Ask the doctor
By Karen Syrjala, PhD
Director of Biobehavioral Sciences and co-director of the Survivorship Program at Fred Hutchinson Cancer Research Center
Q: As I move from active treatment to survivorship, how can I ensure that I am getting the care I need and doing all that I can to avoid recurrence?
A: The following are 10 tips for moving forward.
Get a summary of your treatments. Have a list of what surgery, radiation, and chemotherapy doses you received so that you can communicate these to your primary care providers. This will help you plan for the next tip on the list.
Make a plan for monitoring the long-term effects of your cancer treatment. Talk to your doctor about the potential long-term effects of your treatment and what to watch out for. For example, some cancer treatments can increase the risk of cardiovascular problems or second cancers; others can have an impact on your bones.
Learn how to manage the fear of recurrence. First, find out your risk of recurrence from your healthcare provider. Second, remember that risk is based on averages and does not apply to you as an individual. Third, consider counseling or other assistance to help you face your fears and move forward.
Get moving. If you choose one healthy thing to change in your life, physical activity is likely to have the fastest effect on how you feel and also potentially reduce your cancer-related risks. Make opportunities to walk or take stairs. If it’s just too hard to do alone, find an exercise program to join to get you started. Check your local YMCA for a LiveSTRONG® exercise program near your home or workplace.
Eat well. Your diet doesn’t have to be perfect, but fruits, vegetables, and whole grains can make a big difference in how you feel. Eating healthier foods can make it easier to avoid the things that add weight or complicate digestion. Talk to a nutritionist if you are unsure what is healthy for you or if you have digestion problems.
Live a healthy lifestyle. Exercise and nutrition are just a part of the big picture. To help ensure your long-term survival and a better quality of life, stop smoking, limit alcoholic drinks to one per day, and use sunscreen to protect your skin. Also make sure you get sufficient vitamin D. Your doctor can do a blood test to measure the vitamin D in your body and make recommendations for how to get the right amount.
Reclaim your body. Most women gain weight following breast cancer treatment. Weight control is important. Menopause, tamoxifen (Nolvadex®), and aromatase inhibitors can lead to body changes and weight gain. Check with your doctor and a nutritionist and consider joining an exercise program to help you control your weight and build muscle instead of fat.
Manage your symptoms. Don’t suffer unnecessarily. Talk to your doctor if you have fatigue or lack of stamina that does not improve with time, “chemo brain” that makes it hard to work or remember what you need to do, or other aches, pains, and symptoms that make it hard to enjoy your life. Make an appointment to focus solely on the symptoms that reduce your quality of life.
Connect with other survivors. Although your family and friends are great support pillars, many women find it immensely valuable to talk or exercise with women who have experienced what they have and truly understand what it’s like to be a survivor.
Make use of available resources. Explore the options online and in your community for cancer survivors and especially breast cancer survivors.
For more information about survivorship, visit www.fhcrc.org/patient/support/survivorship, call (206) 288-1046, or check www.LIVESTRONGCarePlan.org.
Dr. Karen Syrjala is a clinical psychologist and the co-director of the Survivorship Program at Fred Hutchinson Cancer Research Center. She also serves as director of the center’s Biobehavioral Sciences Program. Dr. Syrjala says the best thing about working with cancer survivors is their eagerness to live life to the fullest. “I feel honored to do my job because I am working with people at a time of life when they’re most open to new experiences and they’re most able to make changes in their lives,” she says. Dr. Syrjala received her doctoral degree from Boston University and completed her postdoctoral fellowship at University of Washington and Fred Hutchinson Cancer Research Center.
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