August 22, 2013

Living Amidst the Potential Late Effects of Cancer Treatment

The potential late effects of cancer treatment walk hand in hand with the unknown. On one hand you wonder IF you will experience physical and/or emotional late effects, and IF you do, then what will you experience and when will you experience them.

The unknown and uncertainty are mighty powerful striking at the core of personal security and scaring us to our wits end. We wonder, we fear, we worry, we cry, and we panic as we muck  around in what might happen today, tomorrow, a year from now, or five to ten years from now. We know this sucks the LIFE out of us, methodically taking the ‘right now’ away from us. Yet, those thoughts and emotions dance on, making us believe we have little control.

Why is it we get very little if any instruction on how to deal with the unknown and this uncertainty? Clearly, managing our thoughts and feelings in this realm seems essential to our emotional and physical wellbeing.

Working with cancer patients and caregivers in psychotherapy dealing who live in the shadow of the unknown and uncertainty that follows a cancer diagnosis and its treatment, I’ve discovered some effective emotional wellbeing tools for every survivor’s toolbox.

1) Validate How You Feel

“Of course I feel _______, whatever it is you feel. It’s normal to feel your feelings. Validate your feelings. Sometimes, we try to push them down, only to have them come back with greater intensity and usually at the most inopportune times.

Once validated, move your thoughts on to another subject or distract yourself with another activity. You want to establish a habit pattern of not dwelling on the unknown, the uncertainty.

The only caveat to validating is when your emotions are interfering with your daily functioning at which point it’s important to consult your doctor.

2) Remind Yourself

You were already facing the unknown when you were diagnosed with cancer or when you became a caregiver. You most likely didn’t know how to move through that either, but you did. Remind yourself of the path you traveled that you thought impossible at the time and draw courage.

3) ‘What If’ Thinking

One ‘what if’ thought leads to another, which leads to another, which leads to yet another.

What if thoughts are so powerful they can spiral you into tremendous fear and anxiety.

What if I’m not at risk for late effects, but they come anyway? What if I’m in need of a heart transplant, or I’m diagnosed with recurrent cancer? What if the doctors can’t do anything for me?

Nothing good comes from ‘what if’ thinking. Catch ‘what if’ thoughts as soon as you can and don’t answer it, or each time you hear ‘what if’ answer with what if, what if, what if ENOUGH! Then, choose to think about something else.

4) Breathe to Calm

Research has repeatedly established physiologically we can’t be anxious and relaxed at the same time. Become skilled with a helpful breathing technique for calming.

Take a deep breath saying the word inhale silently. Breathe in slowly, INHALE. Then exhale slowly, saying EXHALE silently, as you breathe out. After you’ve exhaled, say the word PAUSE silently. In the pause, nothing is going on. You are not inhaling and you are not exhaling. You are simply pausing. When you are pausing work with thinking P A U S E 1, 2, 3, 4. If the pause feels too long, adjust the numbers to feeling comfortable.

Once you’ve tried the exercise several times, you can substitute: a favorite word, phrase, or color for the word “pause” and for the counted numbers. When using this tool, choose whatever meaningful word, color, or phrase leads to enhanced relaxation.

You will want to work with this tool before you need it, as it is a skill requiring practice in order to be effective. Once you have mastered it, you can use this technique virtually any time, except when you’re driving.

5) Moving Forward

Since the unknown is always present, managing your thoughts and emotions within this realm is both empowering and essential for your own wellbeing, perhaps even your sanity. Managing anything is a skill you can learn and master, or at least become proficient enough to benefit.

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  1. Beth Gainer

    August 23, 2013 at 9:56 am — Reply

    This is truly an excellent post. As a breast cancer “survivor,” all of these points resonate with me, but I truly think the “what-if” thinking is my Achilles’ heel. I have to do my best to drown out those “what if” thoughts. Your tips are useful and really insightful.

    • mhyh

      August 26, 2013 at 1:01 pm — Reply


      I think we all have a chink in our armor and I would bet none of us are immune to the “what if” questions that silently scream within the confines of our minds. Personally, my mind is a battleground unlike any other.

      I appreciate your comment and thanks for stopping by myHeart…


    • Niki Barr, PhD

      August 29, 2013 at 1:48 pm — Reply


      I’m so pleased my post was helpful to you! And exactly right “what if” thinking is such a powerful, destructive thing we do to ourselves, often without even realizing it. I appreciate your taking time to write your thoughts and comments.

  2. Susan Zager

    August 26, 2013 at 12:44 pm — Reply

    This is so helpful at addressing the late effects of breast cancer treatment. I love the way you talk about “breathing for calm” and “moving forward”. This is empowering! Thank you!

    • mhyh

      August 26, 2013 at 1:07 pm — Reply


      I am so very glad you found this post not only helpful, but empowering against the scars that trauma brands into our lives, our souls. No one is left unscathed.

      I invited Niki to guest post because we both agreed that healing is a far cry from cured and all of us need strategies that we can implement in the VERY moment that we NEED them, when our “what ifs” evolve into the worst case scenarios, or worse yet, our reality.

      Thank you for sharing your heart-thoughts with us.


    • Niki Barr, PhD

      August 29, 2013 at 1:52 pm — Reply

      I appreciate so much Susan you found this article’s tools empowering! Thank you for noting what you found most helpful i.e. “breathing for calm” and “moving forward”.

  3. Niki Barr, PhD

    August 29, 2013 at 1:55 pm — Reply


    What a special opportunity for me to share with you and your blog readers what I have learned that seems to be especially beneficial within the emotional realm of cancer. Thank you!

  4. Karen Ingalls

    September 4, 2013 at 2:45 pm — Reply

    I have always used relaxation and breathing techniques which is something I learned from my grandmother. I am a 5 year ovarian cancer survivor and thriver, yet the “what if” game always tries to get the best of me. I believe my purpose now is to concentrate on my mission in life now which is to spread the word about this too often deadly disease. Doing that diminishes the “what if’s” of life.

    • mhyh

      September 4, 2013 at 10:55 pm — Reply


      Thanks for sharing yourself and your lived experience with us and congratulations on thriving ovarian cancer.

      I hope you will be able to join us on 9/12, 9-10pm EDT as we tweet chat with Niki Barr, the author of this post, about FEAR: How to Keep it Caged.

      Thank you for spreading the word about ovarian cancer and thank you for stopping by myHeart. I hope you’ll stop by again.


  5. sally pagryzinski

    June 11, 2014 at 3:37 pm — Reply

    I have been fighting stage 4 breast cancer with mets to the bones since 2008. Just recently due to oversight on my doctor’s part I was informed it has spread to my liver, lymph nodes, spleen and one of my lungs–I am furious with him. He said so sorry Misses, you slipped thru the cracks. So, I switched providers and hopefully am headed in the right direction.

    • mhyh

      June 17, 2014 at 1:47 pm — Reply

      Thank you for sharing your lived experience with us; I am always sorry to hear when things appear to have slipped through the cracks; hoping you are now headed in the right direction under the direction of your new providers.

      All my best,


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