally behind you, you are different now. In order to minimize your chance of future problems, you need to be evaluated periodically for evidence of problems from your cancer or its treatment. This section will teach you about your follow-ups and about available treatments aimed at keeping you healthy and preventing recurrence.

What Is the Purpose of Routine Follow-up?
Regularly scheduled checkups allow your oncologist to "follow you." This involves • monitoring the continuing response to your treatments net to
• evaluating and treating problems left over from your cancer or small l1 cancer treatments months
• looking for signs of complications or aftereffects of the treatments
• looking for signs of recurrent cancer

What Determines What Is Needed at My Follow-up Visits and Their Frequency?
Many factors affect the specifics of your follow-up evaluations:
• your type of cancer
• your type of treatment
• the length of time since your last treatment
• the stage of your cancer at the time of diagnosis
• the rapidity with which your cancer was growing at the time of diagnosis
• the presence or absence of persistent problems related to your cancer or cancer therapy (e.g., abnormal blood tests and lung/ digestive/kidney problems)
• tests needed for data collection if you were part of a clinical trial
The routine follow-up schedule provides only a broad guideline. Exactly when you have your follow-up and what is done there must be tailored to your circumstances.

    *14/32/5*

AFTER CANCER: FOLLOW-UP

You are a cancer survivor. Although you would like to put your cancer totally behind you, you are different now. In order to minimize your chance of future problems, you need to be evaluated periodically for evidence of problems from your cancer or its treatment. This section will teach you about your follow-ups and about available treatments aimed at keeping you healthy and preventing recurrence.

What Is the Purpose of Routine Follow-up?
Regularly scheduled checkups allow your oncologist to "follow you." This involves • monitoring the continuing response to your treatments net to
• evaluating and treating problems left over from your cancer or small l1 cancer treatments months
• looking for signs of complications or aftereffects of the treatments
• looking for signs of recurrent cancer

What Determines What Is Needed at My Follow-up Visits and Their Frequency?
Many factors affect the specifics of your follow-up evaluations:
• your type of cancer
• your type of treatment
• the length of time since your last treatment
• the stage of your cancer at the time of diagnosis
• the rapidity with which your cancer was growing at the time of diagnosis
• the presence or absence of persistent problems related to your cancer or cancer therapy (e.g., abnormal blood tests and lung/ digestive/kidney problems)
• tests needed for data collection if you were part of a clinical trial
The routine follow-up schedule provides only a broad guideline. Exactly when you have your follow-up and what is done there must be tailored to your circumstances.

    *14/32/5*

AFTER CANCER: DO I HAVE TO BE TOLD I AM “CURED” OF MY CANCER IN ORDER TO HOPE TO FEEL NORMAL AGAIN?

 Absolutely not. Normal life after any crisis or change means learning how to adjust to all the changes. You will probably not feel the same after surviving cancer as you did before your diagnosis, but you probably will not feel normal again.
Change, loss, and fear are not unique to cancer survivors. Many chronic diseases other than cancer require ongoing medical care and demand changes in the day-to-day details of diet, activities, and relationships. Survivors of other chronic diseases work, lead stable family lives, and feel normal. People with diabetes, arthritis, or emphysema learn to adjust and compensate for their physical problems with the help of medications, physical therapy, walking aids, and dietary restrictions. Each of these diseases is potentially life threatening, yet people learn to live well and feel normal again, despite the risks and limitations imposed by their illness. These people do not feel the same as they did before their illness began, but they feel normal. People living with cancer can learn to lead normal, fulfilled lives, too, despite the need for ongoing follow-up and therapy.
Feeling normal is a state of mind in which you are adjusted to your circumstances. Maintaining your sense of normal throughout life involves accepting and adjusting to an unending series of changes, whether related to aging, illness, or injury. You would have had to adjust to some physical changes even if you had not developed cancer.
Unwanted change is an issue for everyone. Healthy fifty-year-olds are very different physically, emotionally, and spiritually from their earlier, adolescent selves. Yet a healthy fifty-year-old person usually feels "normal" despite the changes in vision, hair and body fat distribution, and muscle mass. Many of the changes accompanying cancer resemble those of healthy aging. There is much to be learned from people who grow old gracefully and continue to live full lives throughout their days.
You may resent or resist having to make adjustments after completing your cancer therapy. Understandably, it is easier to adjust to age-related than to cancer-related changes, because they are gradual, expected, and shared by others in your age group. With time, you can adjust to the unexpected, relatively sudden changes brought on by your cancer and its treatment. Normal life, with or without cancer, involves change.
Another reality needs to be mentioned: being in remission long enough to be considered "cured" does not magically eliminate the fears, anxieties, and potential medical problems. Too many people who are cured of their cancer continue to have medical or emotional problems related to their earlier treatment. Being cured does not necessarily make you feel normal.
Whether or not you feel normal or happy depends on how you adjust to the changes related to your cancer. Many survivors in temporary remission from incurable cancers or with stable, persistent cancer, as well as those who are cured, experience fulfilling, happy, normal lives without significant physical or emotional problems.
Take steps both to maximize the meaning and enjoyment of each day and to maximize your chance for cure or durable remission. Working toward the goal of personal peace and fulfillment is life enriching, and possibly life lengthening, no matter what your circumstances.

Cure is not a magical state where all problems end. Aim for personal peace no matter what the specifics of your cancer situation.

          *9/32/5*

AFTER CANCER: DO I HAVE TO BE TOLD I AM “CURED” OF MY CANCER IN ORDER TO HOPE TO FEEL NORMAL AGAIN?

 Absolutely not. Normal life after any crisis or change means learning how to adjust to all the changes. You will probably not feel the same after surviving cancer as you did before your diagnosis, but you probably will not feel normal again.
Change, loss, and fear are not unique to cancer survivors. Many chronic diseases other than cancer require ongoing medical care and demand changes in the day-to-day details of diet, activities, and relationships. Survivors of other chronic diseases work, lead stable family lives, and feel normal. People with diabetes, arthritis, or emphysema learn to adjust and compensate for their physical problems with the help of medications, physical therapy, walking aids, and dietary restrictions. Each of these diseases is potentially life threatening, yet people learn to live well and feel normal again, despite the risks and limitations imposed by their illness. These people do not feel the same as they did before their illness began, but they feel normal. People living with cancer can learn to lead normal, fulfilled lives, too, despite the need for ongoing follow-up and therapy.
Feeling normal is a state of mind in which you are adjusted to your circumstances. Maintaining your sense of normal throughout life involves accepting and adjusting to an unending series of changes, whether related to aging, illness, or injury. You would have had to adjust to some physical changes even if you had not developed cancer.
Unwanted change is an issue for everyone. Healthy fifty-year-olds are very different physically, emotionally, and spiritually from their earlier, adolescent selves. Yet a healthy fifty-year-old person usually feels "normal" despite the changes in vision, hair and body fat distribution, and muscle mass. Many of the changes accompanying cancer resemble those of healthy aging. There is much to be learned from people who grow old gracefully and continue to live full lives throughout their days.
You may resent or resist having to make adjustments after completing your cancer therapy. Understandably, it is easier to adjust to age-related than to cancer-related changes, because they are gradual, expected, and shared by others in your age group. With time, you can adjust to the unexpected, relatively sudden changes brought on by your cancer and its treatment. Normal life, with or without cancer, involves change.
Another reality needs to be mentioned: being in remission long enough to be considered "cured" does not magically eliminate the fears, anxieties, and potential medical problems. Too many people who are cured of their cancer continue to have medical or emotional problems related to their earlier treatment. Being cured does not necessarily make you feel normal.
Whether or not you feel normal or happy depends on how you adjust to the changes related to your cancer. Many survivors in temporary remission from incurable cancers or with stable, persistent cancer, as well as those who are cured, experience fulfilling, happy, normal lives without significant physical or emotional problems.
Take steps both to maximize the meaning and enjoyment of each day and to maximize your chance for cure or durable remission. Working toward the goal of personal peace and fulfillment is life enriching, and possibly life lengthening, no matter what your circumstances.

Cure is not a magical state where all problems end. Aim for personal peace no matter what the specifics of your cancer situation.

          *9/32/5*

AFTER CANCER: ABOUT ALTERNATIVE THERAPY

What Is Alternative Therapy?
Alternative therapy is cancer treatment offered instead of conventional medical therapy, often with the claim that it will give better chance against your cancer, with fewer side effects. Alternative therapy is not the same as investigational or experimental therapy. Examples of alternative therapy include laetrile (the apricot pit medicine), herbal tonics, homeopathy, acupuncture, and metabolic therapy.
Every conventional therapy’s effectiveness against cancer has been determined by numerous rigorous, scientifically sound studies. In contrast, no alternative therapy has been shown in a controlled scientific study to be more effective than conventional therapy in curing cancer. All of the well-investigated alter therapies have been shown to be less effective or ineffective curing or controlling cancer.
Testimonials documenting the effectiveness of alternative therapies abound. Although exciting and inspiring, they do not constitute scientific evidence. The US National Institute of Health has established the Office of Alternative Medicine to assess sciententifically the value of alternative therapies. The information studies provide will enable people to make informed decisions about the role of alternative therapy in their cancer treatment.
People with cancer have been using alternative treatment thousands of years. Only in the past thirty years have large numbers of people with cancer been cured or enjoyed long survival and this is due to advances in science and technology. Conventional therapy is far from perfect, but by all rational measures it represents the safest and best treatment for cancer available to you at this time.

Why Would I Consider Alternative Therapy Now, after I Have Completed My Conventional Treatments?
There are many reasons why you may consider alternative therapy:
•You may feel the need to be doing something active to treat your cancer or prevent your cancer from recurring. After completion of conventional treatment, the usual prescription from conventional oncologists is to "wait and see."
•You may feel discouraged with the toll conventional therapy has taken and want to get away from conventional medicine.
•You may feel the need to be followed more closely than conventional therapy recommends, so you see alternative therapy as another setting for closer follow-up.
•After treatment may be the first time you have the energy to look at anything other than the treatment you were getting.
•Well-intentioned friends and family may pressure you to look into alternative therapies.
•A desire for control of your situation may lead you to alternatives.
•You may find the alternative-medicine practitioner more optimistic than your oncologist.
•You may find the setting of alternative medicine more comfortable and soothing than the offices and hospitals of conventional medicine.

    *36/32/5*

AFTER CANCER: ABOUT ALTERNATIVE THERAPY

What Is Alternative Therapy?
Alternative therapy is cancer treatment offered instead of conventional medical therapy, often with the claim that it will give better chance against your cancer, with fewer side effects. Alternative therapy is not the same as investigational or experimental therapy. Examples of alternative therapy include laetrile (the apricot pit medicine), herbal tonics, homeopathy, acupuncture, and metabolic therapy.
Every conventional therapy’s effectiveness against cancer has been determined by numerous rigorous, scientifically sound studies. In contrast, no alternative therapy has been shown in a controlled scientific study to be more effective than conventional therapy in curing cancer. All of the well-investigated alter therapies have been shown to be less effective or ineffective curing or controlling cancer.
Testimonials documenting the effectiveness of alternative therapies abound. Although exciting and inspiring, they do not constitute scientific evidence. The US National Institute of Health has established the Office of Alternative Medicine to assess sciententifically the value of alternative therapies. The information studies provide will enable people to make informed decisions about the role of alternative therapy in their cancer treatment.
People with cancer have been using alternative treatment thousands of years. Only in the past thirty years have large numbers of people with cancer been cured or enjoyed long survival and this is due to advances in science and technology. Conventional therapy is far from perfect, but by all rational measures it represents the safest and best treatment for cancer available to you at this time.

Why Would I Consider Alternative Therapy Now, after I Have Completed My Conventional Treatments?
There are many reasons why you may consider alternative therapy:
•You may feel the need to be doing something active to treat your cancer or prevent your cancer from recurring. After completion of conventional treatment, the usual prescription from conventional oncologists is to "wait and see."
•You may feel discouraged with the toll conventional therapy has taken and want to get away from conventional medicine.
•You may feel the need to be followed more closely than conventional therapy recommends, so you see alternative therapy as another setting for closer follow-up.
•After treatment may be the first time you have the energy to look at anything other than the treatment you were getting.
•Well-intentioned friends and family may pressure you to look into alternative therapies.
•A desire for control of your situation may lead you to alternatives.
•You may find the alternative-medicine practitioner more optimistic than your oncologist.
•You may find the setting of alternative medicine more comfortable and soothing than the offices and hospitals of conventional medicine.

    *36/32/5*