Published on May 27, 2020
Sticking to cancer treatment can be challenging—even for the most motivated patients.
Juggling multiple appointments and healthcare team members. Dealing with nausea, fatigue, pain and “chemo brain.” Coping with the anxiety and fear of recurrence, the cancer spreading, and possible death.
At times you may wonder whether treatment is even worth it, especially if it feels worse than the actual cancer. You may even consider—at least fleetingly—stopping treatment altogether.
“I think there are a lot of factors that contribute to treatment fatigue,” says Dr. Megan Hosey, an assistant professor of physical medicine and rehabilitation at Johns Hopkins Medicine in Baltimore. Dr. Hosey was diagnosed with triple-positive stage IIB breast cancer in 2015 at the age of 32.
“Certainly, someone’s stage of illness and the length of time they have to endure treatment are factors, in addition to the perceived severity of side effects,” she says. “And surprisingly, trust and willingness to ask your treatment team medical questions can also contribute to treatment fatigue.”
Here are 10 tips for what to do when treatment feels like too much.
1. Try Chunking
If the course of treatment or long-term concerns seem overwhelming or too anxiety-provoking, try to break time into smaller, containable chunks—one treatment day at a time for example, suggests Natalie Schnaitmann, a licensed clinical social worker and director of operations in the Department of Supportive Care Medicine at City of Hope, a comprehensive cancer center with locations in California.
“Focusing your energy on the time frame that you think you can cope with can help you contain the anxiety,” Schnaitmann says.
2. Set Reasonable Expectations
Hosey says before her diagnosis she was used to working 50 to 55 hours a week, coming home and exercising, and doing projects around the house. During treatment, she learned to be satisfied with doing a load of laundry.
“It takes a little bit of work to readjust that way,” she says. “But it is doable, especially if you try to work hard to not compare your treatment self to your pre-treatment self.”
3. Think About What Has Helped in the Past
Think back to a time when you struggled with motivation. Maybe you wanted to give up on something—school, a job, an exercise program. What helped you stick with it? Could that work for you now?
4. Use Distraction
Think about or engage in an activity that can distract you from your cancer, Schnaitmann says. Perhaps that is meditation, yoga, knitting, spending time with grandchildren, walking in nature, “whatever distraction that can create a sense of calm and peace,” she says.
5. Think About Your Goals and Values
Request a palliative care consult to talk with experts in symptom management and goals of care. Think about what you are willing to endure treatment-wise, what you most value in life and what the realistic goals might be.
“Some people will say ‘do everything until there’s no hope,’’’ Schnaitmann says. “Other people will have conversations such as ‘If I can’t recognize the people I love anymore, then my life isn’t worth living.’” She suggests patients and families have these conversations early in treatment when they have the most clarity of mind and revisit them when prognosis or treatment changes.
6. Find a Bright Spot to Treatment
“I had a team armored with little bracelets and T-shirts that friends and family sent me to remind myself that I wasn’t alone,” Dr. Hosey says. “I always brought folks who were very comforting to treatment.”
Try to find something to look forward to with your treatment appointments, such as having time to read a book or spending time with a friend or family member who is going to accompany you. Reward yourself after a treatment with something small, like lunch, a walk, Zoom time with family.
7. Ask for Help With Side Effects
A neuropsychologist and occupational therapist can help you cope with “chemo brain.” Healthcare providers can prescribe anti-nausea medications. You can also try adding deep breathing and mindfulness which can help with pain and anxiety, Schnaitmann says. If fatigue is the issue, are there times in the day when you have more energy?
“Plan around that for some light physical and socially engaging activity,” Schnaitmann says. Be sure to talk to your healthcare team if a side effect is particularly bothersome. Perhaps there is another drug you can try or some other things that can help mitigate the side effects.
8. Find Something to Look Forward To
Perhaps you are looking forward to a wedding next year or spending time with family and friends over the holidays. Finding something to look forward to can help you stay motivated.
9. Seek Professional Help
Consider speaking to a social worker or psychologist about how you are feeling. “When anything that usually gives you pleasure or joy, such as playing with the kids, going for a walk, you now find little or no interest in, that’s the time to speak to a therapist,” Schnaitmann says.
10. Remember the Big Picture
“There are a tremendous number of cancer survivors,” Schnaitmann says. “If possible, take a long-term view of the future after the treatment. It might help you get through the hardest parts.”
“I think the thing about treatment fatigue is it’s a little like a roller coaster,” Dr. Hosey says. “It’s totally normal to feel some days that you’re at the top of the roller coaster, staring down and thinking, ‘this is really scary.’ It’s also totally normal to feel like on other days ‘I got it. I’m on top of it.’”
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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
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