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Post treatment/Survivorship

Post treatment
If we just focus a little bit specifically on the radiation oncology patients, in general what do you find that they can expect following treatment? Can they usually return to normal activities? Yes, so I think the challenge for radiation oncology patients, I would divide it into three different areas. One is the area of the medical consequences of the treatment. The second is the psychological consequences. And thirdly are the practical consequences. So from a medical perspective, really you’re looking at things like, particularly fatigue and the issue of loss of appetite, and supports around those. And it’s important that all radiation oncology patients get support in those areas.
From a psychological perspective, any cancer diagnosis can have a significant impact on a person’s psyche. Distress can often be a very important part or a very prevalent part, particularly in radiation oncology because it’s a long treatment. You’re in a daily treatment probably for 10 minutes a day over a six week period. And there’s a lot of time within that for reflection. In many cases, patients can be away from home because the treatments are concentrated in areas of big population. And distress can be an issue. So counselling services, support groups, peer support, learning from older patients who’ve been through the same experience is very important.
And then I think from a practical perspective, work is certainly– more and more patients are thinking about getting back to work or indeed staying at work if they can right through the treatment, because the radiation quality treatment has progressed so much over the last number of years that for many people they can stay at work with– but they need support from their employers. They need to be able to have those conversations with their employers so that they can take both the time off, but also be given a little bit of leeway when it comes to managing fatigue or indeed distress associated with their treatment.
Then access to information in relation to insurance, life insurance, all issues, the financial consequences of their treatment. These are all things that thus radiation oncology patients really need support with. Now more so than ever because more and more patients are having radiation oncology. And more and more patients are living and surviving for many, many years after treatment. After treatment life changed for me in so many ways. In some aspects, you know, I think it was the most horrendous thing that ever happened to me. And I would never term myself a survivor. I think it’s just one of those things that you overcome and you can make something of yourself or you can make another decision.
As I mentioned earlier, you know, I suffered from anxiety for a very long time– not really wanting to ask for help or wanting things to be a different way. It was only really when I went to talk about my own experience of having cancer and talking to my own therapist about, you know, the person I lost when I got a diagnosis and, you know, grieving for that person who had lots of dreams and lots of plans ahead of her. And then to kind of stop and to feel lost and not know where I was going.
So in a sense I’m sad about it, but on the other hand, you know, if I never stopped and went and had a chat with this lady whom I knew from adam you know, how anxious I was or how lost I was being and how sad I was about the whole thing, I’d never really be where I am today. I never would have gone back to college. I never would have given talks to other patients who’ve been diagnosed and with other different types of cancer. You know, I wouldn’t be involved in all the really wonderful charities I’m involved in. And I certainly would be a very unhappy person.
And I certainly would kind of blame maybe other people for feeling so lost or so sad. And so I suppose having cancer in a way changed my life for the positive. And although, you know, I don’t know what that girl would have done beforehand, you know, I think I’ve done pretty well for someone who went through such a bad time. So in a sense I’m kind of quite proud of myself. And I think it’s important that when people do get diagnosed that there is life outside of cancer and you can live your life, not just through cancer either. If that makes sense. I don’t think I really felt like myself again for about 18 months.
And the other thing I’d just like to quickly say to you is, I didn’t have my first experience of depression. Now again, as a radio broadcaster I have done use with scores of people about depression, but I think until you experience it yourself, I was 60 and having it for the first time, it’s very hard to explain what it’s like. So I was a person who’s normally up and out early in the morning. I had a very heavy, tired feeling. I had trouble waking up in the morning. And I became a bit socially isolated because during the treatment month you’re as busy as a bee and you’ve got a whole team of people taking interest in everything you do.
And all your friends are visiting you and your partner’s staying home if they’re lucky enough to be able to. And as the weeks pass you spend a bit more time alone. So again, I would really recommend if you feel yourself getting blue, don’t be embarrassed. Talk to someone. I started taking antidepressants I think at about one year and a bit out. And I’m still taking any depressants, even though I’m back at work full-time and to all intents and purposes, living a normal life again. I’m still using antidepressants and I’m still seeing a psychiatrist. And I think that’s wise.

Following radiation therapy, together with other treatments for cancer, patients still need support for a variety of reasons. As Donal mentions in the video, these can be grouped into three categories:

Medical support

Many patients may continue to experience side effects after they are finished radiation therapy. It is important to know that there are experts available who can advise you and that you are not on your own once treatment has finished.

  • For example, many patients experience fatigue or tiredness for quite some time following their radiation therapy. It is important to talk to experts who can advise you on the combination of exercise and rest that will help manage this fatigue.

  • Some patients also feel that they may have a loss of appetite after cancer treatment. Community-based dietitians can help you with this and give you some practical advice on how to meet dietary requirements necessary for your future.

Psychological support

A cancer diagnosis is a time of extreme stress, anxiety and even depression. During treatment, you are extremely busy keeping up with appointments, advice and having an entire expert team on hand to answer your queries and the support of fellow patients. When radiation therapy finishes, it is easy to feel lost and a little bit isolated.

  • There are counseling services, peer support and general support groups available for you to attend from your national cancer society.
  • As Julie and Roisin explain, some patients may need medical intervention for their anxiety and depression while others may benefit from psychotherapy; others may only require peer and family support.

Practical support

Patients who have had to stop working during radiation therapy can find themselves with the additional stress of financial pressures. Your cancer society can advise you on your rights and entitlements as well as how and when to return to work and how to discuss your future working needs with your place of employment.

Thinking about this video:

  • What is your opinion on the term ‘surviving cancer’?
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An Introduction to Radiation Oncology: From Diagnosis to Survivorship

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