Essential Elements of Cancersurvivorship Care: Symptoms

Colleen Dwyer, Brad Buchanan, and Dr Josie explain in this episode that symptoms after cancer treatment can be physical, emotional, functional, or financial, and they often come in clusters. Some begin during treatment, some appear much later, and some problems such as bone loss or heart disease may stay silent until they become serious. Because evidence for symptom treatment in cancer survivors is sometimes limited, care often involves shared decision-making: talking openly with providers about symptoms, personal preferences, and the pros and cons of different options.

A major theme is that survivors should not hide symptoms or try to manage everything alone. Help may come from many places, including doctors, physical therapy, occupational therapy, talk therapy, massage, exercise programs, and community resources. Brad’s story shows how recovery can involve trial and error, emotional healing, trauma processing, support for intimacy and relationships, and adapting over time as the body changes.

The episode also strongly emphasizes support groups. They help normalize what people are experiencing, reduce isolation, offer practical advice, and create meaning. Survivors may not always be ready right away, but finding the right group and staying connected can be deeply helpful. 

Overall, the message is: speak up, keep seeking support, and remember that healing after cancer is an ongoing process that is best done with a team.

Relevant links for this episode: 

• https://manuptocancer.org/
• https://onecancerplace.org/
• https://colontown.org/
• GvHD Speaks has been defunded since this recording. 

General Links:

• Disclaimers: https://cancersurvivormd.org/disclaimers/
• Brad Buchanan: https://linktr.ee/bradthechimera
• G [Josie] van Londen: https://linktr.ee/cancersurvivormd
• CancerBridges: https://cancerbridges.org/

Transcript

Post Cancer Treatment Symptoms

[00:00:00] Overview of post-treatment symptoms

[00:00:00] G van Londen: Hello everybody. This is the series on the essential elements of Cancer survivorship care. And today's topic will be post-treatment symptoms and its management. And I might sound a little breathier today. That's because my breathing is a little down today, but I won't let that stop me.

[00:00:22] G van Londen: So we're just going ahead with me are Colleen Dwyer and Brad Buchanan, who you've met on the past episodes and sort of the rhythm that I think we've settled with is a rhythm where I sort of do my spiel and then I let Brad add from his patient experience and I let Colleen add from her social worker experience.

[00:00:48] G van Londen: So without further ado, I'm going to do my spiel on the assessment and management of post cancer treatments symptoms, [00:01:00] and the spiel is not that long. I'm talking more about as I usually do, general pearls of wisdom. The post-treatment symptoms can be many. The list can be endless from emotional, functional, physical to financial toxicity, and then you can delve into all the specific symptoms that individuals may have.

[00:01:27] G van Londen: From night sweats to nausea, to pain, to not being able to sleep, to being distressed either from anxiety or depression, losing your friends, but this list can go on and these symptoms, they can cluster.

[00:01:47] G van Londen: One may set off the other, and then before you know it, you have a whole bunch of symptoms clustered together. If you have night sweats overnight, you don't sleep as well, so that makes you the next day a [00:02:00] little groggy and you might be irritable and you might have some brain fog.

[00:02:05] General approach to treatment

[00:02:05] G van Londen: Now, all these symptoms. Outside of the cancer context, we have a large arsenal of treatments that we could use that are evidence-based to try to decrease, if not totally negate your symptoms. However, within the cancer arena, we don't have such a large evidence base just yet. So for example, night sweats, and hot flushes or vasomotor symptoms that women and men could have, there is quite an arsenal of treatments that we can utilize to control the hot flushes and the night sweats outside of the cancer arena, but in the cancer arena.

[00:02:49] G van Londen: First of all, we are limited in what we can do because the number one treatment we often apply are hormones. And many cancer survivors have a relative, [00:03:00] if not an absolute contra indication to hormones. And furthermore, there's not great evidence that any of those treatments really work and are safe in the cancer setting. so we extrapolate from the non cancer setting. 

[00:03:18] G van Londen: So you can see this in two ways one way you can say, well, that's a little bit of a bummer. But you could also look at it from the other side where it allows us to be engaged in a shared discussion where we discuss the pros and the cons of all the different treatment options that we could consider for whatever symptom or symptoms you may have.

[00:03:46] G van Londen: In a way that fits with who you are. Always keeping in mind your life's philosophy. Are you somebody who likes to pop pills? Are you somebody who prefers to stay away from any [00:04:00] chemicals, who prefers to help yourself in any other way? Such as through things that might perhaps be more costly and or more time consuming, such as exercise, acupuncture, talk therapy.

[00:04:15] G van Londen: Um, the general gist of what I'm trying to say here is that, one, don't hide your symptoms because if you don't tell us, we can't help you. And secondly, hopefully your provider will be open to engage in a discussion with you, in which we can find together. A treatment that works best for you and to regroup over time to see if anything needs to be tweaked.

[00:04:48] Timing of Symptoms

[00:04:48] G van Londen: Next thing I was gonna hit on is the symptoms can be different in terms of their timing. [00:05:00] Some can be having an early onset. Sometimes even while you're undergoing the cancer treatment, still. Some may have a late onset even decennia later or anything in between. Some of these symptoms might be short lasting, like a radiation burn usually resolves within days, weeks, months.

[00:05:22] G van Londen: Some other symptoms might be much longer lasting like neuropathy or. Any other symptom that maybe you have in mind right now and are struggling with? Lastly, some symptoms are asymptomatic, so I should say some concerns are asymptomatic until they become symptomatic, you might wonder. What does she mean with that?

[00:05:47] G van Londen: Thats for example, heart disease. Heart disease, develop slowly. You don't often know you have heart disease until you present with a heart attack. Same thing with bone loss. You [00:06:00] may lose bone slowly over time, which you may not be aware of until you break a bone. And so what that means is that sometimes for some of these post-treatment concerns, we may have to be a bit proactively in terms of exploring.

[00:06:18] G van Londen: for bone density, you may need to start to do a bone density scan earlier than the average person would. You may need to start heart disease screening earlier than the average person would given your history. But this all depends on who you are. What is your personal philosophy? What is your past medical history, what is your cancer treatment? And together with your provider, you can discuss the pros and cons of screening earlier and whether that's really needed in your case.

[00:06:56] G van Londen: And that where I'm going to take a breath [00:07:00] and give it over to Brad and Colleen.

[00:07:03] What can symptoms be attributed to and does it matter?

[00:07:03] Brad Buchanan: Well, okay. Well, yeah, I mean, I have to confess that, for me it's often difficult to tell at this point, you know, and I'm about 10 years removed from my. first cancer treatments, it's sometimes difficult to tell what's the side effect of, or the lasting effect of the cancer treatments.

[00:07:26] Brad Buchanan: and what is a symptom of the chronic illness that I had because of my transplant, graft versus host disease. but I know that I certainly do have neuropathy in my hands and feet, not as badly as some people do. I don't take any medications, any longer for that neuropathy if I ever did.

[00:07:46] Brad Buchanan: I know I've taken Gabapentin, at various times. but that's been a long time since. I can trace some of the problems with my joint pain and loss of, joint flexibility maybe to some of [00:08:00] the radiation, that I got, the total body ir radiation that I got, and also chemo.

[00:08:06] Brad Buchanan: pretty much I can't run any longer because it hurts my knees too much. That kind of happened during my summer of chemotherapy when, for the first four treatments or so, I felt great. And then, played soccer one time and still felt great and then tried to play again the next week.

[00:08:24] Brad Buchanan: And then, my knees were just hurting too much and I had to stop Running in general became kind of an impossibility. uh, I also lost a lot, a lot of, muscle mass, because of my extended period of disability during my transplant. and I also lost some bone density.

[00:08:42] Brad Buchanan: I don't know if that, my sense is that most of that was due to the prednisone that I was taking. I'm doing some very amateur armchair, self-diagnosis here. and please, feel free to step in and correct me if I'm grossly misstating the [00:09:00] effect of these drugs. But 

[00:09:01] G van Londen: no, yeah, I was gonna jump in though.

[00:09:05] G van Londen: Okay. Because you, you're right. It's hard sometimes to differentiate, which you're not the only one who has been telling me that many patients are confused what is really caused by the cancer, the cancer treatment, or their comorbidities, other diseases they've had preexisting, but that also many of us were lucky enough to grow older.

[00:09:30] G van Londen: As your body ages. that also throws a, a wrench in this whole situation where it's sometimes really hard to figure out what this is from. And sometimes I say, you don't even need to always know what this is from. Sometimes a, a pain is a pain. And it, it, it'll be helpful to know whether it's a muscle, a tendon, the nerve.

[00:09:58] G van Londen: But what I'm trying to say [00:10:00] is it doesn't help what the symptom is caused by. Yeah. Because many of these symptomatic treatments are focused on treating the symptoms. So it doesn't always, is it always necessary to a hundred percent figure out what this is caused by.

[00:10:16] How to get help

[00:10:16] G van Londen: Another thing you brought up, Brad, before I give it back to you and Colleen, is how to get help for it.

[00:10:24] G van Londen: in terms of where do you go? And that's hard to say because not every cancer center or place where cancer treatments are administered has the resources needed for comprehensive survivorship care. But it doesn't mean you should not speak up. What I'm trying to say is tell your providers, and they often have a network that may not be under one roof, but they probably have a network in the local community where you can [00:11:00] receive help, from either physical therapists occupational therapists, speech therapists, talk therapist, uh, I mean, there's so many approaches to treat symptoms that, um, talk with your provider and have them come up with you to find a plan that will help you. 

[00:11:25] Real world experiences

[00:11:25] Brad Buchanan: Yeah. thank you Josie. And I did pursue some of those options. I did some physical therapy, when I was trying to kind of like reeducate myself, about walking and getting stronger. After my transplant. I was, I was also blind at that point. so I kinda had to relearn how to navigate the world.

[00:11:48] Brad Buchanan: and, you know, that was definitely graft versus host disease that hit me. my ocular graft versus host disease was what caused my blindness. but, I also had people [00:12:00] from the Sacramento Society for the Blind come and show me how to use my white cane, which was very helpful.

[00:12:07] Brad Buchanan: but again, these are side effects of the transplant. I did get before the pandemic, I think I've mentioned before that the physical therapists who were offered by my local. health plan were overbooked and inconvenient to get at, so it was really more trouble than it was worth, to connect with them.

[00:12:27] Brad Buchanan: So we ended up kind of, well at first we hired caregivers to come and to sort of like walk with me around the block and we were fortunate to be able to afford that. And then I got more aggressive when I regained my vision and, mobility. I went and did some, I joined a gym basically like right before the pandemic.

[00:12:48] Brad Buchanan: So the timing was bad, in that I didn't get to do it for very long. But yeah, I went to a gym that was geared towards basically retired folks or people rehabbing [00:13:00] from major. medical challenges, surgeries, et cetera.

[00:13:06] Brad Buchanan: But I found out that it was actually perfect for me. and I would go twice a week and, you know, lift some weights, do some cross training. I really didn't enjoy it, but it actually was very helpful. it didn't rebuild me to the point where I could run, and that was really, honestly, if I'd been a younger man, I might have, and if the pandemic hadn't intervened, I might have pushed it, further.

[00:13:29] Brad Buchanan: Um, but yeah, as you say, Josie, at, at some point also the effects of aging kind of, uh, creep in and. I did pursue that. I also went and did, some talk therapy because I had some pretty bad medical trauma to process. basically it was hard for me to, especially, after my transplant to go, and get a haircut because.

[00:13:56] Brad Buchanan: When anyone would touch me even when I was expecting it, the shock [00:14:00] of that touch was still pretty unpleasant. I had a tendency to flinch, it was embarrassing superficially, but then it bespoke this deeper level of medical trauma that I really had to work through.

[00:14:14] Brad Buchanan: And I did go to a therapist. I've had like, I think two different therapists plus a couple's therapist also because there was a huge relationship trauma that. you know, I could go into more detail about, but Josie, you did a, you've done podcasts with both me and my former spouse, Kate Washington. we're now amicably divorced, and successfully co-parenting our two kids.

[00:14:40] Brad Buchanan: but anyway, there was major relationship trauma that we tried to manage through couples therapy and we bounced through three different couples therapists. Before finally getting, what was called discernment counseling, which was essentially saying, okay, we're, we're gonna stop [00:15:00] trying to sort of repair the couple and we're just gonna decide, how we're gonna, like, what, what, what is the plan going forward?

[00:15:11] Brad Buchanan: And the plan ultimately was that we should separate as a trial period and then. And then, and that's what we did. And then ultimately, after the separation of divorce was finalized, maybe a year and a half, like I'm getting, I'm probably getting that wrong. But anyway, so yeah, lots of therapists were, yeah.

[00:15:33] Brad Buchanan: And most of these, by the way, were out pocket. And again, we were fortunate to be able to afford all of this. 'cause my insurance wasn't covering. My talk therapists, the ones that I wanted to talk to, I, that they were not covered by my insurance. So yeah, there was a lot of that. and also a male sexual therapist because I was having, difficulties, in that regard as well.

[00:15:56] Brad Buchanan: Um, some erectile [00:16:00] dysfunction and also, again the physical trauma of not wanting to be touched was kind of profound. I ended up also going to get massages for the first time in my life. that actually really helped. That might've been the most helpful thing of all. at first I got something called oncology massage, which was very gentle.

[00:16:21] Brad Buchanan: I don't know exactly what distinguishes oncology massage from regular massage, but for me it was just the gentleness. I was actually told at that point, this would've been again, pre pandemic. so like 20 17, 18, 19. I was told at that point like, avoid deep tissue massages. 'cause I was still getting photophoresis treatments and I still had a, a double port line in my chest. Um, but, uh, anyway, after, after a while and after the pandemic, they said, okay, you can finally get like normal massages, deep tissues, style massages. So I then, started going [00:17:00] to see my current massage therapist.

[00:17:03] Brad Buchanan: I still see her once a week and. For lack of a better way of putting it. Uh, she kinda reassembled the body parts that I felt like my transplant had kind of, sewn back together. Very imperfectly. And it's very hard to like describe this feeling to someone who doesn't, who hasn't had a stem cell transplant.

[00:17:22] Brad Buchanan: But, a lot of us will say things like, oh, well I feel like Frankenstein's monster. I feel like I'm. a different person than I was before. Like physically, I feel physically wrong. I feel like my head is not connected to my body any longer or, you know, my toes are down there and they're not really connected to my torso.

[00:17:45] Brad Buchanan: Or there was just a sense of being almost like, dismembered, but still somehow one organism. And that's a pretty common feeling, for transplant [00:18:00] recipients. And I think the more aggressive deep, deep tissue massages. helped to realign my shoulders. My shoulders got way outta whack.

[00:18:10] Brad Buchanan: After my transplant, after all the time in the hospital, I think sleeping on my side, in such uncomfortable hospital beds, my shoulders were completely, malformed. the massages gradually eased them back into place.

[00:18:28] Brad Buchanan: And then, I was told I should do weight bearing exercises, so I still lift very light, you know, five and 10 pound weights just to, not to build muscle mass particularly, but to kind of, again, try to retain whatever bone density I've managed to regain. through those various means.

[00:18:50] Brad Buchanan: but yeah, I'm, you know, if I were younger, I would probably more aggressively pursue an exercise regimen. But, that's where I'm at today. [00:19:00] And, a lot of what you talked about, Josie, it applies to me.

[00:19:04] Keep trying different ways until the shoe fits

[00:19:04] Colleen Dwyer: Thanks for sharing all that, Brad. I mean, I think that's a really great example of the ups and downs and all that you go through in that post-treatment phase. I love how you have tried so many different things to heal, is what it sounds like. I think that's really important piece of this, when you talk about post-treatment symptoms and, you know, Josie talked about it, it being early and late effects, early it might look different than what it looks like a couple years after.

[00:19:45] Colleen Dwyer: But I think a big takeaway from this is the awareness of it and knowing that it really is a process of healing, emotionally and physically. It does take time and having patience with yourself [00:20:00] and, reaching out. I think that's another piece of this is making sure that you feel like you're part of a team and that you have providers that support you along the way and that you feel like you can go and talk to somebody about that.

[00:20:16] Colleen Dwyer: Josie mentioned, you know, maybe you're not living in an area that has all the resources, but there are places to go to. You can go online and you, of course you can, Google a lot of things. But Brad, I loved your example of going to the gym and at first maybe it didn't feel like it was a gym for you, but you gave it a try.

[00:20:39] Colleen Dwyer: And from there you realize that, it was a gym for you. And maybe at the time it felt like it was for older folks, but that was kind of what you needed. And you made that work and to this day, you're still strengthening and you're still using weights, which we know is so important. So I think that your [00:21:00] example was really great from.

[00:21:02] Colleen Dwyer: Exercise to therapy, talk therapy.

[00:21:06] It takes a village

[00:21:06] Colleen Dwyer: Um, of course your relationships are impacted by this. I'm sure with your children, your personal relationship, your marriage, you know, there's a lot of ups and downs and trying to work through that. The sexual, the intimacy piece, of course. So many people, their bodies change and you know, you're trying to figure out how to trust your body again.

[00:21:30] Colleen Dwyer: just be able to feel like you can reach out and, Hug somebody or talk about whatever's happening in your life or your feelings and your thoughts. That's a big step. It's very scary. It's very scary to be vulnerable like that when you've been through such a traumatic experience.

[00:21:49] Colleen Dwyer: Um, you talked about massage. It sounds like that was something that was really, uh. That's been very helpful for you, and I'm sure there's other things along the way that you've [00:22:00] tried that maybe weren't so successful, but you know, you kept at it. And I, I think that's a big piece of what we're trying to say today is, you know, communication is huge.

[00:22:09] Colleen Dwyer: Don't give up. You're not alone. There are other people that are going through this, and unfortunately There's no one way to do it. There's no right way. There's a lot of wrong ways, but you don't know that until you experience it and you go through it what you need. The one thing I will just say is don't try to do this alone.

[00:22:33] Colleen Dwyer: Please find a team that's around you. Reach out to Cancer Bridges, Dr. Josie, Brad, one of us. If you're listening and you're trying to find somewhere to go to get some support because it, this isn't something that you can talk with everyone about, not everybody understands this, like Brad was talking about stem cell transplant.

[00:22:54] Colleen Dwyer: You know, unless somebody's had that, they might not understand what it feels like. [00:23:00] But there are groups out there, there are places to go to be able to connect with others who are sharing a similar experience. 

[00:23:06] Brad Buchanan: Yeah, that's a great point. And um. You know, I, I've had different types of, support group, connections as I've gone through my various stages.

[00:23:20] Brad Buchanan: in the beginning I connected with the local, blood cancer support group at uc Davis, which was an in-person group that, met and I went there for the first time with my wife. Right after I got outta the hospital for the first time. I had my lung tumor burst and was, sort of rushed to the er.

[00:23:45] Brad Buchanan: Finally got my first, chemo treatment that then, caused my lung to collapse. And so I showed up at the support group, really kind of just bewildered and frightened and. Kind [00:24:00] of in shock still, even though it was at least a month after the tumor burst. But, going to that group was really important for me in the beginning, even though when it, you know, you go around the table, introduce yourself and everyone, I think I might've been one of the last people to go, and when it was my turn, I said, hi, I am Brad, and I just kind of stopped and just started, like, I started crying because I just couldn't put anything into words at that moment. it was just so overwhelming. And, so my spouse helpfully introduced me to the group, introduced us to the group. And, and yeah, that group was really important, for me going through the first few months leading up to my transplant.

[00:24:52] Brad Buchanan: 'cause there were other people in the support group who had gone through transplants. one woman in particular had been through, an autologous transplant where she was her [00:25:00] own donor. And, you know, she had a very easy experience and, very different from mine. It was great to have her perspective anyway on, you know, she was in the hospital for a month, which is kind of the expected amount of time, or was at that point in 20 16, 20 15.

[00:25:20] Seek and give support

[00:25:20] Brad Buchanan: After my transplant, it was like, well, I, what's the point of going back? I now have a new illness. And, finding support groups for GVHD was really challenging, and basically I found 'em only on Facebook. So, but I, I did eventually join those groups.

[00:25:37] Brad Buchanan: I did eventually get connected with. something called GVHD Speaks, which is, funded by a big pharma corporation, but it's still a way of connecting, people, who have GVHD or caregiving for someone with GVHD, with a mentor. I'm now one of the mentors, and I get new conversations with folks now [00:26:00] almost monthly.

[00:26:01] Brad Buchanan: for a while I was directing my patient advocacy very much at GVHD, but lately I've gotten back into the cancer patient support group, networks, at first with a group called One Cancer Place, which was founded by, Erica Hanson Brown, who's a wonderful, very smart, highly motivational and motivated

[00:26:25] Brad Buchanan: person she actually founded Colon Town, which was kind of a game changer for, colorectal cancer patients. and then with her group, I went to ASCO last year, the, I call it the Cancer Super Bowl, where big pharma companies show up and they build almost like little villages in this huge exhibition hall.

[00:26:46] Brad Buchanan: And then in another building, there's all the high powered oncology research getting presented. And, you know, I, I sort of toured the exhibition hall and I attended a couple of panels where Well, all the [00:27:00] research was essentially over my head, except immunotherapy was clearly where it's at. But the people I connected with, there were fellow cancer survivors or people who are in treatment themselves, and that's where I got involved in the cancer support group that I'm now much more seriously involved with, which is a man up to cancer.

[00:27:22] Brad Buchanan: and I, for a long time I was like, I don't want to be involved in the cancer support group. Like, it doesn't do me any good to be a cancer survivor, like I'm still sick. but yeah, eventually I sort of found my people again, in the cancer world because one thing that is pretty obvious if you've been to any cancer or any other support groups for that matter, is the gender imbalance.

[00:27:46] Brad Buchanan: It's usually, unless you're in a prostate cancer group, let's say. but just general cancer group, most of them people are, there are women. 'cause men don't tend to reach out and ask for support. [00:28:00] They often sort of hide. when they get bad medical news, they deflect, deny delay. That's the classic male strategies.

[00:28:09] Brad Buchanan: it's great to see that there's a group that, Addresses this situation head on and, you know, invites men specifically into that, group, man up to cancer. And, so that has kind of reconnected me in some ways with the, with the cancer world. Uh, you know, and frankly, I would never have gotten graft versus disease if I hadn't had cancer.

[00:28:34] Brad Buchanan: And I've had two types now of blood cancer. Um. so it's possible to be an advocate for two different types of illness. It's possible to seek and give support for two different types of illness and all the side effects that come from each of them. So one of the things that, uh, being involved in this cancer support [00:29:00] group, has done for me in some ways is kinda give a purpose to my otherwise, kind of meaningless as I felt it was a meaningless, like, okay, I'm a cancer survivor, so what? Now i, I have a purpose in that survivorship. I can show other men. Look, it's gonna be tough for a lot of you, but it's worth getting through it.

[00:29:23] Brad Buchanan: If you possibly can. It's worth going to your doctor. It's worth getting the second opinion. It's worth gritting your teeth and getting the treatments that you need. It's worth, you know, just keeping, keeping faith with the process and not just hiding out in your man caves, because that's where a lot of guys end up.

[00:29:42] Brad Buchanan: so that is the other piece of all this, that, That you kind of, mentioned, Colleen, that I really wanted to echo. that, seeking and giving support as cancer patients and as cancer survivors has been super meaningful for me. partly [00:30:00] because I now have a lot of survivor guilt because of my mother's death from cancer.

[00:30:06] Brad Buchanan: Um, you know, because, uh, all, both of my parents have had significant medical issues subsequent to my own cancer ordeals, and I wonder whether, watching me go through what I did, kind of, uh, sent them into a, a, a darker, more stressed out place where my dad had his, um, mental health crises, plural. And my mom got, uh, B-cell lymphoma that proved to be resistant to, um, the chemo and, and immunotherapies until it was really too late.

[00:30:44] Brad Buchanan: So what do I do with that sense of guilt? well, there's only one thing to do about it, and that's to, it's not gonna go away, but to find a purpose in that is pretty powerful. So now I have a purpose in my cancer survivorship. I can say yes, [00:31:00] I fought and at least didn't lose my battle with cancer.

[00:31:04] Brad Buchanan: there's a meaning behind that survivorship. Whereas previously I denied myself that because I had another identity, as A-G-V-H-D patient that I wanted, to affirm. But, uh, anyway, so that's the, that's the other piece of all this is like, if we're lucky enough to survive cancer, what do we do with those sort of leftover feelings of, gee, what about all those people who didn't make it?

[00:31:33] Brad Buchanan: and why, why me? Why did I make it and they didn't make it. Mm-hmm. and those feelings can be pretty dark and difficult. Mm-hmm. But, if we can find a purpose that our survivorship is serving, you know, as we get up each day, that, that to me is, is a way of making it meaningful and making it less painful, psychologically painful, anyway.

[00:31:57] Colleen Dwyer: Yeah, I was actually gonna ask you about [00:32:00] that, about the, give back in a way, the purpose. if you find that, if you've found that to be helpful. Because I think I talked to people who are just recently out of treatment and they talk about wanting to give back, but not yet being ready to do it, which I always think that's like really smart that they know that not everybody, but a lot of people do know, I'm not ready to do that, but eventually I wanna get there and I wanna be able to help other people, because I feel like, you know, I feel lucky that I can do that.

[00:32:33] Colleen Dwyer: That it's can be so meaningful to, to give back. And they also feel like so many people gave to them that they want to be able to help others. I was just wondering when you were talking about that and all that you've done, like all the groups that you've been in, because I also think that, you know, when you go to a support group, you put yourself in a very vulnerable [00:33:00] situation.

[00:33:00] Colleen Dwyer: because you're basically, saying that you're willing to talk about your cancer. I mean, I know not everybody, but you don't know how you're gonna feel. It brings up a lot of different emotions. Yeah. So I think you're sort of giving back by opening that door and stepping into a group and sharing your experience.

[00:33:17] Colleen Dwyer: It's so helpful to other people. we wouldn't exist if people weren't willing to be vulnerable and be put in that situation where they do have to share, but that sharing is what makes the connection, as you well know. Like that's where people learn and people understand they're not alone.

[00:33:37] Colleen Dwyer: there are other people that are going through this and then they share and, it's just very powerful. I've been witness to that for so many years and I just encourage people. To go and find a group that works for them. And I know that's not always the case. Sometimes you have to be ready for it, and sometimes you don't find the right group.

[00:33:59] Colleen Dwyer: [00:34:00] But give it more than one chance. You know, go more than once. See if you can make those connections, because I just feel like there's just so helpful. Some of it depends on where you are in your journey. just back to what you were saying about, giving back or making those connections with people and, the purpose in your cancer journey, I think that's also a really important thing for people to figure out what it is for them individually.

[00:34:30] Brad Buchanan: I think that's a great way of putting it. And, to be honest with you, this is where having some type of religious faith would be helpful. I don't happen to have that belief, like, I don't believe that God saved me for some special purpose that he or she has in mind 

[00:34:47] Brad Buchanan: I just don't have that faith. but that doesn't mean that my ongoing survival can't have some type of purpose. I need to make that purpose every day. [00:35:00] otherwise it really doesn't exist. Um. And, uh, where was I? Where was I going with that?

[00:35:08] Brad Buchanan: Well, yeah, I guess so for me, I'm fortunate, right? Like I retired from my teaching job. I have a stable income. It's modest, but it's sufficient. my pension and so forth. I do have the time and to some extent the energy to offer support. in a cancer support group space. Um, I went to the gathering, and, you know, I met some guys who were like myself, you know, older guys who had sort of more or less put cancer in the rear view mirror for the time being. and we all, we were sort of like, yeah, I feel kind of like an imposter here. 'cause most of the other guys are inactive treatment. And, you know, and I'm not, and I don't have scanxiety anymore.

[00:35:52] Brad Buchanan: I don't wake up every morning wondering, you know, is the phone gonna ring? And with more terrible news about [00:36:00] my cancer experiences and, and so on and so forth. And then we actually listened to what the other guys were telling us. And they were saying things like, thank you for being here, first of all, to show us that there's some light at the end of the tunnel.

[00:36:15] Brad Buchanan: Like you guys got through your cancer ordeals and mine was pretty dark and pretty scary. that, no doubt about that. And they want to know like. People do survive. Like it's possible to get to even really rough news, even when the doctor said you have X amount of days, weeks, months to live, that they can be wrong.

[00:36:39] Brad Buchanan: Medicine can evolve, there can be a clinical trial, as in my case right when I got my terminal, blood cancer number two diagnosis. Couple of weeks later, it was like, well, now there's a clinical trial. So they said basically, you guys are beacons of hope, whether you know it or not. Long-term survivors are beacons of hope [00:37:00] also, as I've gotten more involved in man up to cancer, I also know that it's important to have, people who

[00:37:09] Brad Buchanan: are in relatively stable medical condition in positions of leadership because we want to ensure continuity of the group itself. Right? and you know, no one's gonna be denied a position of leadership on the basis that there's still an active treatment, but it is good to know that there are, you know, guys who are like not in imminent danger of dying of cancer, who couldn't kind of be supportive of the infrastructure of the support group itself. So that was like learning those things. kind of took care of whatever that imposter syndrome was 

[00:37:49] Support groups through good and bad times until the end

[00:37:49] Brad Buchanan: It also doesn't shy away from the fact that some of us are going to die and that we need to be there to support them when that happens too. And that is the final leg of [00:38:00] the journey of support that I have already experienced in man up to cancer where, you know, there was one particular man who showed up at the gathering, he said.

[00:38:10] Brad Buchanan: I will not be back here next year. I'm, you know, like I'm going into hospice care. And indeed, he died, um, uh, a couple of weeks ago and we just had a, you know, a Zoom memorial for him yesterday. And the group reaffirmed its value of mutual support right up to the end, for him. That is a really powerful thing.

[00:38:37] Brad Buchanan: that Zoom, well, it just shows me that this is the last support group I'll ever need because it doesn't, it doesn't, sort of ostracize people or sideline them or silence them, you know, When death is, right around the corner. And in fact, that's really kind of what ultimately convinced me that this [00:39:00] group was, where I needed to stay.

[00:39:01] Brad Buchanan: support groups have to be there in good times and in bad. And We will all have those bad times, you know, even if it's not. Directly related to our cancers. we'll all need that support system at some point. 

[00:39:15] G van Londen: Thank you, Brad. And I'm sorry for your loss.

[00:39:19] Colleen Dwyer: Me too.

[00:39:21] Conclusion

[00:39:21] G van Londen: And, we talked a lot about support groups in this episode, because it normalizes things to make you feel less crazy, that empowers you to reach out for help Thirdly, it's word of mouth. People in the support group, some of them have tried to find help for themselves and they have figured it out and they can tell you where you can go to find the help you need for whatever symptom it is you have.

[00:39:52] G van Londen: And so support groups have multiple, multiple purposes. 'cause we're almost coming to the [00:40:00] end. So I wanted to go back to Colleen and Brad. And see if they have any final input.

[00:40:07] Colleen Dwyer: Uh, no, I, I just, I think we highlighted, the subject and some those things about communication with your doctor is huge and you don't have to do this alone. I, I think the awareness of this piece, um, you know, that it changes. Yeah, just, uh, please keep in connection with people that are aware of cancer and things pop up.

[00:40:35] Colleen Dwyer: it's good to have some relationships and support around your needs as they change. 

[00:40:43] G van Londen: Brad, is there anything you would like to share? 

[00:40:46] G van Londen: No, I think we've covered the bases pretty well. Well then I thank you both and that will, bring this episode to a closure.

[00:40:57] G van Londen: Hope you enjoyed it and [00:41:00] see you the next time.