Welcoming remission

With great relief

After the period of initial shock and disbelief – and as reality sinks in regarding your new prostate cancer diagnosis – you have made some decisions and you have received the treatment you have agreed on for it. Your follow-up with your urologist, radiation oncologist or medical oncologist now consists of regular medical visits, PSA blood tests and, possibly, a digital rectal exam. In response to treatment, your PSA level has probably gone down and is stable. This period of remission is very welcome and reassuring.

The fact that something has been done to treat your prostate cancer will give you back a feeling of control over your life. Strong feelings like anger will probably have subsided. Temporary changes in your role in family life at the time of diagnosis can return, or may undergo additional adjustments, according to your needs. This situation may also have opened up new lines of communication: those people who could not deal with your illness may stop avoiding you, now that they see you are doing well.

Even so, the fear of a recurrence never really goes away completely. This is a normal response to a life-threatening disease. Thinking about your next medical visit, next PSA blood test, and dealing with the side effects of treatments can all be very upsetting, and are constant reminders of your cancer. But remember the most important thing: you have made it; you have fought for your life and won. Through this experience, you may also have learned to prioritize what’s most important to you, and have learned that nothing should be taken for granted – that life should be lived to its fullest and that every moment it brings us should be enjoyed.

Reorganizing yourself

The post-cancer phases

When you began your cancer treatment, you couldn’t wait for the day you’d finish. But now that you’ve completed your treatment, you aren’t sure if you’re ready for life after treatment as a cancer survivor.

With your treatment completed, you’ll likely see your cancer care team less often. Though you, your friends and your family are all eager to return to a more normal life, it can be scary to leave the protective cocoon of doctors and nurses who supported you through treatment.

Everything you’re feeling right now is normal for cancer survivors. Recovering from cancer treatment isn’t just about your body — it’s also about healing your mind. Take time to acknowledge the fear, grief and loneliness you’re feeling right now. Then take steps to understand why you feel these emotions and what you can do about them.

Fear of recurrence is common in cancer survivors. Though they may go years without any sign of disease, cancer survivors say the thought of recurrence is always with them. You might worry that every ache or pain is a sign of your cancer recurring. Eventually, these fears will fade, though they may never go away completely.

Cope with your fear by being honest with yourself about your feelings. Try not to feel guilty about your feelings or ignore them in hopes that they’ll go away. Ask your doctor about what you can do to reduce your chance of a cancer recurrence. Once you’ve done all you can to reduce that risk, acknowledge your fears. Take control of those fears and do what you can to influence your future health. Try to:

Take care of your body

Focus on keeping yourself healthy. Eat a healthy diet with plenty of fruits and vegetables. Fit exercise into your day. Go easy at first, but try to increase the intensity and amount of exercise you get as you recover. Get enough sleep so that you wake feeling refreshed. These actions may help your body recover from cancer treatment and also help put your mind at ease by giving you a greater sense of control over your life.

Have a balanced and restful sleep

Sleep is essential for the body and allows it to recover from the treatment as well as maximizing a delicate, much needed psychological balance.

Go to all of your follow-up appointments

You may fear the worst when it’s time for your next follow-up appointment. Don’t let that stop you from going. Use the time with your doctor to ask questions about any signs or symptoms that worry you. This appointment can also be an opportunity for you to discuss the side effects – incontinence, erectile dysfunction – you’re concerned about and talk about solutions. Write down your concerns and discuss them at your next appointment. Ask about your risk of recurrence and what signs and symptoms to watch for. Knowing more may help you feel more in control.

Be open about your fears

Express your concerns to your friends, family, other cancer survivors, and your doctor or a counselor. If you’re uncomfortable with the idea of discussing your fears, try recording your thoughts in a journal. Get out of the house and find activities that will take your mind off your fears.

Most cancer survivors report that the fear of recurrence fades with time. But certain events can trigger your fears. The feelings might be especially strong before follow-up visits to your doctor or the anniversary of your cancer diagnosis.

Stress in cancer survivors

Being overwhelmed – When you were diagnosed with cancer, you might have focused completely on your treatment and getting healthy. Now that you’ve completed treatment, all those projects around the house and the things on your to-do list are competing for your attention. This can make you feel stressed and overwhelmed. Don’t feel you need to do everything at once. Take time for yourself as you establish a new daily routine. Try exercising, talking with other cancer survivors and taking time for activities you enjoy.

Being anxious – Lingering feelings of sadness and anger can interfere with your daily life. For many people, these feelings will dissipate. But for others, these feelings can develop into depression. Tell your doctor about your feelings. If needed, you can be referred to someone who can help you through talk therapy, medication or both. Early diagnosis and prompt treatment are keys to successfully overcoming depression.

Lacking confidence – If surgery or other treatment changes your appearance, you might feel self-conscious about your body. Sexual and/or urinary disorders, weight gain or loss can lead to poor self esteem. You might withdraw from friends and family. And self-consciousness can strain your relationship with your partner if you don’t feel worthy of love or affection.

Grieving – Take time to grieve. But also learn to focus on the ways cancer has made you a stronger person and realize that you’re more than the scars that cancer has left behind. When you’re more confident about your appearance, others will feel more comfortable around you. The support of family and friends is essential during this phase.

Being lonely – You might feel as if others can’t understand what you’ve been through, which makes it hard to relate to other people and can lead to loneliness. Don’t deal with loneliness on your own. Consider volunteering, enrolling in a walking, cycling, or gym club, or consider adopting a pet as a way to combat this isolation.

We are here for you

You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.

Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause.

Thinking about the future

Planning for the future

Some people find it helpful to set goals, because this gives them something to think about and work toward. There are different types of goals people may look at, such as travelling, making a career change or going back to school, or developing a new, healthier lifestyle. One way isn’t better than the other – the most important thing is figuring out what works for you.

Putting affairs in order makes sense for everyone, sick or well. All adults should have a will and other legal instructions that clearly describe what they want for their medical care and finances. Sorting out these details doesn’t mean that cancer treatment wasn’t successful, or that you expect to die soon. Ensuring that your affairs are in order can help you focus on living your life after cancer as fully as possible, and bring you and your loved ones peace of mind knowing that your wishes will be carried out.

There are several types of advance directives (legal instructions that describe what a person wants for their medical care, finances and estate) that you may want to consider when planning for your future after cancer.

It’s best to talk to a lawyer or your healthcare team for more detailed information. Copies of any advance directive you make can be given to a lawyer, your healthcare team (to be put in your medical file) or your next of kin.

You will find a wealth of information on Vos droits en santé website.

Going back to work

Adopting a strategy for my job

If you’ve taken a leave from work, you may be very happy when you can go back. Going back can represent a big step on the way to “normal” or be a sign of overcoming cancer. You are happy to have your routine back and the company and support of your co-workers. But even if you’re looking forward to it, it’s normal to be nervous about returning to work.

If you wish to keep working despite prostate cancer and its treatments, you should first find ways to stay at work with your care team. For example, you can identify the type of work you can do as well as the duration of the task.

Most people return to work without any problem. But if you’re uncertain, talk to your human resources department. Some companies provide an employee assistance program that can offer support in various ways to people returning to work. Some examples of adjustments could include:

• allowing a phased return to work after extended sick leave
• allowing you time off to attend medical appointments
• changing your job description to remove tasks that cause particular difficulty
• allowing some flexibility in working hours
• allowing extra breaks to help you cope with fatigue
• temporarily allowing you to be restricted to ‘light duties’
• adjusting performance targets to take into account the effect of sick leave and side effects such as fatigue
• moving you to a post with more suitable duties (with your agreement)
• moving your work base – for example, transferring you to a ground-floor office if breathlessness makes it difficult to climb stairs
• allowing working from home
• providing appropriate toilet facilities.

When you are at work, plan your professional activities according to your abilities and availability. In this way, your employer can prepare in the event of absence, whether short-term or long-term. Your physician can also suggest you some ways to manage the side effects while working.

Planning my withdrawal from work

It is often difficult to reconcile work and cancer. Treatments, as well as the disease itself, often lead to decreased energy, which affects your ability to work. So, fear of losing your job or a part of your income can generate a great deal of anxiety.

Repeated absences from work due to a treatment against prostate cancer can make you lose part of your income, just like a prolonged or even a definitive leave. Therefore, it could be wise to consult a financial planner to know your options in case of a permanent withdrawal.

For a temporary absence, but more or less prolonged, a social worker can also guide you towards financial resources available for you or other kinds of support. It is important that you do not feel powerless regarding your situation.

You have rights

It is against the law to discriminate against someone who has cancer or a physical disability. For example, an employer cannot treat you differently from other workers in job-related activities because of a cancer history, as long as you are qualified for the job. Employers have to reasonably accommodate changes, such as changes in work hours or duties, to help you do your job after cancer treatment. However, they do not have to make changes that would be overly costly or disruptive.

You have rights, as an employee in Quebec and in Canada, with respect to employment and critical illness. Visit the Quebec Commission des normes, de l’équité, de la santé et de la sécurité du travail website for complete information. The Canadian Labor Program is responsible for the welfare and protection of workers and employers’ rights in federally regulated workplaces.

Keeping busy without working

Despite your will, it is possible that prostate cancer meets your limits and that you end up being unable to work regularly, which would oblige you to withdraw definitely from work. Fortunately, it does not mean that you cannot do anything. It is possible for you to turn yourself towards other professional activities or to some volunteering once in a while.

Consequently, you can still feel useful while practicing an activity that is not too exhausting, and mostly pleasant for you. This allows you to meet people and to work on your own capabilities. Prostate cancer may take you a lot of energy, yet you can easily dedicate what you still have to a cause dear to you.

Financial concerns

Financial hardship

When you return to work you may feel relieved to have a steady income again. But you may still have financial concerns if you are not able to return to work full time right away. You may have used up all or most of your savings to cover costs during your cancer treatment. And you may still have some ongoing costs, such as equipment or nutritional supplements.

Check with your human resources department to see how your health and employment benefits will be affected after returning to work.

Account managers at your bank, personal financial planners or advisors can help you budget your money and help you with a financial plan now that you have returned to work.

You may still be able to claim some of your ongoing medical costs (such as drugs, equipment and supplies) on your income tax return.

Long-term disability benefits

Long-term disability (LTD) is a type of insurance that pays a percentage of your salary, if you are not able to work for a long period of time or are unable to return to work at all.

If you are covered by an employer, LTD benefits may be offered after short-term disability benefits end. LTD benefits vary depending on the plan.

You will be asked to provide detailed medical information when you apply for LTD benefits. You may have several medical forms to fill in, some of which have to be completed by all of the doctors responsible for your care. A medical update may be needed at certain times and there may be a limit to the amount of time you can draw benefits.

You may qualify for government disability benefits through the Canada Pension Plan disability benefit or the Quebec Pension Plan disability program.

Insurance and travel

Life and travel insurance

Some private life insurance companies will insure cancer survivors, but at a higher rate. Others may insure cancer survivors after a number of years of being disease-free. In some cases, buying individual coverage can be harder for a cancer survivor.

As a cancer survivor, it may be harder or more expensive for you to get travel health or trip cancellation insurance. Check to see what your healthcare plan covers and read the fine print on your policy to make sure you understand its terms. When you’re applying, ask lots of questions and be open about the fact you’ve had cancer and any other health conditions you have. If you don’t tell the insurance company about an illness or health concern, it may invalidate your coverage.

A social worker or financial advisor may be able to tell you about which companies provide extended health benefits, critical illness, travel or life insurance and what they have to offer cancer survivors.

For more information on group and individual life and health insurance plans in Canada, go to the Canadian Life and Health Insurance Association (CLHIA) or OmbudService for Life and Health Insurance.

Reflection and questions

Your finances and your budget