6 COPING q March/April 2009 Visit www.copingmag.com to subscribe or send us your story

O ne evening at a cancer survi-vors’ conference in which I gave a talk, a woman came

up to me and told me a story I’ll never forget. She said that she had been diag-nosed with breast cancer a year earlier.

All during treatment she counted the days until she was finished. Excited about the end of treatment, she made herself a pink graduation cap and gown for her last chemotherapy appointment. As she handed me the picture of her “chemo graduation,” she told me that the happiness she felt when the photo was taken had dimmed over time be-cause she still didn’t feel very well. Then she asked me a question I hear a lot: “Why do I feel so bad so many months later? I thought I was done and would heal right away!” As a doctor of physical medicine and rehabilitation, my work is focused on

helping cancer survivors heal as well as possible from the side effects of treat-ment. I tell my patients that it might take many months or even several years to heal optimally. It is true that despite an intense desire to “get back to normal,” people often end up having to accept a

“new normal.” I frequently tell people, however, not to accept a new normal too early – instead try and heal opti-mally first. When I interviewed cancer survivors for my new book with the American

Cancer Society, What Helped Get Me Through: Cancer Survivors Share Wis-dom and Hope, I asked them what they know now that they wish they had known from the start. Pam, also a breast cancer survivor, explained, “My doctor told me that it would be a minimum of two years be-fore my life would start to turn around. I just didn’t believe her.” However, Pam’s oncologist was right. Though Pam’s doctor told her from the start what to expect, she didn’t really believe it until she experienced it for herself. Sometimes it’s hard to accept what your doctor may be telling you, and other

times there is just so much information that it’s hard to take it all in. Doctors can’t always predict how well someone will tolerate treatment. Mary, an attorney who went through breast cancer treatment, wrote, “I wish I had known that I was going to be

physically well throughout my surgery, chemotherapy, and radiation.” Mary worried about how she was going to manage her “busy and complicated life” during treatment, and it turned out that it wasn’t nearly as bad as she thought. Of course, this is often more the excep-tion than the rule. Mary credits “taking everything off my plate so that I could completely devote my energy toward recovery” as the reason that she felt much better than she expected. David, a journeyman sheet metal worker (also a breast cancer survivor), had the opposite experience. “I wish I had known that chemo treatments were cumulative in the body and that recov-ery from each successive treatment would be more difficult,” he responded. Another answer survivors gave quite often is that they wish they had known they were going to be around many years after their cancer diagnosis. They wrote about how they would have wor-ried less and enjoyed the intervening years more. Janet, an elementary school teacher who was diagnosed in 1993 with colon cancer, shared, “I learned not to listen to survival statistics.” Danielle, a melanoma survivor wrote, “I wish I had known that I would be a survivor and had not wasted so much time in self-pity.” Of course, knowing what the future holds is impossible, and it’s hard not worry. Still, it was heartening to hear from so many survivors how well they

are doing many years after the initial diagnosis. One strong message that people who had been through cancer wanted those who were newly diag-nosed to know is that there is

hope. Pearl, a young breast cancer sur-vivor in Glasgow, Scotland, summed it up this way, “It would have helped me to know that there was a good, but different, life after all the treatment – that I would probably never feel so much heartbreak as I did, but that it would ease in time.” Certainly, survivors may feel more or less hopeful at different times. There’s

Despite an intense desire to “get back to normal,” people often end up having to accept a “new normal.”

Dr. Julie Silver

If I Knew Then What I Know Now … by Julie K. Silver, md

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plenty of bad news that comes with the initial diagnosis and beyond. However, one woman who had a very poor prognosis when she was diag-nosed with colon cancer in 1998 wrote, “There is always hope, and that hope is sometimes changing. It means something different for each person in any given situation. When one doctor tells you there is nothing more that can be done, he is merely saying that he has exhausted his ex-pertise. The next oncologist may have more up his sleeve. Hope may come in the second, third, or fourth opinion, or totally evolve in a different form.” My friend and colleague, Dr. David Johnson, who is the director of the division of Hematology and Oncology at Vanderbilt-Ingram Cancer Center in Nashville, TN, put it this way, “Hope is what you feel when you know your doctors and other care partners are

doing everything that is possible and reasonable to help you get well. Hope stems from that support you get from your family and friends.” What many survivors said they learned on their journeys and felt they would have been better off understand-ing from the start is this: It may take a long time to heal after treatment. Don’t be surprised if you are alive many years from now. And there is always hope in one form or another.

Editor’s Note: Dr. Julie Silver, a physia-trist, is an assistant professor at Harvard Medical School in Boston, MA. She has authored over a dozen books, including her guidebook to recovery from cancer treatment, After Cancer Treatment: Heal Faster, Better, Stronger. Her new book, published by the American Cancer Society, What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope, marks her fifth year of survivorship. n

This is Tracy. Daughter. Sister. Wife. Mother.Stage IV breast cancer survivor.CanCare volunteer. Tracy has already helped 13 women with cancer feel more hopeful. She is the voice of experience in a battle they are just beginning. Talk to someone surviving your same cancer type. Free and confi dential support from people who truly understand what it’s like to have cancer.

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