The Other Cancer Survivors

Lisa Schulmeister, RN, MN, APRN-BC, OCN®, FAAN

Editor-in-Chief OncLive Nursing

Oncology Nursing Consultant, Adjunct Assistant Professor of Nursing Louisiana State Health Sciences Center in New Orleans, Louisiana

It’s been well established now that cancer survivorship begins on the day of diagnosis. Despite the positive spin that this presents for patients, families, friends, and coworkers, most people still associate cancer survivorship with completing treatment and getting on with life.

With so much focus on the person with cancer, the other cancer survivors often are overlooked or under-recognized. These other cancer survivors are the spouses and children of people who have been diagnosed with cancer, as well as “extended family,” which may include friends, coworkers, and anyone else with a close relationship to the family. To one degree or another, all of these people are “along for the ride” during the cancer journey.

I’m always humbled when I hear of the office staff that donates unused sick time to a coworker being treated for cancer. This gesture of support goes such a long way when the person with cancer is not only grappling with treatment, but is worried about job security as well. Coworkers also are known for helping out with meals and transportation and will send get well wishes during treatment.

Upon return to work, though, many people report that supervisors and coworkers treat them differently and view them not as cancer survivors but as people who have just finished grueling treatment and need an easier, less stressful job. Many have reported being overlooked for job promotions and advancement. This may be due in part to employers’ lingering concerns about physical endurance, but also may be related to unfounded concerns about the potential for cancer recurrence.

Probably the best thing that employers can do upon return to the workplace (or continuation of work while receiving cancer treatment), is to let employees confer with their healthcare providers and decide what job limitations, if any, are necessary. In other words, the employee should be making these decisions, not the employer.

Cancer survivorship also poses challenges for immediate family members. Spouses, children, and parents of cancer survivors have reported feeling like they, too, underwent cancer treatment. As one husband put it, although he did not get in the chemotherapy chair or lie down on the radiation therapy table, he felt like he underwent treatment himself since he was with his wife every step of the way. Another spouse said that being the wife of a cancer survivor is a full-time job and described how she was now handling everything from mowing the lawn to dealing with the insurance company. And when the husband of a friend of mine was diagnosed with cancer and unable to work, tensions grew over time as he became increasingly dependent on her and she realized that she was now his nurse and no longer his wife.

Fortunately, there are many resources for these other cancer survivors. However, linking those in need with available resources doesn’t always happen, as the focus of office visits and chemotherapy treatments often is the patient. I’ve included assessment of the other cancer survivors in my work and hope that you do as well. I’ve also asked patients who they are close to, and ask how these individuals are coping with the patient’s treatment and needs. Several patients have been surprised that I’ve asked this, and a few have admitted that they haven’t given much thought about the impact of cancer and its treatment on anyone but themselves.

Patients report that the family dynamic changes, sometimes for better and sometimes for worse, when cancer treatment has completed. This step in the cancer journey is finally getting its due recognition. Many patients and their families describe this time as the “new normal.”

As the National Cancer Institute (NCI) notes, each caregiver has a unique response to having had a loved one with cancer. The NCI has published a booklet titled Facing Forward: When Someone You Love Has Completed Cancer Treatment to inform families and loved ones about common feelings and reactions that many caregivers have had after treatment ended. It’s a wonderful resource for the other cancer survivors.