No one would deny that cancer is a long journey. It is filled with ups and downs, victories and defeats. The cancer journey is tough and most understand the love and care a cancer patient needs during that time.

There is a major component to cancer, however, that is often forgotten—remission. How a cancer survivor is treated by family and friends following a cancer-free diagnosis is complicated. Survivors should not and cannot instantly go back to living the way they did prior to their diagnosis. It is a much more complex transition.

What a person experiences following their cancer battle can actually be more powerful and more frustrating than the cancer itself.

Survivors need an active participant in their lives to ensure they stay on track. Knowing what challenges they could potentially face, and how to help them navigate are important to their continued health.

Unexpected Trials

There are some challenges following remission that patients must endure including lingering physical and emotional effects. Understanding these trials is imperative to truly caring for the person.

A few of the potential challenges include:

• Vision or hearing loss caused by some chemotherapy drugs
• Lingering effects of "chemo brain"
• Permanent or long-lasting changes in physical appearance
• Loss of fertility
• Sleep problems
• Organ damage
• Weight gain
• Financial concerns
• Feelings of being replaced at work or in the home

Physical challenges can be easily diagnosed and understood. However, guilt and depression are occasionally after-effects of the disease and can be undiagnosed and confusing. Depression following remission is puzzling to both the survivor and their supporters because the prevailing thought is that they should be celebrating their remission. What may occur, though, is "survivor's guilt," fear of recurrence, anger or despair from the changes to their body, to name a few.

According to Anthony Perre, MD, Hodgkin lymphoma survivor and chief of the Division of Outpatient Medicine at Cancer Treatment Centers of America®, "When you look at people who have gone through cancer treatment, it's like having post-traumatic stress disorder," he says. "I don't know if I have PTSD, but I can tell you it was overwhelmingly stressful."

Survivorship

There may be an expectation that following a cancer-free diagnosis, a cancer patient can resume their normal life and drop all the things they had been doing to help fight the disease. Although regular trips to a physician and treatments will likely no longer monopolize their daily calendars, there are still intentional acts they will need to continue in order to maintain their positive trajectory.

• Keep up with regular check-ups and appointments to stay on track with appropriate health care. If there are side effects from treatments, survivors may need to see new specialists.
• Maintain a nutritious and balanced diet to help reduce the probability of recurrence. (See American Cancer Society guidelines).
• Exercise regularly and sustain a normal body weight. Adults should get at least 150 minutes of moderate intensity exercise, or 75 minutes of vigorous intensity exercise per week.
• Bring peace and mental wellness into your regular routine through prayer and meditation, yoga or other relaxing activities.
• Give your body a chance to recharge every day with a solid seven to eight hours of sleep each night for adults, according to the National Institutes of Health.

Caring for Survivors

As a cancer patient transitions into survivorship, they may need more guidance and support than ever as they develop survivorship skills. From a caregiver perspective, the support changes, but it remains significant to the survivor's continued health.

It is important to ensure they are keeping up with appointments and actively working towards continued wellness. The most impactful way to do that is to ensure the survivor's primary care physician (PCP) is connected with their oncologist and that both doctors are able to openly share information.

As church members, we may feel there is nothing we can do to serve them, but there are many practical ways to continue ministering to survivors.

• Eat out. Instead of the regular meal deliveries they had become accustomed to, ask them out to lunch or dinner frequently. This will help ease them into a new life outside the home, and they will still feel the love and support of their friends.

• Ask questions. If you notice they are in pain or seem depressed, don't shy away from approaching the subject with them. There is no need to pry into a specific situation, but offer to take them to a follow-up appointment, or ask if they have been struggling with anything in this new life they are experiencing.
• Inspire them to be healthy. Encourage them to take back what they can control for their health by meeting with a dietitian, eating nutritious foods and exercising regularly. Making their body as healthy and strong as possible will help them to feel they are controlling what they can when it comes to their future health.

• Attend outings. Encourage an outing of their choice that you can participate in with them, going to the movies, attending a sporting event, shopping for a new wardrobe if financially possible, or going to a musical concert or festival may be a way to celebrate their new start.
• Pray. Keep them on your prayer list at church. Celebrate the milestone and ask for continued prayers as they learn to navigate this new life they have been blessed with.
• Suggest a support group. There are other members of your congregation and in the community who may also be experiencing survivor's guilt after the trauma of cancer.

Cancer survivors are often overlooked. We are tempted to celebrate their victory and emotionally move on, leaving them to deal with the aftermath. They can be facing confusion, frustration and isolation and though many understand the sentiment is unintended, it can be hurtful at a time when they are very much in need of support. Continued encouragement from the church can make a world of difference in the life of a survivor!

Rev. Percy McCray is the director of pastoral care for the Cancer Treatment Centers of America.

For more guidance on how to help minister to cancer patients and survivors, join the Ministry Leader's Network, a part of the Our Journey of Hope cancer care ministry. The network offers free resources and tips on how to best serve those dealing with cancer in your congregation and your community.

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