No One Prepared Me for “The After” – A (Very) Candid Look at Life After Cancer

Treatment is over. Can you breathe a sigh of relief? Maybe. For a second. But I’m here to remind you that it’s not over yet. Probably not what you wanted to hear, huh? But I’m sharing this candid advice because no one prepared me for “the after.” The after treatment. The after cancer.  And boy, did “the after” knock me on my ass.

My family, who had come to stay with me during treatment, went home. I wasn’t going to the hospital every day anymore. I was left to just go on. 

Go on? 

Go on like it didn’t happen? 

I could barely walk up a flight of stairs, let alone do a load of laundry. I could barely eat anything. All I wanted to do was close my eyes. 

My mind would spin. I’d stub my toe and somehow, I would rationalize that I had cancer in my left pinky toe and my whole foot would have to be amputated! Rational thought went right out the window. 

And the tired, the oh so very tired…

Because even though the official treatment regimen is over, the radiation keeps working and will continue to work for 6 months at least. For me, it then took another 6 months to get any resemblance of energy back.

Those first months of The After are among the hardest cause you want to ‘bounce’ back and jump back into life. You want everything to go back to normal, yet you want and need to do it all different all at the same time.  How the hell do you do that? Especially when the fatigue continues and you can barely get up off the couch (except to dart to the bathroom before you poop your pants.)

Don’t beat yourself up about it. Easy to say, hard to do, I know. My advice? Allow yourself to just be. Realize that it’s okay to not be okay. Most of all, be gentle with yourself.

Samantha, enjoying some of the creative healing of woodworking.

You have just either had your insides ripped out or got repeatedly zapped with radiation. The toll of treatment is a heavy load. Give yourself some credit. You’ve paid the price and you can now cross the bridge to life after treatment. You are on that other side, but on that other side…

The fatigue is real.

Brain fog is real.

Those hot flashes, night sweets, insomnia, vaginal dryness and memory loss is real. 

The continued bowel explosions are real.

Bladder leakage is real.

The crushing reality of infertility is real.

Also real – and sometimes, debilitating – is the fear and “scanxiety” and the questions that always lurk in the shadows of our minds:  

Is it still there? 

Did it come back? 

Will it come back? 

Every pain, every ache, every spot of blood turns your mind into rapid fire AK-47 of fear, anxiety, panic and then depression because you’re exhausted and just can’t handle anything on top of the already immensely heavy load.

Rest assured, you are not alone in any of these feelings. 

And you know what? 

It’s okay to not be okay sometimes.

I’ll say it again: it’s okay to not be okay.

A few tidbits of advice from someone who has been in “The After” for eight years and counting:

  1. If you need a little medication or talk therapy to get you through the crazy roller coaster ride of The After Life, get it! You don’t have to stay on it forever if you don’t want to, but antidepressants can help you ease some of that mind-spin so you can make some sense of what is going to be your new life. Antidepressants and therapy helped me. I was not okay, and there was no shame in that. I just needed help to realize that and get through it. 
  1. Don’t feel guilty or ashamed for taking care of your head too, now that you are done with that treatment for your physical body. It might take every ounce you have left in you to make one more appointment, to a one more doctor, for one more thing. I can tell you, it’s worth it to push yourself to make that call to see about your mental health. Not sure where to start? Your social worker at the hospital may also have a list of therapists and psychiatrists that specialize in cancer patients.
  1. Vent! Let it out! You can vent here with the Cervivor community or with friends or in a journal. I guarantee one of us can relate to how you are feeling. Those feelings have the most power over you when you keep them inside. So share them. Or write it in a journal and then burn the pages. Get it out of you!  That dread. That doom. That weight. That worry. It only has power when it’s held inside. Get it out of you and then you won’t have to carry it alone.
  1. Be gentle with yourself. My sister told me that (when I was venting to her!). I didn’t fully absorb it when she said it, but I fully believe and appreciate that advice now – so much so that I have it tattooed on my hip as a physical and spiritual reminder. It’s okay to not be okay, and to give myself a break, and give myself some credit.  Things will get better in time…and sometimes time…just needs time.

Cancer survivor Samantha is a wildlife ecologist in San Diego, CA. When she is not protecting sea birds and restoring habitat for sea ducks injured by coastal oil spills, she volunteers with Burning Man and has attended the art festival five times. Samantha encourages women undergoing cervical cancer diagnosis and treatment to start therapy well before “The After” to head off (or at least lessen) many of the emotional issues she went through. Samantha encourage women to start a conversation with the social worker at their hospital, or to visit the “find a therapist” page on psychologytoday.com.

Read Samantha’s Cervivor story.

AYA Week Reflections

As AYA Cancer Awareness Week draws closer, I am reflective on how much the AYA cancer community means to me. I recall how for two years after treatment, I didn’t even know this community existed and how today, I can’t imagine my life without it.

During my treatment in 2013, I didn’t want any part of the AYA cancer community because I didn’t want to be labeled as the girl with cancer. I did not want to be the youngest cancer patient in the radiation waiting room, or to be told yet again that treatment would be easy because I was young (by the way, it wasn’t), or to become more familiar with insurance deductibles and FMLA than someone twice my age. I just wanted my pre-cancer life back. I wanted to go on dates, to go to the state fair without the worry of being immunocompromised in a large crowd, and to be able to eat whatever I wanted without getting sick.

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I first met a fellow AYA cancer survivor two years after my treatment and it changed my life. I was no longer alone. Someone finally understood me. I had a community and I felt like I belonged for the first time in a long time. Alongside other AYA cancer patients and survivors, I was able to process what I had just gone through and I gained knowledge about what survivorship should look like. This growth gave me a sense of purpose as an AYA cancer survivor that I needed.

Today, I am a seven-year AYA cervical cancer survivor. I share my story with a lot less fear than I did five years ago because I want people to see that I am what an AYA cancer survivor looks like. I want people to know that a cancer diagnosis in your 20’s and 30’s is difficult to navigate, not only during treatment but as a survivor. I also share my story with medical professionals so that they can better understand the unique needs of the AYA cancer community. And I mentor AYA cancer patients and survivors, so they don’t feel the loneliness that I felt during and after treatment. No one should go through cancer alone.

I’ve watched the AYA cancer community grow since 2015 from a few scattered voices to one loud collective voice. This community’s advocacy and momentum has generated much needed attention and change that will impact not only our lives, but the lives of future AYA cancer patients and survivors. During AYA Cancer Awareness Week, we deserve to recognize and celebrate our community’s accomplishments.

Emily Hoffman is a seven-year cervical cancer survivor who was diagnosed with stage 2B cervical cancer at age 30. After cancer, Emily didn’t realize she even had an advocacy voice until she attended her first Cervivor School in 2016. Today, she is a patient advocate and active Cervivor Ambassador who shares her cancer story to raise awareness for ending cervical cancer and to educate others on the importance of cervical cancer screenings and prevention. Emily is the recipient of the 2020 Cervivor Spark Award. She is currently pursuing her certification to become a cancer registrar.