"When will things be back to NORMAL?"

Many cancer patients and their families find themselves asking this question. Sometimes it's one of the first questions asked by new patients of doctors, counselors, and friends who have experienced their own cancer journey. Many times the question is asked over and over throughout the battle, and the available answers are few or unsatisfactory.

The problem with looking for a "normal" life after cancer treatment is that each individual's experience can be vastly different from another individual's experience, even when those individuals received the same diagnosis. Differences in socioeconomic issues, support (or lack thereof) from family and friends, location of treatment facilities and whether or not one decides to enter a research trial... all of these things, and many more, can contribute to the length of time it takes for patients to get back to a "normal" way of life after battling cancer and what that life eventually looks like.

Cognitive
One of the most-discussed long-term effects of cancer treatment involves cognitive functioning. Commonly known as "Chemo Brain", these effects are frustrating enough to make them one of the first things survivors bring up to counselors who are working with them to smooth transition from patient to survivor. Some common complaints patients share include:

• Forgetting things that they usually have no trouble recalling;
• Trouble concentrating, inability to focus, or being easily distracted;
• Trouble remembering details like names, dates, and sometimes larger events;
• Trouble multi-tasking, like answering the phone while cooking, without losing track of one task;
• Taking longer to finish things due to slower thinking & processing or disorganized thoughts;
• Trouble remembering common words.

There has traditionally been no real help for these cognitive challenges, and in fact, there's not really any clear evidence that they're caused by chemotherapy. Some people who suffer from memory problems after cancer treatment still score well on cognitive testing, and many of the things mentioned by patients are not even noticed by most of their friends and family. Many doctors will only "diagnose" Chemo Brain if the symptoms don't go away over time, but the reality is that many patients do find a certain amount of memory loss and difficulty completing tasks or learning new skills to be part of life after cancer treatment.

Physical
Fatigue is another issue that many patients think will only be a short-term problem as they are undergoing their treatments. In reality, the speed at which our bodies recover from the onslaught of medications, surgeries and radiation treatments it has been put through over the course of several months also varies greatly from individual to individual. The one constant that most patients agree on is that the recovery doesn't happen fast enough! It's important for patients (and their loved ones) to recognize that support may be needed for many months after treatments end, and that it's okay to take it easy for as long as necessary. If there has been a need to take time off work, going back on a full-time schedule might need to be delayed or done a little at a time. A healthy diet and exercise routine will continue to be important, as well as getting plenty of rest. (i.e. don't do away with those naps just yet!)

For some survivors, there are also physical scars from surgery and radiation and/or long-term physical impairments and alterations made to their bodies. A former cancer patient may have to become comfortable with a new appearance or learn new ways of performing common daily functions the rest of us take for granted. These kinds of changes can be challenging at best, and their emotional toll can be heavier than the physical scars themselves.

Emotional
1 in 4 people will be diagnosed with cancer in 2011 according to American Cancer Society estimates. That means it's highly likely that you or someone you know will hear the words, "You have cancer." this year. Nothing can prepare a person to receive a diagnosis that can be potentially fatal. And even when a patient has successfully made it through treatment and is declared "cancer free" there is still a tremendous amount of residual worry and frustration to deal with.

The fear of recurrence is also a very real emotional burden for every cancer survivor. Some cancer diagnoses, like bladder and some brain cancers, carry a high probability of recurrence. Others require regular follow-up for many years after treatment ends. Every single time that patient goes in for a follow-up, there is a worry that doctors could find something that will cause the patient to require another round of treatments. Even common aches and pains that have nothing to do with cancer can bring on fearful speculation and worry.

So, how can a patient find their way to their own "new normal"? 
It's important from the very start to have a strong support network. Friends, family, church groups, or even followers of a blog or Facebook page can be a tremendous source of strength, advice, and "good vibes" during cancer treatment and beyond. Support groups are a great place to start building some of these helpful relationships if a patient doesn't already have them in place. If you're in Northwest Arkansas, our social workers are tremendous resources. We also provide a list a local support groups on our website. National organizations such as StupidCancer.com and LiveStrong.org have navigation and support services available if you're unable to find a group close to you.

As a patient becomes a survivor, the support doesn't have to end. Many groups are populated by survivors who are willing to provide the encouragement and advice a newly diagnosed patient needs. A person living with regular follow-up appointments can find a great deal of comfort in that kind of group as well, as they continue to deal with the "new normal". Perhaps one of the most important things a cancer survivor can do is give them selves time to redefine themselves. Time may not really heal all wounds, as the old adage says, but it does provide a good lens with which to examine what life should look like in the wake of cancer treatment.