Avoid Avoidance

Avoid Avoidance
November 30, 2015 Alene Nitzky
Cancer Recurrence and Avoidance | Cancer Harbors Cancer Survivorship Care Plan

There are certain topics that are avoided by cancer survivors and health care providers alike. Some of the reasons why they are not discussed include fear it means cancer recurrence, not having the skills or expertise to address it, not enough time, shame or stigma associated with the issue, lack of resources, financial, professional, or otherwise.

Avoiding something is not going to make it go away, and in the case of cancer survivors, avoidance can mean a problem never gets resolved or gets worse. You’d be surprised at some of the statistics for how commonly these problems occur, not just in cancer survivors but also in the general population.

If you have one of these issues, you are definitely not alone, there is help out there, sometimes it can be low cost or even free in your community. There are professionals out there who work with people with these struggles all the time and there is no reason why you should have to suffer or hide.

The biggest hurdle is initially allowing yourself to reach out for help. Once you have done that, you’re on your way to improvement. No matter what the circumstances, there is always one first step that you need to take to get yourself going in the direction of help. Identify that initial step and act on it, from making a phone call, to getting a ride, to putting on your shoes.

Social workers and nurses tend to take a more holistic approach to looking at the entire picture of what you’re struggling with, and can make good recommendations on where to go locally. With movement issues, experienced physical therapists are an ideal place to start.  Just remember, if all a practitioner has are brochures or internet handouts, but they don’t have the actual expertise or real life resources to direct you to, they’re not likely to be as helpful.

When seeking help, ask the practitioner if they have experience working with people who have had your type of cancer and your type of treatment. Ask them about their success rate, and the outcomes for people like you. Any practitioner who is willing to take the time to talk with you and listen to your concerns is worth considering.

Let’s look at the big topics for avoidance, how common they are, and some places to start seeking relief:

  • depression & mental health issues- the sooner you go for help, the sooner you will get to feeling better. Many people who struggle for years with depression, once they seek help and begin to feel better, they wish they had done so years earlier. Seek a licensed counselor, social worker, clinical psychologist, or psychiatrist. Up to 25% of people with cancer, according to the National Cancer Institute experience depression, and according to the National Institute for Mental Health, 6.7% of the general population (2013).
  • sexual dysfunction- 2/3 of cancer survivors, according to MD Anderson, experience some form of difficulty with sexual function: erectile dysfunction, pain with sexual activity, loss of sexual drive, body image changes after surgeries, and other issues. According to the Prostate Cancer Foundation, 25-50% of men experience this after treatment for prostate cancer. A good place to start is with a mental health professional such as a social worker, who can also refer to sex therapist.
  • addiction & substance abuse- nearly every community has help for recovering from tobacco, alcohol, street drugs, prescription drugs, or other addictive substances. Again, a mental health professional such as a social worker can be a good place to start, if you don’t feel comfortable talking with your family physician about it.
  • pain- This is an important one to discuss with your primary care doctor, or nurse practitioner. Pain, especially back pain, can be a sign of cancer recurrence in the bones, so it should never be ignored. Don’t avoid getting it checked out of fear of it being cancer recurrence however, because it’s better to know what’s causing it, so you can be as proactive in getting relief.  If it is muscular, joint, neuropathy, a result of radiation, Pain management doctors may be needed sometimes, but there are many ways to manage pain without seeing a pain specialist. More than a third of cancer survivors experience pain as a result of cancer treatment. Physical medicine and rehab specialists, physical therapists, and exercise trainers can help with activity, which is an important component of pain management, along with someone with a holistic approach such as a nurse practitioner in your physician’s office.
  • incontinence-  physical therapists can help with pelvic floor exercises, which is an effective way to manage many cases of incontinence. Urologists and GI specialists can help, and your primary care physician can refer you to one of these experts. Some of these problems can surface months to years after radiation, especially with pelvic radiation, and 30-50% of men struggle with urinary problems after radiation and/or prostatectomy, according to the Prostate Cancer Foundation.  Bowel dysfunction and fecal incontinence can also result from certain treatments, such as treatment for rectal cancer.
  • finances- Over half of all cancer patients experience financial stress. Between insurance coverage struggles, loss of income, and the ongoing needs for follow-up care after treatment, you need an advocate to help you. Social workers in community agencies, senior centers, as well as in hospitals and health care organizations where you have been treated, can help you find resources and assistance, including free or inexpensive legal assistance. Financial stress is tied to poorer health, more depression and anxiety.

You’re not alone, help is available, and the longer you wait, the longer you suffer. Take that first step.

With more detailed information on actions to take with each of these topics, Cancer Harbors can help you move forward.

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