AD­JUST­ING TO A “NEW NOR­MAL”

Life after breast can­cer treat­ment.

Woman's Era - - Short Story - By Dr. D C Do­val

Women un­der­go­ing breast can­cer treat­ment hope that once their treat­ment (surgery, chemo­ther­apy or ra­di­a­tion) is com­pleted, life will re­turn to nor­mal and con­tinue as it did be­fore they went through the treat­ment phase. Un­for­tu­nately, many breast can­cer sur­vivors have said that they were ill-pre­pared and un­aware of how dif­fer­ent their life would be after treat­ment. There were new chal­lenges and cir­cum­stances to face and this re­quired a great deal of phys­i­cal and men­tal prepa­ra­tion. In ad­di­tion, there was the lin­ger­ing, nag­ging fear that the can­cer could re­turn.

If you or some­one you care for is com­plet­ing treat­ment for breast can­cer, it is ad­vis­able to be aware of the changes one can ex­pect, in or­der to be bet­ter equipped to cope with the re­cov­ery process.

The treat­ment may be over, but the side ef­fects could per­sist

The hair loss, nau­sea and vom­it­ing will stop, but some side ef­fects of chemo­ther­apy could linger on for longer, like fa­tigue and dif­fi­culty in fo­cussing and re­mem­ber­ing, which were not present be­fore the treat­ment. This is nor­mal. I sug­gest that you make a note of all the changes you no­tice and dis­cuss them with your doc­tor at your next check-up.

Here are some prac­ti­cal ways to cope with fa­tigue: plan your day in ad­vance; pace your­self through the day; take short breaks and naps dur­ing the day; al­low oth­ers to help you; and find eas­ier ways to do your reg­u­lar work, such as sit­ting while trav­el­ling or clean­ing the house. If you are find­ing it dif­fi­cult to focus or con­cen­trate, try the fol­low­ing: write down your to-do lists for the day; stick post-it notes where you can see them eas­ily or set re­minders on your phone for im­por­tant tasks; focus on one task at a time; and learn to re­lax and man­age your stress.

Reg­u­lar doc­tor vis­its must be­come part of your life

Sched­ule reg­u­lar check-ups with your on­col­o­gist, as pre­scribed. You may also be re­quired to do reg­u­lar check-ups such as pelvic ex­ams or bone den­sity tests de­pend­ing on the drugs you are tak­ing.

A healthy lifestyle is an im­por­tant as­pect of re­cov­ery

There is no sure method that can pre­vent the re­cur­rence of the can­cer. A healthy lifestyle, how­ever, can help you feel bet­ter, more en­er­gised and phys­i­cally stronger. Some things that you must in­clude are: healthy food choices, such as 5 to 9 daily serv­ings of veg­eta­bles and fruit, less salt and less fat in your diet; reg­u­lar ex­er­cise for at least 30 min­utes a day to re­duce treat­ment side ef­fects such as anx­i­ety, fa­tigue, nau­sea, pain and di­ar­rhoea; no smok­ing be­cause it in­creases the like­li­hood of de­vel­op­ing can­cers at the same or a dif­fer­ent site; and re­duced con­sump­tion of al­co­hol.

Your body may not be the same, but that is okay

For women who have had to un­dergo a mas­tec­tomy (breast re­moval surgery), los­ing one or both breasts can be very dis­tress­ing. Even a breast-con­serv­ing surgery (lumpec­tomy) where only the tu­mour is re­moved, could lead to some scar­ring or a change in the shape or size of the breast. Some women re­spond to this by opt­ing for a breast re­con­struc­tive surgery, whereas oth­ers choose to wear a breast

pros­the­sis. What­ever your choice may be, my advice is to ac­cept the change your body has gone through, love your body re­gard­less of this change and ap­pre­ci­ate the fact that it all hap­pened as part of your treat­ment and re­cov­ery. Choos­ing clothes that make you feel at­trac­tive and not self-con­scious can also help.

In­ti­macy and sex­ual ac­tiv­ity may be af­fected, but can be over­come

Women also worry about whether they will be able to en­joy the same kind of in­ti­macy with their part­ner after breast surgery as they did be­fore. Yes, after treat­ment you may have to ap­proach sex­ual ac­tiv­ity a lit­tle dif­fer­ently. An open dis­cus­sion with your part­ner could be help­ful. You may find that your worry was com­pletely un­founded. It would be a good idea to also con­sult with a sex ther­a­pist. What­ever you choose, know that breast surgery and ra­di­a­tion do not usu­ally de­crease li­bido or sex­ual plea­sure.

Ev­ery sur­vivor has a dif­fer­ent story to tell. Ev­ery story is spe­cial be­cause it is a story of courage and hope in the face of over­whelm­ing odds. The road to re­cov­ery can be man­aged with a lit­tle re­solve on your part and sup­port from fam­ily and care­givers. It helps to re­mem­ber that one of the hard­est parts of your breast can­cer jour­ney – the treat­ment – is over. It is time to cel­e­brate and make lifestyle changes that will pave the way for liv­ing ev­ery day joy­fully.

Dr. D C Do­val Direc­tor Med­i­cal On­col­ogy, Ra­jiv Gandhi Can­cer In­sti­tute and Re­search Cen­tre, New Delhi

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