Maintaining Good Health Overall

Protecting your health is more important now than ever before. To maintain your ability to live well after treatment it is important to improve, or avoid developing, other health conditions to the extent this is within your control. Do you smoke? Do you have a sedentary lifestyle? Do you have a poor diet or drink to excess?

One positive effect of making changes to improve (or maintain) your health is that this commitment to better health can also boost your emotional wellbeing. Even doing small things to take care of yourself and making time for yourself can increase your confidence and feelings of self-worth.

Many wellness and cancer patient support programs offer meditation, yoga and other classes geared toward stress reduction. Exercise classes can be fun and are wonderful ways to connect with others and relieve stress. Spiritual communities can be extremely comforting to their members, providing assistance and emotional support, as well as continuing to offer purposeful opportunities to help others, which can be very gratifying.

Self-care includes being honest with yourself about your own needs, especially those involved in getting you to your goals. This may involve setting limits on your time and responsibilities with both family and friends and choosing to make time and space for yourself when you might have neglected to do this in the past.

Emotions and Low-Grade NETs

While it is heartening to realize that it is possible to live a long time with this disease, and to live well, it is also daunting to wrap your head around the fact that you will always have cancer and that it needs to be managed and controlled. It’s important to give your emotional and mental health needs the same level of attention that you give your disease. Don’t be hesitant or embarrassed about asking for help when things become too heavy.

"Patients need an outlet to be able to talk about what they’re dealing with. I would argue that everybody with a cancer diagnosis needs professional psychological assistance. I bring that up in conversation during the first one or two visits. ‘Cancer is stressful. What are you doing to help with the stress? If you don’t have a patient support group, here are some options. If you’re interested in meeting with counselors, here’s how to get in touch with them."
--Scott Paulson, MD

Since slow-growing cancers typically do not benefit from chemotherapy and are treated in other ways, NET patients do not have the visible signs of cancer treatment, like hair loss. They also may remain stable for a number of years—something that people don’t associate with cancer. While that is a welcome scenario (comparatively), it can be frustrating to patients when those around them, including those closest to them, don’t recognize or acknowledge the worry and discomfort of living with cancer. The familiar term “remission” really does not apply to stable, progression-free NET cancer, and sometimes this is difficult to explain.

Fatigue: Causes and Solutions

Being a patient can be exhausting in many ways, and you might find yourself with limited energy even after treatment ends. You would not be alone in this. The most common symptom and the one identified as most troublesome to all cancer patients, including NETs, is fatigue. Yet fatigue will get worse if ignored.

"If you have fatigue, it needs to be carefully evaluated by your care team. Fatigue may be related directly to the cancer itself and/or to the cancer treatments that patients might be receiving. There may be more than one cause of fatigue to be addressed, such as:

• Underlying medical conditions, for example, low thyroid gland function or low B12 levels—these can be treated to improve energy levels.
• Poor nutrition—sometimes evaluation by a dietitian might be needed to make sure you are getting proper nutrition.
• Deconditioning (not being able to exercise)—try to remain active.
• Trouble sleeping—try to optimize your daily schedule so that you will get enough sleep at night. Limit daytime naps.

Other ways to help combat fatigue include:

• One could try to conserve energy. For example, delegate some of your responsibilities to others or schedule your activities during times when you are at your peak performance.
• Psychosocial approaches, for example, cognitive behavioral therapy, help some people.
• Other approaches include yoga, acupuncture, physical therapy and light therapy.
• Occasionally, in cases of severe fatigue that cannot be corrected otherwise, doctors use medications (for example, methylphenidate) to help patients stay alert.”
  --Boris Naraev, MD, PhD

Advice on Reaching a Self-Improvement Goal

If you have an issue that needs attention, or a self-improvement goal, use the “4 I’s” below to help you focus on what is most important to you right now. The goal of such an exercise is to increase self awareness and prioritize goals for improvement, whether spiritual, emotional, physical or interpersonal.

The 4 “I’s” to a Healthier Life

1. Identify What issues am I struggling with? What would I like to improve?
2. Investigate How can I address my issues? Who can help?
3. Initiate Develop a plan. Take the first small steps.
4. Integrate Make these changes a part of my life

As you go through the steps, consider writing them out and sharing your responses with a friend or loved one. Support can be a powerful way to reinforce your commitment to change. If you have access to a professional like a certified health coach, counselor, or social worker, they can help you with this self-assessment.