One of the most difficult times for individuals who have experienced a cancer diagnosis is the period right after cancer treatment has ended. This is known as the ‘re-entry period’. This time can be anywhere from immediately after cancer treatment ends to a year and a half after treatment. It can be a time where both the relief of finishing treatment and the anxiety of treatment failure and recurrence coexist. It is important that medical providers take an active role in recognizing that care of some kind may still be necessary even if individuals are not actively receiving treatment anymore.

Re-entry period After Cancer treatment

After cancer treatment ends, the doctor visits either cease or become less frequent and the support from loved ones may diminish.  The perceived safety net that existed during treatment is no longer present during this re-entry period.

Patients can feel frustrated and confused if they find that resuming “normal” pre-treatment activities after treatment is not realistic. The Foundation frequently hears from people asking, “when will I be normal again?” It is important to let individuals know that immediately after treatment the “normal” that previously existed in their lives may not be appropriate. This may relieve some of the added stress of unrealistic expectations. Expectation management can also be helpful for caregivers as well. Identifying key areas with caregivers where their loved one may require extra care or patience can be useful.

There is also a lack of information about what one should be doing during this time. During treatment, clinicians provide information on diet, physical activity and daily habits that help manage side effects. After treatment, this information is often left up to the individual to figure out. This can amplify confusion and frustration. Similarly, there is little to no information readily available to many anal cancer thrivers beyond their diagnosis so the period right after treatment leaves many with questions like “what now?”

This re-entry phase may be particularly difficult for anal cancer thrivers as they can experience compounded feelings of isolation due to the small anal cancer population and the removal of the treatment safety net. Programs like the Foundation’s Peer to Peer Support Program can be very helpful in ending feelings of isolation during this period. Speaking with others, who have been there, can normalize and validate the feelings and experiences of thrivers.

Continuity of care

A number of simple steps that providers can take to help minimize the distress felt. Care for anal cancer thrivers needs to extend beyond treatment of the disease. Thrivers need to be equipped with information to facilitate a positive re-entry period. Information should include fact sheets, a discussion of expectations for life after treatment, and information on how to access supplementary resources. It may also be beneficial to include any caregivers in this discussion so they too can anticipate needs during this adjustment period. Psychosocial interventions can be extremely helpful during re-entry and can provide clinicians with the opportunity to focus on the care of individuals still in treatment. Connecting or referring thrivers to sex therapists, pelvic floor physical therapists, dietitians, and counselors can be instrumental in empowering thrivers and help in the transition to life after treatment.

Sources

Stanton, A. L. (2012). What happens now? Psychosocial care for cancer survivors after medical treatment completion. Journal of Clinical Oncology,30(11), 1215-1220.

de Moor, J. S., Mariotto, A. B., Parry, C., Alfano, C. M., Padgett, L., Kent, E. E., … & Rowland, J. H. (2013). Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiology Biomarkers & Prevention22(4), 561-570.

Jacobsen, P. B., Holland, J. C., & Steensma, D. P. (2012). Caring for the whole patient: the science of psychosocial care. Journal of Clinical Oncology30(11), 1151-1153.