Coffee with Komen – Co-Survivorship

by Anne Mattingly, MD
Breast Surgical Oncologist
Hendricks Regional Health Breast Center

Breast cancer affects 1 in 8 women and rates of survival continue to improve, making quality of life central to recovery and life after treatment.

  • A survivor is someone who lives through and beyond cancer diagnosis and treatment.
  • Co-survivors are the friends, family, and caregivers also affected.

Survivorship begins at diagnosis as a path that the patient and the entire family unit walks together.

Cancer diagnosis and treatment can have broad impacts on physical, mental, financial, and even professional wellness. Breast cancer treatment can impact femininity, sexuality, fertility, and a sense of self. Many survivors attest that life after cancer is never the same. It is common to focus on the concrete physical changes, such as the loss of the breast with surgery or the loss of hair with chemotherapy; however, the entire family will often experience persistent psychological and financial effects.

From a patient perspective, survivorship is returning to a “new normal.” Significant distress and anxiety are common in as many as 1 in 5 breast cancer survivors. Distress impacts sleep, exacerbates fatigue, impacts cognitive function, and even influences compliance with ongoing treatment or follow-up.  Depression can worsen self-image concerns, decrease libido, and contribute to relationship problems.

Co-survivors may experience similar levels of distress including:

  • Fear of cancer recurrence
  • Concern regarding medical costs of treatment
  • Worry about change in intimacy for partners of cancer survivors

Co-survivors often will help survivors deal with physical, psychological, and social effects of treatment while foregoing treatment for their own heath conditions or other needs. Co-survivors may not recognize the impact of distress regarding their ongoing caregiver role. Cancer survivors undergoing treatment often experience a sense of helpless, which is mirrored in their co-survivors as they watch their loved one suffer the consequences of cancer treatment.

For co-survivors, coping with caregiving can be challenging. Overall, co-survivors need to maintain their own physical and psychological well-being to avoid burn out. Reaching out to support groups for caregivers or to friends and family may lessen mental and physical burdens.

Depression symptoms among caregivers can be vague, including:

  • Loss of interest or pleasure in normal activity
  • Increasingly feeling “down” or hopeless
  • Uncontrolled worry or nervousness

Caregivers must recognize distress and depression and seek appropriate and prompt medical care. Caregivers need to take care of themselves to care for their family member, which includes getting adequate sleep, exercising, eating healthy foods, maintaining other supportive relationships, and taking breaks from caregiving as needed.

Cancer treatment and survivorship should include the family unit as the center, as this is the most effective way to adequately address survivor and co-survivor needs as well as improve long-term quality of life. Including caregivers and co-survivors into cancer survivorship care plans may also reduce some fears and distress.

I know many breast cancer patients are so grateful and indebted for the love and support from their co-survivors as they walk on their breast cancer journey. Recognizing the positive impact of these caregivers, and thanking them for their contribution in cancer survivorship, is paramount to success.  November is an appropriate time to reflect and give thanks.

“Somehow, some way, you’ll get through this. And no matter the outcome, you’ll be grateful for the gift of time.” — Judy Overton, caregiver

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