Navigating the Long-Term Effects of Cancer Treatment are Reminders of a ‘New Normal’

It is not just about the cancer. Sometimes it is about the cure. Even when there is no evidence of disease, ongoing medical concerns remind us that we need to make room for a new normal.

Every cancer treatment is different, so side effects differ, but the common thread is that something changes. In my case, I developed lymphedema in my right arm along with a goal to keep it in check through physical therapy, swimming, compression sleeves and other suggested routines. There are also mental side effects that lead us to seek therapy and even the risk of future cancers from one of our cancer treatments. Cancer is a complicated journey.

This year, I have dealt with a side effect I put out of mind best I could when it started: tinnitus, which is a ringing in the ears. Carboplatin, one of my chemo drugs, increases risk of tinnitus. Marilyn F. Dille and her co-authors go into detail about risks in their article “Tinnitus Onset Rates from Chemotherapeutic Agents and Ototoxic Antibiotics: Results of a Large Prospective Study” (Journal of American Audiology).

This year, the tinnitus got worse or at least more noticeable. I have different theories about why that happened. One of my theories is that I got COVID-19 (despite all precautions), which can exacerbate preexisting tinnitus, and did not know it. Another more likely theory is that I retired and had more time on my hands to listen to what was going on inside my head. My former job meant I spent a lot of time talking and listening, as well as thinking complex thoughts that competed with ringing sounds.

Retired, socially distanced, I had a lot of time on my hands to notice the ringing. One study on tinnitus during the pandemic headed up by Anglia Ruskin University and published in “Frontiers in Public Health” (see a summary in Science Daily) suggests that social isolation might have exacerbated tinnitus. For whatever reason, the tinnitus got worse, which made me a little depressed. I did seek a hearing test only to discover that my hearing is normal, just with a musical accompaniment (or cacophony, depending on my mood).

I cannot close that stable door, so to speak. While I would never had said “no” to carboplatin, we always hope that we will be in the majority that does not experience rare side effects. Fortunately, the audiologist I visited suggested meditation, which is an interesting process to take one’s mind off bodily distractions while surviving cancer. While I am still a student of meditation, I appreciate its promise.

But back to the point of this reflection. Compromise means learning to embrace whatever we have to live with as we question if we can ameliorate or mitigate other side effects from cancer treatment. We need to be mindful without worrying so much about long-term side effects of our “cure” that we do not enjoy life as best we can or should.

My strategy to deal with things that upset me is to try to understand them. I like to put things in context. After my tinnitus flared recently, I decided that it would be helpful for me to be more prepared for future surprises. I made a list of cancer drugs and printed out information about long-term side effects for future reference. I do not want to prep myself to experience side effects, but I do want to consider them in the context of general health.

When we get wellness checks, doctors ask us about smoking habits and drinking patterns. They caution us about sugar intake. Sorting out symptoms as we age can be challenging, but it will help all around if we understand how side effects of cancer treatment factor into ongoing health patterns. Cancer survivors have special needs that we need to be aware of to make the most of our new normal.

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