Center For Survivorship
Oncology Rehabilitation and Research

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The Emotional Toll of Cancer

Yesterday I had the privilege of working with two cancer survivors. One woman had been diagnosed with triple negative breast cancer and the other woman had been diagnosed with lung cancer.  They are very strong women and warriors battling the emotional and physical side effects of losing body parts and experiencing severe fatigue, nausea, vomiting, insomnia, weakness, pain, neuropathy and mental fogginess.  During each of their individual evaluations, tears flowed, sometimes to the point of bodily tremors trying to deal with the emotional and physical changes that have occurred so quickly and totally changed their lives.  These women were both very active and vibrant women prior to their diagnosis. 

However, it was a comment that both of them shared that made me tremor inside.  Each shared how medical professionals and family members had told them “don’t cry…that is being negative….you have to be positive to get through this….you’re crying too much…you need to take an anti-anxiety pill….”

What I shared with these beautiful survivors and what I share with every survivor and every medical professional that I present to about Oncology Rehab (in the area of “What Not to Say to a Cancer Survivor”) is this:

1.       “DON’T EVER tell a survivor to just be positive…EVER… Unless you have walked in their shoes , you have no idea what it feels like to have body parts removed and your life turned upside down in a moment.  People who are positive die also.

2.      Crying is a great way to get rid of toxins from their body and release a lot of stress.  I hand survivors a box of Kleenex and tell them to cry it out as much as they want to. 

a.      Medical professionals and family members feel bad because their patient or loved one is crying and they don’t know what to do. We must be very careful.  We may be feeling uncomfortable as health care practitioners or family, however, our discomfort does not require the survivor to block or suppress their emotions to make us feel better.

3.      AND PLEASE DON’T SUGGEST MORE MEDICATION as the first line of intervention…These survivors are already taking a lot of medication. More medication should not be considered until all other avenues of evaluation and treatment have been considered.


a.      What is the baseline Vit B12 and Vit D levels…Low Vit B12 can cause neuropsychological effects (read the pharmaceutical insert)and can cause a person to cry at dog food commercialsI know…I was one of them.  In eleven years of treating cancer survivors, 99% of them had low Vit B12 and low Vit D levels.  It is not standard of practice to automatically test those levels. Consider checking these first.  Just bringing those levels up may change physical and emotional status.

b.      Exercise is the most effective treatment for the emotional and physical side effects of cancer treatment.  AND it gives survivors back some control…..something they can do during the craziness of treatment.  There are NO ADVERSE EVENTS as a result of exercise that is prescribed and monitored by a physical therapist.  There is a plethora of research to prove this and I have hundreds of anecdotal stories from eleven years of working with cancer survivors to prove its worth.

c.       In Oncology Rehabilitation, we evaluate then EDUCATE, EDUCATE, EDUCATE….. Knowledge is power. This is power that gives survivors emotional and physical strength.

d.     If you want someone to be positive, give them something to be positive about. Give survivors strategies for getting through the painful and traumatic treatments for cancer.  Give them hope by helping them to see and look forward to the life after cancer. That is what we do in Oncology Rehab.

As a result of the philosophy of oncology rehab to empower survivors, both women left my office with a list of strategies and things that they could do to get through the weeks they had left with chemo or radiation. They had smiles on their faces as they knew there was a hope and a real life after cancer that they could look forward to.  And it won’t end with this treatment.  I will work with these survivors throughout their chemo and radiation and keep empowering them so their quality of life only improves.

They are already embracing their hummingbird courage! - Deb Dohery