Facing the future

Surviving cancer can have a profound effect on the way that people look towards the future. Many will take an optimistic view that all will be well, while others may feel that a recurrence of their cancer is likely and that they should plan for the end of their life. Of course things are not that clear cut, and many people we spoke to expressed mixed feelings about what the future might hold.

It was common for people who had been in remission a long time with no problems related to their cancer to feel very positive about the future. Claire had survived cancer twice and said she had a vision that she would still be alive aged 100. Some said that, although they had thought about their illness and the possibility of recurrence a lot at first, as time had passed they thought about it less and less. Some only thought about it when it came up in conversation or in the media, they went for a check-up, or they experienced symptoms which they thought might suggest a return of the cancer.

Michael is feeling optimistic about his future having probably been cured of chronic lymphocytic…

Age at interview 60

Gender Male

Age at diagnosis 54

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At first she couldn’t go to sleep without feeling for a recurrence of her ovarian cancer but then…

Age at interview 58

Gender Female

Age at diagnosis 44

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Claire doesn’t worry about her colorectal cancer on a day-day basis except when she…

Age at interview 46

Gender Female

Age at diagnosis 16

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Having check-ups or attending for routine screening after having breast cancer could make people anxious until they were reassured that everything was fine. Experiencing symptoms can also be worrying and many people had taken their concerns to a doctor and asked for tests. Although it was easy to become overly worried about bodily changes, several people said they had been grateful that the health professionals had taken their concerns seriously because of their medical history, and they had felt reassured by having tests done to rule out a recurrence of their cancer. Norma had tests after experiencing bowel symptoms but was never told the results so had to assume that her colorectal cancer had not returned. Not everyone automatically worried that their cancer had recurred when they developed symptoms; some attributed them to other health issues.

Whenever Dorothy experiences symptoms she worries that her breast cancer has returned or spread…

Age at interview 74

Gender Female

Age at diagnosis 62

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In general, the longer someone has been in remission from cancer the less likely it is to recur, but there are no guarantees and recurrences can occur after many years, sometimes in a different part of the body. Many people we spoke to said that although they understood that recurrence was possible they didn’t worry about it. Some said that worrying could have a negative impact on their life but others said they had more pressing health issues to worry about. Some hoped that by keeping fit and healthy or reducing stress they might reduce the risk of recurrence. While some wanted to know how likely recurrence was, others preferred not to.

Thomas doesn’t worry about his colorectal cancer coming back but he has an irregular heart beat…

Age at interview 79

Gender Male

Age at diagnosis 69

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Some took a pragmatic approach towards recurrence, saying that there was nothing they could do to influence whether it occurred and if it did they would deal with it; having been through cancer already most felt better prepared for coping with it again. In some types of cancer, recurrences can be successfully treated but in others they are more likely to lead ultimately to death. As a result some people had faith that they could survive a recurrence whereas others had resigned themselves to dying if the cancer recurred, especially if they were already elderly.

He does not worry about whether his testicular cancer will recur because that is down to fate. He…

Age at interview 48

Gender Male

Age at diagnosis 34

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Olivia doesn’t worry about her breast cancer coming back because she is nearly 76 and knows she…

Age at interview 75

Gender Female

Age at diagnosis 58

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Others took the view that their cancer would not recur or that they would die of something other than cancer. A woman who was taking Glivec for chronic myeloid leukaemia hoped to travel to Bali in the future to try managing her condition with meditation rather than drugs.

Jim is convinced that his prostate cancer has been cured and won’t come back; he doesn’t worry…

Age at interview 72

Gender Male

Age at diagnosis 64

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By contrast, other people did worry about recurrence and some said the prospect frightened them. It was common for people to say that it was always at the back of their mind or they worried subconsciously all the time no matter how small the risk was. A woman who had ovarian cancer six years ago aged 35 said she worries more, not less, as time goes on. A woman who has survived seven years so far won’t allow herself to be lulled into a false sense of security because she knows that recurrence is almost inevitable with the type of lymphoma she has. Some women and men who had breast cancer said they were more likely to check themselves for lumps nowadays. Sandra was concerned about stopping hormone therapy after 5 years because this treatment aims to prevent recurrences.

He knows that his testicular cancer is very unlikely to come back but he can’t get out of his…

Age at interview 50

Gender Male

Age at diagnosis 44

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She is afraid that if she tells her doctor about her symptoms they will find her cervical cancer…

Age at interview 42

Gender Female

Age at diagnosis 36

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People sometimes acknowledged that their future was uncertain either because of the possibility of recurrence or because they were living with chronic or advanced cancer and facing further treatment. Many said they couldn’t make long-term plans. Some thought they might die prematurely from their cancer but didn’t know how it would happen.

She knows that at some point there will be no more treatment she can have for her ovarian cancer…

Age at interview 66

Gender Female

Age at diagnosis 56

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Dealing with a life threatening illness such as cancer can help people to come to terms with the reality that we all have to die sometime. Some people said it had led them to put their affairs in order, think about their preferred place of death, or plan their funeral. Others said that they were not afraid of death and felt comfortable talking about it. A man who’d had non-Hodgkin’s lymphoma for 13 years said that knowing your life expectancy is limited provides an opportunity to plan how you will spend your time and to tell your family how much you love them. A few knew they were likely to die within weeks or months and were making plans for the end of their life.

Having had breast cancer Frances has come to terms with the concept of death and can cope with it…

Age at interview 64

Gender Female

Age at diagnosis 54

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Knowing that she will soon die from her ovarian cancer she held a pre-funeral’ party to mark…

Age at interview 57

Gender Female

Age at diagnosis 52

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Some people who had expected to die were now facing a longer life expectancy due to new treatments becoming available that had put them into remission. They said this had been difficult to come to terms with because they had to pick up aspects of everyday life that they thought they had dispensed with.

He was originally told he wouldn’t survive his lymphoma so stopped caring about his finances;…

Age at interview 49

Gender Male

Age at diagnosis 39

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