LIVING WITH COLORECTAL CANCER
Any cancer diagnosis is traumatic. Your diagnosis will change your life, but it doesn’t have to take over your life. You can control many aspects of this challenging journey. One of the keys to keeping colorectal cancer in perspective is learning ways to manage the way it affects your physical and emotional life. Staying strong - physically and mentally - will let you keep living your life while you are on treatment and beyond.
ACCEPT SUPPORT AND PRACTICAL HELP
It can be difficult to accept help from others, as we live in a world that promotes autonomy and self sufficiency. Dealing with a cancer diagnosis, subsequent treatments and their after-effects can be very daunting and cause many to feel alone and isolated.
Reaching out to ask for support (practical or emotional) or accepting it when it is offered can have a significant impact on health outcomes. Patients and families who feel supported, fare better.
Here are some examples of support you can benefit from:
- Have someone come to medical appointments with you or attend via telephone, to take notes and help you make sense of what is happening.
- Help with the day-to-day activities like housecleaning, grocery shopping, meal prep, childcare
Please see below for some facts and tips about keeping yourself healthy - body and soul — during your treatment and beyond.
Appetite can vary throughout your illness. Stress and medications you are taking may be the cause. For example, some chemotherapy patients report a metallic taste following the treatment and particularly when eating. Here are a few tips to offset this side effect:
- Avoid eating 2-3 hours post treatment
- Use plastic utensils instead of metal ones
- Adding lemon to water or drinking lemonade or other acidic drinks (avoid if you have mouth sores)
- Carry mint-flavored gum or hard candy for in between meals
- Cooking with herbs/spices or using sauces can mask the taste for some. You can experiment and see what works for you
Eating a well-balanced diet will help you feel more energetic, giving you the strength to cope with the emotional and physical impacts of the disease and treatments.
In addition, eating a well-balanced diet will help you maintain an ideal weight as cancer is often associated with weight loss.
NB: If you are trying to lose weight, it is recommended that you wait until after you’ve finished cancer treatment. At that point, you should talk to your nurse or doctor if it’s appropriate to start losing weight, and how.
If you find that your appetite has decreased, here are a few tips that might help you ensure you have the energy you need:
- Eat small meals throughout the day instead of three large meals. Whenever you are feeling hungry, eat something; keep healthy snacks available (see Foods that Fight Cancer for inspiration and ideas)
- To encourage your appetite, take a walk or do some exercise before your meal.
- Avoid coffee and tea (appetite suppressants). Drink water, milk, milkshakes or juice.
- If you find that meat has a bitter taste, you may want to try marinating it before cooking. Eating with plastic cutlery instead of metal cutlery may also help. If the bitter taste persists or you don’t want to eat meat, try eating other foods that are rich in protein: chicken, dairy goods (Greek yogurt is high in protein), ham, eggs, fish, nuts, seeds, legumes, tofu, or soy beverages are all good alternatives.
- Consult one of the many cancer-related cookbooks available - ask your treating team’s dietitian for a recommendation.
NB: Some patients report weight gain during their treatments. This may be a side effect of certain medications or an increase in appetite/consumption. In this case, speak with your doctor, nurse, or dietitian about how you can control any potential weight gain.
Staying physically active is good for your body and mind. Exercise is important - it can help raise your energy levels and improve your emotional overall well-being. But don’t think you have to train to run a marathon to receive the benefits. Activities as simple as walking or gardening can do the trick. Suggested frequency is a half hour; five days a week (180 mins). Anything that gets you moving can give you a boost, increase your appetite, and decrease your stress level. Group activities such as golfing or curling give you the added benefit of being with other people while staying active.
Listen to your body and don’t overexert yourself. Do what feels right. Exercise only if it feels right to you and rest often. You might want to ask your doctor or nurse for suggestions about what type of activity might be best for you (even light walking is beneficial if sustained for a long enough period).
Some cancer treatments can cause physical changes which may result in patients feeling unlike themselves or less attractive.
Fatigue, hair loss, brittle nails, skin rashes, scarring, presence of an ostomy bag are some examples of changes that may occur. For some these are temporary. For others, the effects or changes are more permanent. There are ways to manage some of these changes. Ask your medical team how to take care of your skin during cancer treatment.
Look Good Feel Better® is a free, national public service program that helps women with cancer learn how to cope with appearance-related side effects of their treatment. If you want to learn more about their beauty workshops and consultations, call 1-800-914-5665 or go to www.lookgoodfeelbetter.org.
If you are having chemotherapy, ask your doctor or nurse if the drugs you will be taking involve a risk of hair loss or thinning. If so, you may want to plan in advance what you want to do: some patients cover their heads with scarves, hats or wigs; others decide not to do anything at all. The choice is yours.
Talk to your nurse if you are interested in buying a wig - he or she can help you locate a store that has experience with cancer patients and find out if you qualify for a tax credit or insurance claim for your wig.
Certain medications, such as acetylsalicylic acid (ASA) and over-the-counter heartburn medications, may interfere with your cancer treatment. Before you take any medication, check with your doctor or nurse to make sure it won’t react negatively with your cancer treatment. You may be on several different drugs as part of your cancer treatment. If there is ever a medical emergency, the medical staff will need to know what medications you are taking. Having a list of the medications that you are currently taking makes answering their questions a lot easier. Keep a credit-card sized list in your wallet or purse and update it as needed. It’s a good idea to give a copy to the person who will likely be accompanying you to appointments or during emergencies.
MENTAL HEALTH AND DEPRESSION
Part of your physical well-being depends on your emotional well-being - when you feel mentally and emotionally healthy, you are better prepared to take on the challenges facing your body. Living with cancer can be an emotional challenge. You may be thinking about questions concerning life and death and examining your relationships with the people around you. You may recognize that roles within the family unit may change to accommodate your present needs. It is important to maintain good communication within the family unit, to ensure everyone is aware of what is expected of them. For some cancer patients, the emotional challenges of fighting cancer can lead to feelings of deep sadness or depression. Concern and anxiety over the cancer can also trigger depression. The medications prescribed may cause mood swings. Regardless of how it is caused, seek help when you are feeling down. Your support team recognizes that fighting cancer can be a tough emotional battle, and they can help. Don’t be afraid to talk to them about how you are feeling or reach out to a community cancer care organization where emotional and physical wellness support are available Please see our website for links or reach out to us for guidance.
SEX AND SEXUALITY
Your body will go through some changes during your treatment. Though these changes may not be visible, you may feel different. For some colorectal cancer patients, cancer treatment can be very stressful or tiring and they may have a decreased interest in sex. Certain medications can also cause a reduction in sexual drive. For other colorectal cancer patients, their sexual drive may be the same as before cancer treatment. Still, others may find that the experience has brought them closer to their partner. Just as your response to treatment is individual, your feelings towards sex are your own. If you are finding that your sexual drive is less than usual, know that this is probably temporary. Cancer treatment can take a particularly heavy toll on your body and it might take a little bit of time for you to feel "back to normal" again. Talk to your partner and let him or her know how you’re feeling; keeping the lines of communication open at this time is very important.
Women may have a feeling of vaginal dryness, burning, or itchiness that results from chemotherapy. Using a personal lubricant may help you feel more comfortable, especially during sexual intercourse. Irregular menstrual cycles are another side effect of chemotherapy. Some women may find that their menstrual periods stop altogether. Once chemotherapy stops, it is possible that regular menstrual periods may begin again.
PREGNANCY AND FERTILITY
Becoming pregnant during your cancer treatment is not recommended because the drugs or other treatments may harm the unborn child. If there is a chance that you may become pregnant, it is important to use some form of birth control. Talk to your doctor or nurse about the best birth control options for you and your partner.
If you are thinking of having children in the future, there are few things you should know. The long-term effects of chemotherapy may include sterility or premature menopause. The risk of this happening varies with the type of chemotherapy you receive and your age. Talk to your doctor to find out more about your own risks and if you should consider sperm banking or egg harvesting.
For national and provincial fertility support resources, click here.
STAYING OUT OF THE SUN
Undergoing chemotherapy and radiation make you more sensitive to the sun; therefore, it is important that you use sun protection. This includes using a broad spectrum/high number sunblock or sunscreen and wearing a wide-brimmed hat, long-sleeved tops, and long pants, as well as sunglasses. Try to stay in shaded areas whenever possible and remain well hydrated.
How soon you feel ready to return to work is up to you. If you are having chemotherapy, you may want to wait until you’ve finished 1 to 2 months of treatment to see how it affects you. You may find that you need to take a little more time off, or perhaps very little at all. Every patient has a different reaction to cancer treatment. Listen to your body and take enough time to recover. That way you’ll be in good shape when you return to work.
Some patients feel that they can work while going through chemotherapy. This is something you should discuss with your doctor. You must be careful not to overdo it to the extent that you run yourself down. In addition, since your immune system is affected by the course of treatment, you should avoid contact with people with colds. Employers should accommodate any special needs that arise as a result of your cancer. This may mean physical accommodations to your work environment or scheduling accommodations. Some employers also offer Employee Assistance Programs which include several counselling sessions for you and your family, free of charge. It is important to discuss any necessary accommodations with either your direct supervisor or your human resources agent.
CANCER IN REMISSION
Living in remission seems like a victory, but not a complete one. Having to deal with the uncertainty of cancer returning (recurrence) can be very stressful— no one wants to think that they will have to fight cancer a second or third time. The most important thing you can do is to take care of yourself as best you can. Do what you can to live a healthy lifestyle and listen to your doctor’s advice about medical check-ups. Part of feeling healthy is paying attention to any concerns that you have about cancer returning. You may want to talk to your friends and family about these concerns or connect with other patients or survivors who have been in a similar situation. Ask your doctor or nurse about getting in touch with a patient group or counsellor. Should you have difficulty obtaining the support you require, feel free to contact us so we can assess your needs and refer accordingly.