Why the feelings can arrive late
During treatment, life narrows to appointments, side effects and getting through the next week. The American Cancer Society describes this as a kind of survival mode, the mind's way of protecting you so you have the capacity to get through a frightening experience. It also notes that it is common not to start processing everything until after treatment is over.
So the end of treatment, or a quiet year long after it, can be when the emotional side finally catches up. The American Cancer Society notes that for some people, emotions put aside during treatment come flooding back all at once, and that sadness, anger or fear at this stage makes sense. The National Cancer Institute's booklet for people who have finished treatment, Facing Forward, opens with the same observation: many survivors had a lot of information and support during their illness, and then find themselves with new questions and concerns once it ends.
The National Cancer Institute considers a person a cancer survivor from the time of diagnosis through the rest of life, whether or not they are living with cancer. Some people embrace the word; others prefer a different one. Either way, support is not limited to the months right after treatment. The National Cancer Institute also notes that it can be tough when others think you are ready to move on and you are not, and that many people feel nervous about seeing their oncologist less often.
If you are in the first weeks after treatment ends, Why Finishing Cancer Treatment Can Feel Harder Than Expected looks at that transition in particular. This article is about the longer view.
What survivors often bring to therapy
Fear of recurrence that will not settle
Fear that the cancer will return is common among survivors, and the American Cancer Society notes that for many people it decreases over time. Even years later, though, certain events can stir it up: follow-up visits and tests, the anniversary of a diagnosis or surgery, a family member's illness, or news that someone you know has had a recurrence. Therapy can help when that fear starts to affect sleep, closeness or ordinary decisions. Fear of Cancer Recurrence covers it in depth.
A "new normal" that does not feel normal
The National Cancer Institute describes life after treatment as less about getting back to normal and more about finding out what is normal for you now. That might include different plans or goals, new routines, permanent scars, things that used to be easy and now are not, and emotional scars from going through so much. Some people feel they have to perform being fine because everyone else has moved on.
Changes at home and at work
Roles shift during treatment. The American Cancer Society notes that going back to your place in the family may not be as easy as you expected: others took over tasks and may not hand them back, or you may disagree with how things were done and feel unable to say so. Relationships with a partner, children, friends and coworkers can feel different. Family members may expect you to step straight back into old roles while you are still recovering; the American Cancer Society suggests talking openly about these changes and, if that is hard, asking your cancer care team about a social worker or counselor who focuses on family issues. Facing Forward also covers body changes, intimacy, and going back to work.
Late effects and an uncertain body
The National Cancer Institute notes that cancer treatment can cause late effects that may not show up for months or years after treatment. Living with ongoing physical changes, or with uncertainty about what your body will do next, can bring grief and frustration. The physical side belongs with your medical team; the feelings about it can belong in therapy.
Questions of meaning
Some survivors find that cancer changed their priorities, their relationships or their sense of what matters. The American Cancer Society calls positive changes of this kind post-traumatic growth, and is careful to say that not everyone experiences it, that it is not the same as getting over cancer, and that growth and grief often happen at the same time. Therapy can make room for both, without pressure to find a silver lining.
What therapy can look like years later
Therapy after cancer is not about reliving treatment in detail unless you want to. It usually starts with what is bothering you now, then looks at how the cancer experience, your history and your relationships connect to it. Dr. Lehmann's approach is insight-oriented and integrative, pairing that kind of understanding with practical feedback and coping skills. Read more about cancer-related emotional support.
For some survivors, a focused stretch of sessions around a specific worry is enough. Others prefer longer-term work, especially when cancer has stirred up older patterns or losses. You can talk about pace and length at any point. The American Cancer Society notes that support in any form, from friends and family to support groups and professional counselors, gives survivors a way to express their feelings and develop coping skills. Therapy is one option among those, not a replacement for them.
Starting therapy as a survivor
When you get in touch, it helps to say roughly when you finished treatment, whether you are still in follow-up care, and what has brought you to reach out now. Ask whether Dr. Lehmann can help with your situation; if she is not the right fit, it is reasonable to ask for a suggestion. Appointments are offered during the day, Monday through Thursday, in Franklin or by telehealth for clients physically located in Michigan at the time of the session. The New Clients page explains the first steps.
Support groups through your cancer center, or community programs such as those offered by Gilda's Club Metro Detroit in Royal Oak (248-577-0800), can sit alongside therapy. The American Cancer Society's helpline is 1-800-227-2345.