My seven-year-old recently said, “I sure hope when I grow up I remember my childhood!” First, I thought, what an oddly erudite statement that is for a small child.
As I looked at him, sitting on a bench, swinging his skinned knees, and eating a chocolate ice cream cone, I thought how much we all want to remember our childhoods, complete with the innocence and wonder that each day brings. Some days, we wish we could go back. But we can’t. The best we can do is remember it fondly.
Then I thought of all of our cancer patients; and I remembered a patient telling me just a few days ago that she hoped never to hear the term "Big C” in her life, and now that she had, she hoped never to have to hear it again.
Unfortunately, I couldn’t tell her that she would be cured. I couldn’t tell her that she would never have to think of cancer again if she were cured. Cancer, the monitoring for recurrence, and the management of long-term side effects will forever tarnish her view of herself as a “healthy” person. She might remember her pre-cancer days (her “childhood” so to speak) fondly. But her life will be forever changed.
Just as growing up gives one a certain amount of sagacity, many cancer patients have a kind of wise reverence for life that changes how they see the world. They will never disregard a new ache or pain without wondering if it is cancer recurring. Most will have a greater awareness of their own mortality.
I told my son that he would remember his childhood, but he would also make a lot of new memories that would be just as good. And I plan to tell my patients that, too. They may not be able to take away the difficulties of cancer, but they can still create new memories, and enjoy old ones.
Part of helping them recapture their pre-cancer life is empowering them to pursue well-being. Survivorship care plans play a key role in this empowerment. Providing a cancer patient with a survivorship care plan is like teaching your child life skills. You can’t change the fact that the patient has had cancer, just as you can’t change that your children must inevitably grow up. However, you can give them the tools to be successful.
As time consuming as care plans are, I think we cannot cut corners. We have to make this the most useful document that it can be for each patient. We cannot turn back the clock to a time when they were cancer-free, but there is a good chance we can help them move forward successfully.
I hope my son will never have to deal with cancer. If he does, he’ll have great memories of chocolate ice cream cones and skinned knees to smile about as he sits through treatment. And after treatment, I hope a very conscientious person will give him the tools he needs to build a healthy life after cancer.