Madrid, 8 May 2023-. Society now includes an ever-growing population of individuals who have initially overcome cancer and continue with their everyday lives, free from tumours. These are patients who have concluded their treatment and in whom the disease has abated or been cured. However, they now face the challenge of restarting their work, social life and personal relationships, something which is not always easy.
As a result, the experts maintain that “the oncology process does not end with the disease itself, there are many physical, psychological, emotional and spiritual side effects which may need more time”, as María Isabel González, from the MD Anderson Cancer Center Madrid Psycho Oncology service affirms. “These are people who struggle with a variety of challenges after overcoming the illness, including anxiety, fear of a relapse, the sense of what they have lost during the illness and treatment period - in some cases causing depression - and finally their reincorporation into their social and professional lives and relationships”, she adds, going on to state that “one of the current challenges is to help patients who have finished clinical treatment to achieve a proper quality of life after beating the disease”.
As the psycho oncologist explains, this is the moment when a change occurs in the patient’s experience. During the treatment of cancer, the patient focuses on confronting the illness but, she says, “once the direct treatment is over and the disease under control, it is normal for the patient to detach themselves from that active role and to find a psychological space that encompasses the entirety of their experience”. This is the reason why many patients attend the psycho oncology clinic after completing their treatment.
“In spite of the various observation and checkup procedures all patients will undergo, psychological recovery also takes time. It is not unusual for patients to need a year to assimilate and overcome the psychological impact on their lives caused by this disease and its treatment”, warns the MD Anderson Madrid specialist.
Determining factors beyond clinical treatment: age and impact on the future
There are a number of elements that may cause complications during this period and condition the progress of psychological therapy. These include age, severity of the cancer, how advanced the condition was at the time of diagnosis and the possible aggressiveness of the treatment against the disease. All of these are factors that may affect the ease or difficulty of readjustment to normal life.
One of the most striking examples is recovery in younger patients. “One tends to think that young people will still have more life ahead of them and a lot more energy to reinvent themselves. However, the reverse is often true in such cases. Adjustment is easier for older people, who have fewer life projects that were put on hold due to the cancer, given that they have already had the opportunity to achieve many of them”, says González. On the other hand, a young person will have more ambitions and plans still ongoing or in mind, and many interests that may have been interrupted by the illness and its treatment, such as work, personal relationships, studying, becoming a parent, or simply paying the mortgage. Their experience may be affected by changes to their physical appearance, sexuality or fertility, sometimes even yet to develop.
After recovery from the illness the normality hoped for by the patient’s social circle is not always as expected
In addition, when a patient successfully completes the treatment for a disease such as cancer, their social circle may expect them to readjust immediately to their work or family life. However, the perspective of the patient is often very different from that of those around them. According to Maribel González: “the post-illness period involves facing up to all that fear, sadness and exhaustion that they have experienced during treatment. The clash between the perspectives and expectations of the patient and those of their friends and family can lead to the patient feeling alone and misunderstood”.
It is important that the patient tries to return to their previous life, to replicate as far as possible their everyday routine and life style; always bearing in mind that they are no longer exactly the same person as they were at the time of diagnosis. "Normally at the clinic we like to concentrate in parallel on what we have not lost - what aspects of my personality or my values are still there – together with acceptance of what we cannot get back. Because there are some things that have changed forever, but we can help the patient to adapt and go on with their life, with that new self, which can often actually be strengthened or enriched by the experience," explains the psycho-oncologist.
However, it is also essential that the patient is able to speak openly to their family or social circle about their needs and how they feel. Patients tend to wait for someone else to approach them, ask, listen and assist. "It is better to say clearly what I need, how I feel and how you can help me. Often those outside do not know how to handle the situation. In the end it is better to help than to be helped, and to point others in the right direction so they can provide support," concludes González.