It was so simple in the last movie of The Lord of the Rings trilogy: The Ring was destroyed, and Middle Earth saved. Frodo and Sam Gamgee rode home to the Shire on the backs of giant eagles. Did anyone else wonder why the eagles hadn't taken them to Mordor in the first place? The answer, according to Boromir, is, "One does not simply enter Mordor."
Entering Cancer Land is simple. Leaving it is not. Fear of recurrence makes you feel like you’re only out on a visa, which could be yanked away at any moment. You will only know that you did not die of cancer until you die of something else.
Skipping Through Cancer Land
Some people have more difficulty adjusting than others. I think of Frodo, who was unable to adjust to ordinary life in The Shire after his ordeal. Instead, he sailed away with the elves, trolls, and fairies whose reign of Middle Earth had ended.
Surviving cancer sometimes feels like you cannot return to the life you had before.
How can oncology nurses help patients after treatment ends? What words of advice or encouragement can be offered?
How can cancer nurses help reduce a patient’s fear of recurrence?
Nurses can't, actually. Anxiety will only subside for survivors after several years of repeatedly healthy lab and imaging results. After that, though not entirely gone, the fear is less in the forefront. Maybe a survivor starts eating food for enjoyment, not because of its anti-cancer properties. Maybe they decide it's okay to drink a glass of wine with dinner, or an occasional martini when out with friends.
From time to time, a person may hear about another survivor of the same cancer suffering a recurrence. They put themselves in that place, and it makes them very sad. They wonder if they're too lax about their choices. They remember that while there is hope, there are no guarantees.
Over the years, I've come to think about cancer recurrence like this:
Living with the fear of recurrence is similar to driving a car. You keep the vehicle well maintained on the warranty schedule. You obey the traffic laws, and hope you don't have an accident. But you do not allow fear of an accident to prevent you from driving where you want to go.
In the same manner, as a cancer survivor, you take good care of your health. You reduce stressors in your life, and develop skills to manage the ones you can't make go away. You keep up with surveillance appointments with the oncologist. You do not allow the fear of cancer to prevent you from living.
What advice or instructions do you give patients completing cancer treatment when they ask, "What's next?" Do you have a helpful metaphor you like to use? What resources do you provide?
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