The Biggest Challenge

What is it about cancer that can turn the metaphor of climbing mountains into a real-life adventure? Part of it may be that risks are less frightening, says Pamela J. Haylock, RN, a consultant on issues of cancer survivorship and past president of the Oncology Nursing Society. “After all, they’ve already faced death, probably given it considerable thought, and are now less fearful.”

The ability to adopt this kind of positive change after cancer or other life-threatening experiences is sometimes called post-traumatic growth. But for people faced with lingering health problems even long after treatment ends, simply surviving may be the foremost challenge—physical pursuits may be downright impossible.

“Not everyone feels good after having cancer,” says Brad Zebrack, PhD, an assistant professor at the University of Southern California School of Social Work in Los Angeles, who researches the effects of cancer on survivors. “They may be alive but have many physical effects, ongoing pain and discomfort, or they may continue to feel anxious and distressed. For some people, what works for them may be that they can stay home and watch sports all day and not feel like they have to get up to puke every hour.”

Dr. Zebrack knows from experience why some survivors push and test themselves physically. After his own battle with Hodgkin’s disease at age 25, he spent a year on a bicycle tour around the United States in the name of cancer survivorship—but also to make a personal statement of his own. “I had to prove to myself that I would be healthy again,” he says.

Still, both types of survivors may have a shared desire to fill their lives with meaning and appreciation for the moment. “Everybody has to figure out for themselves what works,” Dr. Zebrack says. “If you’re physically sick after cancer, you have to figure out what makes you feel better.”

Cancer survivors may feel a need to give back to society by volunteering, or they may seek out existential meaning. For others, cancer is liberating, allowing them to muster the courage to end unhealthy relationships or to take the trip they’ve always dreamed about. But for most, Dr. Zebrack says it’s an opportunity to look at what they want to do for the rest of their lives, regardless of how long that might be.