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Dr Nanette Bowles “Living without Cancer”

Living without Cancer
By Dr. Nanette Bowles

Years ago, a friend of mine was diagnosed with breast cancer. As her co-workers and friends, we rallied around to support her. We had a scarf party for her and enjoyed the different colors and styles of her wigs. She was given the time off she needed for treatment. Though the details were obviously private, her work responsibilities were altered during recovery.

Thankfully, the cancer was removed and she made a full “recovery”. Her hair grew back and she was back to work full-time. It was easy to think everything was okay and back to normal, but something that is often overlooked is the long-term effects of cancer and the treatment of it. A major one can be a substantial and prolonged decrease in energy. One evening she confided in me that she was having a tough time keeping up with all her work. She was expected to be back to her pre-cancer level of productivity but just didn’t have the energy she used to and didn’t know what to do.

Recent studies show that many survivors still experience symptoms even five years after cancer treatment. These included fatigue (16%), disturbed sleep (15%), cognitive difficulties (13%) and pain (13%). In the work place, these need to be considered, under the ADA. http://www.news-medical.net/news/ 20110604/Five-years-after-cancer-treatment-many-survivors-still-suffer-symptoms.aspx

“Cancer is a disability under the ADA when it or its side effects substantially limit(s) one or more of a person’s major life activities.”

Example: Following a lumpectomy and radiation for aggressive breast cancer, a computer sales representative experienced extreme nausea and constant fatigue for six months.  She continued to work during her treatment, although she frequently had to come in later in the morning, work later in the evening to make up the time, and take breaks when she experienced nausea and vomiting.   She was too exhausted when she came home to cook, shop, or do household chores and had to rely almost exclusively on her husband and children to do these tasks.  This individual’s cancer is a disability because it substantially limits her ability to care for herself.

Even when the cancer itself does not substantially limit any major life activity (such as when it is diagnosed and treated early), it can lead to the occurrence of other impairments that may be disabilities.  For example, sometimes depression may develop as a result of the cancer, the treatment for it, or both.  Where the condition lasts long enough (i.e., for more than several months) and substantially limits a major life activity, such as interacting with others, sleeping, or eating, it is a disability within the meaning of the ADA.


Another friend of mine just had a cancer scare. She let her weight increase slowly but steadily over several years. She has plenty of equipment in her home to help her lose weight…a good treadmill, punching bag, exercise videos, etc. but has twice as many excuses for not using these to help her increase her activity level and get healthier. Then, after being told that she should NOT exercise for a while as they waited for biopsy results, all she could think of was wanting to be healthy enough to exercise.

I wonder how many of us fall into a category of allowing our lifestyle to increase our chances of cancer, wishing we had the energy to get more activity, wondering if we will ever get back to “normal”, etc. Sad that it takes potentially life altering news to help us get serious about our health. Sad that cancer, like so many other hidden disabilities, can so easily be overlooked when the obvious isn’t there to remind us to be patient and accommodating. At the same time, encouraging that we can make good choices for ourselves and treatment options are improving. Cancer does not have to be the death sentence it was once thought to be.

What’s the take away? Be good to yourself….physically, nutritionally, and in every other way. And be kind and compassionate to others. Until next month…

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