Support for People With Cancer

National Cancer Institute

U.S. Department 

of Health and

Human Services

National Institutes

of Health

When Cancer Returns
For more information . . .

This booklet is only one of many free booklets for people with cancer. 

Here are some others you and your loved ones may find useful: 

•	 Biological Therapy: Treatments That Use Your Immune System 

To Fight Cancer

•	 Chemotherapy and You

•	 Eating Hints Before, During, and After Cancer Treatment

•	 Taking Part in Cancer Treatment Research Studies

•	 Pain Control

•	 Radiation Therapy and You

•	 Taking Time

•	 Thinking About Complementary and Alternative Medicine

•	 When Your Parent Has Cancer: A Guide for Teens

•	 When Someone You Love Is Being Treated for Cancer

•	 When Someone You Love Has Advanced Cancer

These booklets are available from the National Cancer Institute (NCI.) 

To learn more about the specific type of cancer you have or to 

request any of these booklets, visit NCI’s Web site (www.cancer.gov). 

You can also call NCI’s Cancer Information Service at 1-800-4-CANCER 

(1-800-422-6237) to speak with an information specialist. 
 

“When I found out I had cancer again, 

I just felt numb. It was hard for me 

to accept the news at first. 

After a few weeks, though, I started 

to really look at all my options 

and things I could do for myself. 

By doing this, it gave me back 

some control.”

When Cancer Returns

Table of Contents

1. Adjusting to the News.........................................................................1

2. Why and Where Cancer Returns .......................................................3

3. Taking Control: Your Care and Treatment........................................4

4. Managing the Side Effects of Your Treatment ..................................9

5. Your Feelings.....................................................................................15

6. Setting Goals .....................................................................................25

7. Family and Friends ...........................................................................27

8. Looking for Meaning ........................................................................31

9. A Time To Reflect..............................................................................33

10. Words To Know .................................................................................34

11. Resources ..........................................................................................37

Words that appear in bold in the text are defined in the 

Words To Know section on page 34.
“One minute everything was 

fine, and then my doctor 

dropped the bomb that 

my cancer had come back. 

In five short minutes, my 

life had changed again.” 

—Dorothy
1

chapter 1

Adjusting to the News

Maybe in the back of your mind, you feared that your cancer might return. Now you might be 

thinking, “How can this be happening to me again? Haven’t I been through enough?”

You may be feeling shocked, angry, sad, or scared. Many people have these feelings. But you 

have something now that you didn’t have before—experience. You’ve lived through cancer 

once. You know a lot about what to expect and hope for. 

Also remember that treatments may have improved since you had your first cancer. 

New drugs or methods may help with your treatment or in managing side effects. 

In fact, cancer is now often thought of as a chronic disease, one which people manage 

for many years. 

Using This Booklet

This booklet offers some general advice as you adjust to the news that your cancer has 

returned. It covers all aspects of your treatment. These include managing side effects and 

symptoms, as well as seeking emotional support. 

Above all else, remember that your feelings count. There is no “right” way to cope. Some 

people need a lot of information. Others like a little at a time. Likewise, some sections in this 

booklet may address your needs. Others may not. 

n Flip through the Table of Contents to look for topics you need.

n Using this guide along with those booklets listed on the inside front cover may help you 

find the information that you need. 
“I was floored. I thought 

all the cancer was gone. 

I was just getting back to 

a normal life. I was even 

more surprised that it 

came back in a different 

place. But I didn’t care 

where it was. I just 

wanted it to go away.” 

—Ronald
3

chapter 2

Why and Where Cancer Returns

When cancer comes back, doctors call it a recurrence (or recurrent cancer). 

Some things you should know are:

n A recurrent cancer starts with cancer cells that the first treatment didn’t fully remove or 

destroy. Some may have been too small to be seen in follow-up. This doesn’t mean that 

the treatment you received was wrong. And it doesn’t mean that you did anything wrong, 

either. It just means that a small number of cancer cells survived the treatment. These cells 

grew over time into tumors or cancer that your doctor can now detect. 

n When cancer comes back, it doesn’t always 

show up in the same part of the body. For 

example, if you had colon cancer, it may 

come back in your liver. But the cancer is 

still called colon cancer. When the original 

cancer spreads to a new place, it is called a 

metastasis (meh-TAS-tuh-sis). 

n It is possible to develop a completely new 

cancer that has nothing to do with your 

original cancer. But this doesn’t happen 

very often. Recurrences are more common.

Where Cancer Can Return

Doctors define recurrent cancers by 

where they develop. The different 

types of recurrence are:

n Local recurrence. This means 

that the cancer is in the same 

place as the original cancer or is 

very close to it.

n Regional recurrence. This is 

when tumors grow in lymph 

nodes or tissues near the place 

of the original cancer.

n Distant recurrence. In these 

cases, the cancer has spread 

(metastasized) to organs or 

tissues far from the place of the 

original cancer. 

Local cancer may be easier to treat 

than regional or distant cancer. 

But this can be different for each 

patient. Talk with your doctor 

about your options.
4

chapter 3

Taking Control: Your Care and Treatment

Cancer that returns can affect all parts of your life. You may feel weak and no longer in control. 

But you don’t have to feel that way. You can take part in your care and in making decisions. 

You can also talk with your health care team and loved ones as you decide about your care. 

This may help you feel a sense of control and well-being.

Talking With Your Health Care Team

“I always ask lots of questions because I want to be ready just in case 

something happens. I really do believe that everyone taking care of me has 

my best interests at heart. But I worry that if I don’t ask about everything, 

they may forget to give me the answers.” —Bonita

Many people have a treatment team of health providers who work together to help them. This 

team may include doctors, nurses, oncology social workers, dietitians, or other specialists. 

Some people don’t like to ask about treatment choices or side effects. They think that doctors 

don’t like being questioned. But this is not true. Most doctors want their patients to be 

involved in their own care. They want patients to discuss concerns with them. 

Here are a few topics you may want to discuss with your health care team:

n Pain or Other Symptoms. Be honest and open about how you feel. Tell your doctors if 

you have pain and where. Tell them what you expect in the way of pain relief. (See Chapter 

4 for more about pain and other symptoms.)

n Communication. Some people want to know details about their care. Others prefer to 

know as little as possible. Some people with cancer want their family members to make 

most of their decisions. What would you prefer? Decide what you want to know, how much 

you want to know, and when you’ve heard enough. Choose what is most comfortable for 

you. Then tell your doctor and family members. Ask that they follow through with your 

wishes. 

n Family Wishes. Some family members may have trouble dealing with cancer. They don’t 

want to know how far the disease has advanced. Find out from your family members how 

much they want to know. And be sure to tell your doctors and nurses. Do this as soon as 

possible. It will help avoid conflicts or distress among your loved ones. (See page 27 to read 

more about talking with your loved ones.)
5

Other Tips for Talking With Your Health Care Team

“You need a notebook because you go to the doctors and they’re telling you 

things, and you’re so scared that you don’t really listen. Then you get home, 

and you can’t even remember what they said.” —Jake

n Speak openly about your needs, questions, and concerns. Don’t be embarrassed to ask 

your doctor to repeat or explain something.

n Keep a file or notebook of all the papers and test results that your doctor has given you. Take 

this file to your visits. Also keep records or a diary of all your visits. List the drugs and tests you 

have taken. Then you can refer to your records when you need to. Many patients say this is 

helpful, especially when you meet with a new doctor for the first time.

n Write down your questions before you see your doctors so you will remember them. 

(See the box on page 10.)

n Ask a family member or friend to go to the doctor’s office with you. They can help you ask 

questions to get a clear sense of what to expect. This can be an emotional time. You may 

have trouble focusing on what the doctor says. It may be easier for someone else to take 

notes. Then you can review them later.

n Ask your doctor if it’s okay to tape-record your talks. 

n Tell your doctor if you want to get dressed before talking 

about your results. Wearing a gown or robe is distracting 

for some patients. They find it harder to focus on what 

the doctor is saying. 

Treatment Choices

There are many treatment choices for recurrent cancer. Your 

treatment will depend partly on the type of cancer and the 

treatment you had before. It will also depend on where the 

cancer has recurred. For example:

n A local recurrence may be best treated by surgery or 

radiation therapy. This means that the doctor removes 

the tumor or destroys it with radiation. 

n A distant recurrence may need chemotherapy, 

biological therapy, or radiation therapy. (For more 

information see the NCI booklets Radiation Therapy and 

You, Chemotherapy and You, and Biological Therapy.)

It’s important to ask your doctor questions about all your 

treatment choices. You may want to get a second opinion as 

well. You may also want to ask whether a clinical trial is an 

option for you.

Should I Get A 

Second Opinion?

Some patients worry that 

doctors will be offended if 

they ask for a second opinion. 

Usually the opposite is true. 

Most doctors welcome a 

second opinion. And many 

health insurance companies 

will pay for them. 

If you get a second opinion, 

the doctor may agree with 

your first doctor’s treatment 

plan. Or the second doctor 

may suggest another 

approach. Either way, you 

have more information and 

perhaps a greater sense of 

control. You can feel more 

confident about the decisions 

you make, knowing that 

you’ve looked at your options.
6

Clinical Trials 

Treatment clinical trials are research studies that try 

to find better ways to treat cancer. Every day, cancer 

researchers learn more about treatment options from 

clinical trials.

Each study has rules about who can take part. These 

rules include the person’s age and type of cancer. They 

also cover earlier treatments and where the cancer 

has returned. 

Clinical trials have both benefits and risks. Your 

doctor should tell you about them before you make 

any decisions about taking part.

There are different phases of clinical trials. They 

include: 

n Phase I trials test what dose of a treatment is safe 

and how it should be given.

n Phase II trials discover how cancer responds to a 

new drug or treatment. 

n Phase III trials compare an accepted cancer 

treatment (standard treatment) with a new 

treatment that researchers hope is better.

Taking part in a clinical trial could help you and 

others who get cancer in the future. But insurance and 

managed care plans do not always cover the costs. 

What they cover varies by plan and by study. If you 

want to learn more about clinical trials, talk with your 

health care team. 

For more information about clinical trials, see 

NCI’s brochure Taking Part in Cancer Treatment 

Research Studies.

Questions to Ask 

Your Doctor or Nurse 

About Treatment Choices

Decide on the most important 

things you need to ask your 

doctor or nurse. Some ideas:

n What are my treatment 

choices?

n Which do you suggest for me?

n How is this treatment the 

same as or different from my 

last treatment?

n How successful is the 

treatment you recommend? 

Why is it best for me?

n Will I still be able to do things 

I enjoy with the treatment? 

Without the treatment?

n How long will I be on this 

treatment?

n Will I have side effects? If so, 

how long will they last?

n How can I manage the 

side effects?

n Will I have to stay in the 

hospital?

n Is a clinical trial available 

to me?

n Will I have to pay any costs in 

a clinical trial?

n If the treatment doesn’t work, 

then what will I do?
7

Making Your Wishes Known

When cancer returns, 

the treatment goals may 

change, or they may be 

the same as they were 

for your first cancer. 

But for many people, 

it’s the second cancer 

diagnosis that finally 

prompts them to make their wishes known. Although it 

can be tough to think about, and maybe even tougher 

to talk about, having recurrent cancer may prompt you 

to make certain decisions about what you want done 

for you if you are unable to speak for yourself. 

Everyone should make a will and talk about end-oflife choices with loved ones. This is one of the most 

important things you can do. Also, think about giving 

someone you trust some rights to make medical 

decisions for you. You give these rights through legal 

documents called advance directives. These papers 

tell your loved ones and doctors what to do if you can’t 

tell them yourself. They let you decide ahead of time 

how you want to be treated. These papers may include 

a living will and a durable power of attorney for 

health care.

Setting up an advance directive is not the same as 

giving up. Making such decisions at this time keeps you 

in control. You are making your wishes known for all 

to follow. This can help you worry less about the future 

and live each day to the fullest. 

It’s hard to talk about these issues. But it often comforts 

family members to know what you want. And it saves 

them from having to bring up the subject themselves. 

You may also gain peace of mind. You are making these 

hard choices for yourself instead of leaving them to 

your loved ones. 

Make copies of your advance directives. Give them 

to your family members, your health care team, and 

your hospital medical records department. That way, 

everyone will know your decisions.

Legal Papers At-A-Glance

Advance directives

n A living will lets people know 

what kind of medical care 

you want if you are unable to 

speak for yourself.

n A durable power of attorney 

for health care names a 

person to make medical 

decisions for you if you can’t 

make them yourself. This 

person is called a health 

care proxy.

Other legal papers 

that are not part of the 

advance directives

n A will tells how you want 

to divide your money and 

property among your heirs. 

(Heirs are usually the family 

members who survive you. 

You may also name other 

people as heirs in your will.)

n Power of attorney appoints 

a person to make financial 

decisions for you when you 

can’t make them yourself.

Note: You do not always need a 

lawyer present to fill out these 

papers. But you may need a 

notary public. Each state has 

its own laws about advance 

directives. Check with your lawyer 

or social worker about the laws 

in your state. (For more, see the 

Resources on page 37.)
“For me personally, the 

challenge is not to let the 

treatments get the best of me. 

I make sure if I have any new 

aches or pains I tell my doctor 

right away. He’s great about 

working with me to handle 

these things.” —Edna
9

chapter 4

Managing the Side Effects of Your Treatment

You probably already know about ways to manage the side effects of cancer treatment. If so, 

parts of this section will be a review for you. It outlines some of the support therapies cancer 

patients have found helpful.

For more information about side effects, see the NCI booklets Radiation Therapy and You and 

Chemotherapy and You.

Comfort Care 

You have a right to comfort care both during and after treatment. This kind of care is often 

called palliative (PAL-ee-yuh-tiv) care. It includes treating or preventing cancer symptoms 

and the side effects caused by treatment. Comfort care can also mean getting help with 

emotional and spiritual problems during and after cancer treatment.

People once thought of palliative care as a way to comfort those dying of cancer. Doctors now 

offer this care to all cancer patients, beginning when the cancer is diagnosed. You should 

receive palliative care through treatment, survival, and advanced disease. Your oncologist 

may be able to help you. But a palliative care specialist may be the best person to treat some 

problems. Ask your doctor or nurse if there is a specialist you can go to. 

Pain Control

Having cancer doesn’t always mean that you’ll have pain. But if you do, you shouldn’t accept 

pain as normal. Your doctor can control pain with medicines and other treatments. Managing 

your pain helps you sleep and eat better. It makes it easier to enjoy your family and friends, 

and to focus on the things you enjoy. 

Have regular talks with your health care 

team about your pain. Let them know what 

kind of pain it is, where it is, and how bad 

it is. These talks are important because 

pain can change throughout your illness. 

And your pain may show where cancer has 

returned after remission. Many hospitals 

have doctors who are experts in treating 

pain. Tell your doctor if you would like to 

talk to a pain specialist. 
10

Treatments can be used for all types of pain, 

including:

n Mild to medium pain

n Medium to very bad pain

n Breakthrough pain

n Tingling and burning pain

n Pain caused by swelling.

There are different ways to take pain medicine, 

such as:

n By mouth

n Through the skin (with a patch)

n By shots

n Through an I.V. pump.

Your medicine, and how you take it, will depend 

on the type of pain and its cause. For example, 

for constant pain you may need a steady dose of 

medicine over a long period of time. You might use 

a patch placed on the skin or a slow-release pill. 

You may want to keep a pain diary to help you 

explain your pain to your doctor. In the diary, 

write down:

n The time of day you had the pain 

n What you were doing when you felt the pain 

n What it felt like 

n Where you felt it. 

Your doctor may also ask you some questions 

about how your pain affects your daily routine. 

Having your pain managed means that you can 

focus on living your life and not be distracted 

by pain.

To learn more, see the NCI booklet Pain Control.

Controlling Pain

What To Tell Your Doctor

When describing pain to your doctor, 

give as much detail as you can. Your 

doctor may want to know:

n Where exactly is your pain? Does it 

move from one spot to another?

n How does the pain feel—dull, 

sharp, burning?

n How often do you have pain?

n How long does it last?

n Does it occur at a certain time of 

day—morning, afternoon, night?

n What makes the pain better? 

n What makes it worse?

Using Strong Drugs To 

Control Pain

People with cancer often need strong 

medicine to help control their pain. 

Don’t be afraid to ask for pain medicine 

or for larger doses if you need them. 

And the drugs will help you stay as 

comfortable as possible. 

People with cancer hardly ever get 

addicted to these drugs. Sadly, fears 

of addiction sometimes prevent 

people from taking medicine for pain. 

The same fears also prompt family 

members to encourage loved ones to 

“hold off” between doses. But people in 

pain get the most relief when they take 

their medicines and treatments on a 

regular schedule.
11

Other Ways To Treat Pain

Cancer pain is usually treated with medicine and other therapies. But there are also some 

nondrug treatments. They are types of complementary and alternative medicine (CAM). 

Many people have found the methods listed below 

helpful. But talk with your health care team before 

trying any of them. Make sure they are safe and won’t 

interfere with your cancer treatment. 

n Acupuncture is a form of Chinese medicine that 

stimulates certain points on the body using small 

needles. It may help treat nausea and control 

pain. Before using acupuncture, ask your health 

care team if it is safe for your type of cancer. 

n Imagery is imagining scenes, pictures, or experiences to feel calmer or perhaps to help the 

body to heal. 

n Relaxation techniques include deep breathing and exercises to relax your muscles. 

n Hypnosis is a state of relaxed and focused attention. One focuses on a certain feeling, idea, 

or suggestion. 

n Biofeedback is the use of a special machine to help the patient learn how to control 

certain body functions. These are things that we are normally not aware of (such as 

heart rate). 

n Massage therapy brings relaxation and a sense of well-being by the gentle rubbing of 

different body parts or muscles. Before you try this, you need to check with your doctor. 

Massage is not recommended for some kinds of cancer. 

These methods may also help manage stress. Again, talk to your health care team before 

using anything new, no matter how safe it may seem. Ask your health care team for more 

information about where to get these treatments. To learn more, see the NCI booklet Thinking 

About Complementary and Alternative Medicine.
12

Fatigue

Fatigue is more than feeling tired. Fatigue is exhaustion—not being able to do even the small 

things you used to do. A number of things can cause fatigue. Besides cancer treatment, they 

include anxiety, stress, and changes in your diet or sleeping patterns. If you are having some of 

these problems, you might want to:

n Tell your doctor or nurse at your next visit. Ask about medicines that can help with fatigue. 

n Eat a well-balanced diet 

n Plan your days and do only what is important to you 

n Take short breaks every day to rest and relax 

n Take naps

n Ask others for help.

Nausea and Vomiting 

Nausea is feeling sick to your stomach. Vomiting means throwing up. Both can be a problem 

for cancer patients. Untreated nausea and vomiting can make you feel very tired. They can also 

make it hard to get treatments or to care for yourself. There are many drugs to help you control 

nausea and vomiting. Ask your doctor which medicines might work best for you.

You also may want to make these changes to your diet: 

n Eat small amounts of food five to six times a day.

n Avoid foods that are sweet, fatty, salty, spicy, or have strong smells. These may make 

nausea and vomiting worse.

n Have as much liquid as possible. You’ll want to keep your body from getting too dry 

(dehydrated). Broth, ice cream, 

water, juices, herb teas, and 

watermelon are good choices.
13

Nutrition

For some patients, it’s hard to eat the foods they normally enjoy. For others, it’s hard to eat 

anything at all. Are you having trouble eating or digesting food? If so, you may want to talk with 

your doctor about your diet. They may suggest:

n A special diet

n Other ways of getting the nutrition you need

n Tips on eating during treatment 

n Seeing a dietitian.

For more information, see the NCI booklet Eating Hints Before, During, and After 

Cancer Treatment. 

Sleep Problems 

Illness, pain, stress, drugs, and being in the hospital can cause sleep problems. These problems 

may include:

n Having trouble falling asleep

n Sleeping only for short amounts of time

n Waking up in the middle of the night

n Having trouble getting back to sleep.

To help with your sleep problem, you may want to try:

n Reducing noise, dimming lights, making the room warmer or cooler, and using pillows to 

support your body

n Dressing in loose, soft clothing

n Going to the bathroom before bed

n Eating a high-protein snack 2 hours before bedtime (such as peanut butter, cheese, nuts, or 

some sliced chicken or turkey)

n Avoiding caffeine (coffee, tea, cola, hot cocoa)

n Keeping regular sleep hours

n Avoiding naps longer than 15-30 minutes

n Talking with your health care team about drugs to help you sleep.
14

Physical Therapy

Sometimes people with cancer feel pain in different parts of their body. Others feel weak and 

tired. And some feel stiffer than they used to. So it can become hard to move different body 

parts. If you are having any of these problems, your health care team may suggest you see a 

physical therapist. The therapist may use heat, cold, massage, pressure, or exercises to help 

you. Physical therapy may reduce tiredness and help your body function better. It may help 

with strength and balance as well. It also may help with stiffness and other side effects of 

radiation therapy.

Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) treatment can be helpful for some people. 

And some CAM treatments are safe, such as those listed for pain on p. 11. But you may have 

read about different diets, vitamins, and herbs for treating your cancer or symptoms. Talk with 

your health care team before you try anything new. Here’s why:

n Some CAM treatments are not proven to work and could actually harm you. 

n You may have a dangerous reaction. Or the CAM treatment could interfere with the 

medicine your doctor has prescribed. 

n A “natural” product doesn’t mean that it’s a safe product.

Seek information about CAM treatments from trusted sources. Federal agencies and nonprofit 

cancer groups are good sources. You might also want to read the NCI booklet Thinking About 

Complementary and Alternative Medicine: or go to NCI’s Office of Complementary and 

Alternative Medicine (www.cancer.gov/cam). 
15

chapter 5

Your Feelings

“Life has changed again and I can’t help feeling frustrated with all that’s 

going on. One minute I’ll be upset and angry. Then the next minute, I’ll start 

crying all of a sudden. I just never know what’s coming next.” —Kathy

People feel so many emotions when they find out that their cancer has come back. Shock, fear, 

anger, and denial are just a few. The new diagnosis hits them as hard as it did the first time, or 

even harder.

Regardless of your first reaction, starting cancer treatment again can place even more 

demands on your mind and spirit. You’ll have good days and bad days. So just remember that 

it’s okay to feel a lot of different emotions.

Some of these emotions may be ones you have had at other times in your life. But you may 

be feeling them more intensely. If you have dealt with them in the past, you may be able to 

cope with them now, too. If some of the feelings are new, or are so strong that it is hard to get 

through everyday activities, you may want to ask for help.

There are many people who may be able to help you. These include health psychologists, 

oncology social workers, other mental health experts, and leaders in your faith or spiritual 

community. They know many ways to help you cope with your feelings. See the section on 

page 21 for other ideas on how to cope.

Stress

“Once you get diagnosed again and go through more surgeries or procedures, 

your life is not normal. It’s always in the back of your mind. What now? 

What’s next?” —Margaret

Stress is a normal reaction to cancer. After all, you’re dealing with a lot: treatment, family, your 

job, money, and day-to-day living. Sometimes, you may not even notice that you are stressed. 

But your family and friends probably see a change. 

Anything that makes you feel calm or relaxed may help. So try to think of things that relax you 

and that you enjoy doing. Some people try deep breathing, listening to tapes that have nature 

sounds, or listening to music. See page 22 for more ideas on how to relieve stress.
16

Hope

“I just keep telling myself, ‘You’ve got to have hope, you’ve got to have faith, 

because anything can happen.’” —Phil

While you may be sad or depressed about your cancer recurrence, you do have reasons to feel 

hopeful. Science has advanced and cancer treatments have improved. So more people are 

surviving cancer than ever before. Nearly 10 million people who have a history of cancer are 

alive today. 

In other words, cancer is becoming a disease that doctors can manage. To help build your 

sense of hope:

n Plan your days as you have always done.

n Don’t limit the things you like to do just because you have cancer.

n Look for your own reasons to have hope. 

Gratitude 

“I do have a lot of bad days, but you know, I don’t talk about those. 

I forget those. I think about all the good things, and I have a lot of nice 

times when I’m with my grandchildren, when I go to church, and when 

I’m with my friends.” —Helen

Some people see their cancer coming back as a “wake-up call.” They may realize the 

importance of enjoying the little things in life. They go places they’ve never been. They finish 

projects they had started but put aside. They spend more time with friends and family. They 

mend broken relationships.

It may be hard at first, but you can find joy in your life. Take note of what makes you smile. Pay 

attention to the things you do each day that you enjoy. They can be as simple as drinking your 

morning coffee, sitting with a pet, or talking to a friend. These small, day-to-day activities can 

give you comfort and pleasure. 

You can also do things that are more meaningful to you. Everyone has special things, both 

large and small, that bring meaning to their life. For you, it may be visiting a garden in your city 

or town. It may be praying in a certain chapel. Or it could be playing golf or some other sport 

that you love. Whatever you choose, embrace the things that bring you joy when you can.
17

Anxiety 

“I get overwhelmed a lot. There’s so much to deal with right now. 

And I still have to deal with all the things that were going on before 

I got sick again. How am I going to get to the store before it closes? 

Has the dog been fed? What about the report that’s due at work? 

I start to panic when I think of all the things on my plate.” —Jing

Cancer takes a toll on both your body and your mind. You are coping with so much now. 

You may feel overwhelmed. Pain and medicines for pain can also make you feel anxious or 

depressed. And you may be more likely to feel this way if you have had these feelings before. 

Here are some signs of anxiety:

n Feeling very tense and nervous

n Racing heartbeat 

n Sweating a lot

n Trouble breathing or catching your breath

n Having a lump in your throat or a knot in your stomach

n Feeling fear.

Feeling anxious can be normal. But if it begins to disrupt your daily life, tell a member of 

your health care team. They can suggest someone for you to talk to. Or they can give you 

medicines that will help. Some of the nondrug choices for pain may work for your anxiety 

as well (see page 18).

“Every tomorrow has two handles. We can take hold of it with the handle 

of anxiety or with the handle of faith.” —Henry Ward Beecher

Fear

“Honestly, I feel scared about a lot of things. Stuff I try not to think about. 

It comes and goes, but there always seems to be something. Even when I’m 

having good days, the fear is always in the back of my mind. It never goes 

away really.” —Deena

It’s normal to feel scared and worried. You may be afraid of pain or other side effects, either 

from the cancer or the treatment. You may worry about looking different as a result of your 

treatment. You may worry about taking care of your family, paying your bills, and keeping your 

job. You may be afraid of dying.
Signs of Depression

n Feeling helpless or hopeless, 

or that life has no meaning

n No interest in family, friends, 

hobbies, or things you used 

to enjoy

n Loss of appetite

n Feeling short-tempered 

and grouchy

n Not being able to get certain 

thoughts out of your mind

n Crying for long periods of 

time or many times each day

n Thinking about hurting or 

killing yourself

n Feeling “wired,” having 

racing thoughts or 

panic attacks

n Sleep problems, such as 

not being able to sleep, 

having nightmares, or 

sleeping too much.

18

It’s hard to deal with the fear of so many unknowns. 

Some people say it helps if you know what to expect in 

the future. Ask your health care team questions, so you 

can understand more about your cancer and treatment 

choices. Also, update your will and other legal papers, 

if you haven’t already done so. Then you won’t have to 

worry about them. 

Fear can be overwhelming. Remember that others have 

felt this way, too. It’s okay to ask for help.

Sadness and Depression

“I feel sad a good bit of the time now. 

One thing that cheers me up is to be with 

my 4-year-old grandson. I love watching 

him as he grows more and more each day. 

Sometimes just thinking about him makes 

me feel better.” —Pat

Sadness is a normal response to any serious illness. You 

may feel sad that you have to go through treatment again. 

You may feel sad that life won’t be quite the same from 

now on. 

It’s okay to feel blue. You don’t need to be upbeat all the 

time or pretend to be cheerful. Many people say that 

they want the freedom to just give in to their feelings 

sometimes. But others say that it helps to look for what is 

good in life, even in the bad times. 

Depression can happen when sadness or despair seems 

to take over your life. Some of the signs listed on the next 

page are normal at a time like this. But if they last more 

than two weeks, talk 

to your doctor. Some 

symptoms could 

be due to physical 

problems. This is why 

it’s important to let 

your doctor know 

about them.
19

Anger

“It challenged my faith... But I’ve come out of it okay. It was tough in the 

beginning, trying to understand why this would happen to me.” —Bob

You may also feel angry or frustrated. It’s normal to ask, “Why me?” You may be mad at the 

cancer, your doctors, or your loved ones. If you are religious, you might even be angry with God. 

If you feel angry, it’s helpful to remember that you don’t have to pretend that everything is okay.

Try to figure out why you are angry. Anger sometimes comes from feelings that are hard to 

show. These might be fear, panic, frustration, worry, or helplessness. 

It’s not always easy to look at what is causing your anger. But it’s healthy to try. Being open and 

dealing with your anger may help you let go of it. It’s also good to know that anger is a form of 

energy. You can express this energy through exercise, art, or even just hitting the bed with a pillow. 

Guilt

“I’m so tired all the time. I feel bad that my mom has to take care of me 

and handle things for me like she did when I was younger. I see everything 

she and Dad are dealing with, yet there’s nothing I can do about it. I know 

they hate the fact that I’m going through this. I try to do what I can, but 

I can’t stop feeling guilty for what they are going through, too.” —Anne 

It’s normal for some people to wonder whether they did things that caused their cancer to 

recur. People feel guilty for a number of reasons:

n They worry about how their family and friends feel.

n They envy other people’s good health and are ashamed of this feeling. 

n They blame themselves for certain lifestyle choices. 

n They feel guilty that their first treatment didn’t work.

n They wonder if they waited too long to go back to the doctor. Or they fear that they didn’t 

follow the doctor’s instructions the right way.

But it’s important to remember that the treatment failed you. You didn’t fail 

the treatment. We can’t know why cancer returns in some people and not others. So, it’s 

important for you to try to: 

n Focus on things worthy of your time and energy. 

n Let go of any mistakes you think you may have made.

n Forgive yourself.
20

You may want to share these feelings with your loved ones. Some people blame themselves 

for upsetting the people they love or worry that they’ll be a burden to others. If you feel this 

way, take comfort knowing that many family members say that it is an honor and a privilege to 

care for their loved one. Many consider it a time when they can share experiences and become 

closer to one another. Others say that caring for someone else makes them take life more 

seriously and causes them to reevaluate their priorities. 

If you don’t feel that you can talk openly about these things with your loved ones, getting 

counseling or joining a support group may also help. Let your health care team know if you 

would like to talk with someone about your feelings. 

Loneliness

“I have lots of people around me who care, but I still feel like no one 

really understands.” —Carlos

You may feel lonely, even when lots of people support and care for you. Here are some 

common feelings:

n You feel like no one else understands what you’re going through, even those you love and 

care about.

n You feel distant from others. Or you find that your family and friends have a hard time 

dealing with your cancer. 

n You realize that you aren’t able to take part in as many events and activities as you used to. 

Although it may be harder some days than others, remember that you aren’t alone. Continue to 

do the things you’ve always done as best you can. If you want to, tell people that you don’t want 

to be alone and that you welcome their visits. More than likely, your loved ones have feelings 

like yours. They may feel isolated from you 

and lonely if they are unable to talk with you. 
21

Denial

You may feel that this is not happening to 

you. It’s tough to accept that the cancer has 

come back. Feeling that you need more time 

to absorb everything is natural. You may need 

more time to adjust to the news. But this can 

become a serious problem if it lasts longer 

than it should. It can keep you from getting 

the treatment you need or talking about your 

treatment choices. As time passes, try to keep 

an open mind. Listen to what others around 

you suggest for your care.

Ways You Can Cope

Your feelings will come and go, just like they 

always have. If you have some strategies to 

deal with them, you have already taken a step 

in the right direction. 

Know that many other people have been 

where you are. Some do better when they join 

a support group. It helps them to talk with 

others who are facing the same challenges. 

You may prefer to join an online support 

group. That way you can chat with people 

from home. Be sure to check the privacy 

issues before you join.

If support groups don’t appeal to you, there 

are many experts who are trained to give 

cancer support. These include oncology 

social workers, psychologists or health 

psychologists, counselors, or members of 

your faith or spiritual community. For more 

information, see the Resources section on 

page 37.

What I need at least once or twice 

a week is to talk to one or a group 

of people who are in the same 

shoes as I am.” —Vince 

A Word About Support Groups

You may have heard about support 

groups in your area for people with 

cancer. They can meet in person, by 

phone, or over the Internet. They may 

help you gain new insights into what’s 

happening, get ideas about how to cope, 

and help you know that you’re not alone. 

In a support group, people may talk 

about their feelings and what they have 

gone through. They may trade advice and 

try to help others who are dealing with 

the same kinds of issues. Some people 

like to go and just listen. Others prefer 

not to join support groups at all. Some 

people aren’t comfortable with this kind 

of sharing.

If you feel like you would enjoy outside 

support such as this, but can’t get to a 

group in your area, try a support group 

on the Internet. Some people with cancer 

say that Web sites with support groups 

have helped them a lot. 
22

Ways You Can Cope

You may be able to continue 

many of your regular activities, 

even though some may be more 

difficult than before. Whatever 

you do, remember to conserve 

your strength for the things you 

really want to do. Don’t plan too 

many things for one day. Also try 

to stagger them during the day.

Here are some things other 

people with cancer say have 

helped them cope. As you can 

see, even the little things help!

I built a birdhouse with my 

grandson. We had fun, and I loved 

teaching him about tools.

Spend time with the people I love.

I watch a lot of movies.

I like to fix things around the 

house.

I took up photography. I didn’t 

buy a fancy camera or anything— 

I just started taking pictures.

I’m taking a watercolor class. I’m awful at it, but 

I sure don’t care—anything that gets my mind off 

things.

I like to get my nails done.

I started to follow the stock market.

My nieces call and leave messages or songs on my 

answering machine. I listen to them when I need a fast 

way of cheering up.

Sometimes I drive out to the airport and watch the 

planes. For some reason, it’s very soothing to me.
23

Build model airplanes.

Arrange flowers.

Window shop.

People watch at the mall.

Go to a movie.

Play board games or cards.

Attend local concerts and plays.

Go fishing.

Do the things I enjoy, like 

making phone calls or reading.

Listen to music or a 

relaxation tape.

Do woodcarving.

I like to bird-watch. I sit 

on my porch with a pair 

of binoculars.

Read mystery novels.

Spend time outdoors in a 

community garden or park.

Volunteer or find a way to help 

others in need.

Plant flowers.

Go to worship services.

Knit, crochet, or do needlepoint.

Do crossword puzzles.

Meditate or do relaxation exercises.

Start a new daily routine. 

Accept that it may have to be 

different from your old one—

change is okay!

Talk about feelings with friends, 

family, or a leader in your faith 

or spiritual community. 

Do exercise, yoga or gentle 

stretching.
“There are lots of things 

I still like doing, but I know 

that I can’t do them as well 

or as much. But that doesn’t 

stop me from trying to 

achieve them in a different 

way.” —Sookie
25

chapter 6

Setting Goals 

Cancer treatment can take up a lot of your time and energy. It helps to plan something that 

takes your mind off the disease each day. Aim for small goals each day, such as:

n Exercising

n Completing tasks you’ve been wanting to do

n Making phone calls

n Having lunch with a friend

n Reading one chapter of a book or doing a puzzle

n Listening to music or a relaxation tape.

Many people with cancer also set longer-term goals. They say that they do much better if they 

set goals or look forward to something special. It could be an anniversary, the birth of a child 

or grandchild, a wedding, a graduation, or a vacation. But if you set a long-term goal, make 

sure you are realistic about how you will achieve it. 

Remember, too, that being flexible is important. You may have to change your plans if your 

energy level drops. You may have to adjust your goals if the cancer causes new challenges. 

Whatever your goals, try to spend your time in a way that you enjoy.
“My father and I are so 

much closer. It’s a totally 

different family than 

we were before I was 

diagnosed. We’ve learned 

how to talk about how 

we feel, how to talk to 

each other about what’s 

going on and what we’re 

afraid of.” —Charlie
27

chapter 7

Family and Friends 

Your loved ones may need time to adjust to the news that your cancer has returned. They need 

to come to terms with their own feelings. These may include confusion, shock, helplessness, 

anger, and other feelings. 

Let family members and friends know that they can offer comfort just by:

n Being themselves

n Listening and not trying to solve problems

n Being at ease with you.

Knowing that they are able to comfort you may help them cope with their feelings. 

Bear in mind that not everyone can handle the return of cancer. Sometimes a friend or family 

member can’t face the idea that you might not get better. Some people may not know what to say 

or do for you. As a result, relationships may change, but not because of you. They may change 

because others can’t cope with their own feelings and pain. If you can, remind your loved ones 

that you are still the same person you always were. Let them know if it’s all right to ask questions 

or tell you how they feel. Sometimes just reminding them to be there for you is enough. 

It’s also okay if you don’t feel comfortable talking about your cancer. Some topics are hard to 

talk about with people you are close to. In this case, you may want to talk with a member of 

your health care team or a trained counselor. You might want to attend a support group where 

people meet to share common concerns. 

Family Meetings

Some families have trouble expressing their needs to each other. Other families simply do not 

get along. If you don’t feel comfortable talking with family members, ask a member of your 

health care team to help. You could also ask a social worker or other professional to hold a 

family meeting. This may help family members feel that they can safely express their feelings. 

It can also be a time for you and your family to meet with your entire health care team to solve 

problems and set goals. Although it can be very hard to talk about these things, studies show 

that cancer care is a smoother process when everyone remains open and talks about the issues. 

“It’s a roller coaster ride, so we just ride the roller coaster. I’ve got the 

whole family prepared, and that’s what you have to do when you have 

cancer. Things are going well one minute, but you never know when 

they’re going to change.” —Gwen
28

People Close to You

Often, talking with someone close to you is harder than talking with anyone else. Here’s some 

advice on talking with loved ones during tough times.

Spouses and Partners

n Try as much as you can to keep your relationship as 

it was before you got sick. 

n Talk things over. This may be hard for you or your 

spouse or partner. If so, ask a counselor or social 

worker to talk with both of you together. 

n Be realistic about demands. Your spouse or partner may feel guilty about your illness. They 

may feel guilty about any time spent away from you. They also may be under stress due to 

changing family roles.

n Spend some time apart. Your spouse or partner needs time to address their own needs. 

If these needs are neglected, your loved one may have less energy and support to give. 

Remember, you didn’t spend 24 hours a day together before you got sick.

n Body changes and emotional concerns may affect your sex life. Talking openly and 

honestly is key. But if you can’t talk about these issues, you might want to talk with a 

professional. Don’t be afraid to seek help or advice if you need it. 

Children 

Keeping your children’s trust is very important at this time. Children can sense when things 

are wrong. So it’s best to be as open as you can about your cancer. They may worry that they 

did something to cause the cancer. They may be afraid that no one will take care of them. They 

may also feel that you are not spending as much time with them as you used to. Although you 

can’t protect them from what they might feel, you can prepare them for these feelings.

Some children become clingy. Others get into trouble at school or at home. It helps to keep the 

lines of communication open. Try to:

n Be honest. Tell them you are sick and that the doctors are working to make you better.

n Let them know that nothing they did or said caused the cancer. 

And make sure that they know that they can’t catch it from you.

n Reassure them that you love them. 

n Encourage them to talk about their feelings.

n Tell them it’s okay to be upset, angry, or scared.

n Be clear and simple when you talk, since children can focus only 

briefly. Use words they can understand.

n Let them know they will be taken care of and loved.

n Let them know that it’s okay to ask questions. Tell them that you will answer them as 

honestly as you can. In fact, children who aren’t told the truth about an illness can become 

even more scared. They often depend on their imagination and fears to explain the 

changes around them.
29

Teenagers

Teenagers have some of the same needs as those 

of younger children. They need to hear the truth 

about an illness. This helps keep them from feeling 

needless guilt and stress. But be aware that they 

may try to avoid the subject. They may become 

angry, act out, or get into trouble as a way of 

coping. Others simply withdraw. Try to: 

n Give them the space they need. This is 

especially important if you are relying on 

them more to help with family needs. 

n Give them time to deal with their feelings, 

alone or with friends. 

n Let them know that they should still go to 

school and take part in sports and other 

fun activities.

If you have trouble explaining your cancer, you 

might want to ask for help. A close friend, relative, 

healthcare worker, or trusted coach or teacher 

could help answer your teenager’s questions. Your 

support group, social worker, or doctor can also 

help you find a counselor or psychologist.

Adult Children

Your relationship with your adult children may change now that you have cancer again. You 

may have to rely on them more. And it may be hard for you to ask for support. After all, you 

may be used to giving support rather than getting it.

Adult children have their concerns, too. They may start to think about their own mortality. 

They may feel guilt, because of the many demands on them as parents, children, and 

employees. Some may live far away or have other duties. They may feel bad that they can’t 

spend as much time with you as they would like. Often it helps to:

n Share decision-making with your children.

n Involve them in issues that are important to you. These may include treatment choices, 

plans for the future, or activities that you want to continue. 

n If they aren’t able to be there with you, keep them updated on your progress.

n Make the most of the time you have. Share your feelings with them. 

Try to reach out to your adult children. Openly sharing your feelings, goals, and wishes will 

help them adjust. It will also help prevent problems in the future. Remember, just as parents 

want the best for their children, children want the best for their parents. They want to see your 

needs met effectively and with compassion. Your children don’t want to see you suffer.

When a Parent Has Cancer

“My illness became a vehicle for 

teaching my children lessons I’d want 

to teach them if I’d never been sick. 

Instead of fighting or trying to hide 

all the challenges, I used them to 

teach my kids the value of delayed 

gratification, how to find hope when 

the chips are down, that you are 

the same person inside even if your 

appearance changes, and that you try 

your best and forgive yourself if things 

don’t go well. 

“My treatments became a powerful 

way to say to my children, ‘I love you 

and will do whatever I must to be 

with you.’” —Wendy Harpham, M.D., 

author of When a Parent Has Cancer: 

A Guide to Caring for Your Children
“I really struggled with my diagnosis. 

I couldn’t understand why I had to go 

through this one more time. Although I 

wouldn’t consider myself religious, I found 

that prayer helped me. I began to feel as if 

I had a purpose in life, and that the cancer 

was just part of the plan.” —Bill
31

chapter 8

Looking for Meaning

At different times in life, it’s natural for people to look for meaning in their lives. And many 

people with recurrent cancer find this search for meaning important. They want to understand 

their purpose in life. They often reflect on what they have gone through. Some look for a sense 

of peace or a bond with others. Some seek to forgive themselves or others for past actions. 

Some look for answers and strength through religion or spirituality. 

Being spiritual means different things to different people. It’s a very personal issue. Everyone 

has their own beliefs about the meaning of life. Some people find it through religion or faith. 

Some find it by teaching or through volunteer work. Others find it in other ways. Having cancer 

may cause you to think about what you believe—about God, an afterlife, or the connections 

between living things. This can bring a sense of peace, a lot of questions, or both. 

You may have already given a lot of thought to these issues. Still, you might find comfort by 

exploring more deeply what is meaningful to you. You could do this with someone close to 

you, a member of your faith or spiritual community, a counselor, or a trusted friend. Or you 

may find that talking to others at gatherings and services at places of worship is helpful.

Or you may just want to take time for yourself. You may want to reflect on your experiences 

and relationships. Writing in a journal or reading also helps some people find comfort and 

meaning. Others find that prayer or meditation helps them.

Many people also find that cancer changes 

their values. The things you own and your 

daily duties may seem less important. You may 

decide to spend more time with loved ones 

or helping others. You may want to do more 

things outdoors or learn something new. 
“I’ve been through this 

once, and I’ll get through 

it again. I wish I didn’t 

have to, but that’s the 

challenge before me.” 

—Janet
33

chapter 9

A Time To Reflect

This is a hard time in your life. Living with cancer is tough, especially when it has come back. 

You battled the disease once, and now you must face it again. But you’re more experienced 

this time around.

Use this knowledge to your advantage. Try to remember what you did before to cope. Reflect 

on what you might have done differently. By looking back in this way, the hope is that you may 

find new strength. And that this strength can help carry you through each day, and through the 

coming weeks and months.

“Think only of today, 

and when tomorrow comes, 

it will be today, 

and we will think about it.” 

—St. Francis de Sales
34

Words To Know

Acupuncture (AK-yoo-PUNK-cher): A form of Chinese medicine that stimulates certain points 

on the body. It is often done using thin needles. Before using acupuncture, ask your health care 

team if it is safe for your type of cancer. 

Advance directives: Legal documents that allow you to decide ahead of time how you want 

to be treated when you are unable to speak for yourself. The two main types are living wills and 

durable power of attorney for health care.

Biofeedback: Using a special machine, a person learns how to control certain body functions. 

Examples of such body functions are heart rate and blood pressure.

Biological (bye-uh-LAHJ-uh-kul) therapy: Treatment that aims to use or restore the body’s own 

immune (defense) system. It is used to fight cancer, infections, and other diseases. It is also used 

to reduce the side effects that some cancer treatments cause. Also called immunotherapy.

Breakthrough pain: Pain that is sudden and intense or that is very painful for a short time. It 

can occur several times a day. This can happen even when a person is taking the right dose of 

pain medicine.

Cancer: A term for diseases in which abnormal cells divide out of control. Cancer cells can 

invade nearby tissues and spread through the bloodstream and lymphatic system to other parts 

of the body.

Chemotherapy (kee-moh-THAIR-uh-pee): Treatment with drugs that kill cancer cells.

Clinical trial: A type of research study that tests new methods of screening, prevention, 

treatment, or diagnosis of a disease. Also called a clinical study.

Complementary and alternative medicine (CAM): Treatment used along with, or instead of, 

standard health care. CAM includes methods such as acupuncture and massage. Some CAM 

treatments may help relieve cancer symptoms or side effects. But not all CAM treatments are 

safe. And they should not take the place of standard health care.

Diagnosis (dye-ug-NOH-sis): The name and details of your disease or health condition.

Dietitian (dy-uh-TIH-sun): A person with special training in nutrition, who can help you with 

choices in your diet. They also can suggest ways to make eating easier.

Distant cancer: Cancer that has spread from the primary tumor to distant organs or lymph nodes.

Durable power of attorney for health care: This type of advance directive appoints a person 

(a health care proxy) to make medical decisions for you when you can’t make them for yourself.
35

Health care proxy: The person you have named in an advance directive to make medical 

decisions for you. This person can make health care choices for you when you can’t make them 

for yourself.

Health psychologist: A mental health professional who works with people and families affected 

by illness.

Hypnosis: A state of relaxed and focused attention. The person focuses on a certain feeling, 

idea, or suggestion. 

Imagery: A method in which a person focuses on positive images in their mind.

I.V.: Short for intravenous (in-truh-VEE-nus). It means to get medicine or nutrients into the 

body through a vein.

Living will: A type of advance directive. A living will is a legal document that lets people know 

what kind of medical care you want if you are unable to speak for yourself.

Local cancer: Cancer that appears only in the organ where the cancer began. It has not spread 

beyond the original site.

Lymph (limf) nodes: Small, bean-shaped organs that are part of the lymphatic system. 

Bacteria or cancer cells that enter the lymphatic system may be found in the nodes. Also 

called lymph glands.

Massage therapy: Gentle rubbing of different body parts or muscles to help you relax and gain 

a sense of well-being. 

Metastasis (meh-TASS-tuh-sis): The spread of cancer from one part of the body to another. 

Cells that have metastasized are like those in the original tumor.

Notary public: A person with authority from the courts to witness legal documents and 

signatures.

Oncologist (ahn-KAH-luh-jist): A doctor who specializes in treating cancer.

Oncology social worker: A social worker who specializes in helping cancer patients and 

their families.

Palliative (PAL-ee-yuh-tiv) care: Care to improve the quality of life of people with a serious or 

life-threatening illness. The goal of palliative care is to prevent or treat as early as possible:

•	 Symptoms of the disease

•	 Side effects caused by treatment

•	 Psychological, social, and spiritual problems related to the disease or its treatment.

Also called comfort care, supportive care, and symptom management. 
36

Power of attorney: Appoints a person to make financial decisions for you when you can’t make 

them yourself.

Radiation (ray-dee-AY-shun) therapy: Treatment with high-energy radiation to kill cancer cells.

Recurrence (ree-KUR-ens): Cancer that has come back after a period of time during which it 

could not be found. The cancer may come back to the same place as the original tumor or to 

another place in the body. Also called recurrent cancer.

Recurrent cancer: See “recurrence.”

Regional cancer: Cancer that has grown beyond the original tumor to nearby lymph nodes or 

organs and tissues.

Relaxation techniques: Different methods, such as deep breathing and relaxing the muscles, 

that are used to reduce tension and anxiety and to control pain. 

Second opinion: When you go to another doctor after getting a diagnosis. The second doctor 

looks at your test results and examines you, just as the first one did. The second doctor may or 

may not make the same diagnosis. And they may or may not recommend the same treatment. 

Either way, you will have more information. This may help you decide on your treatment.

Specialist: A doctor who has studied and trained in a certain area of medicine.

Standard treatment: In medicine, treatment that experts agree is appropriate, accepted, and 

widely used. Also called standard of care or best practice.

Surgery (SER-juh-ree): A medical procedure that involves entering or cutting into the body. 

Surgery is used to remove or repair a part of the body or to find out whether disease is present. 

Trust: This type of legal document appoints a person you choose to manage your money for you . 

Tumor (TOO-mur): An abnormal mass of tissue.

Will: This type of legal document tells how you want to divide your money and property 

among your heirs. 
37

Resources

Federal Resources

n National Cancer Institute 

Provides current information on cancer prevention, 

screening, diagnosis, treatment, genetics, and 

supportive care. Lists clinical trials and specific cancer 

topics in NCI’s Physician Data Query (PDQ®) database.

Visit: www.cancer.gov 

Cancer Information Service 

Answers questions about cancer, clinical trials, and cancer-related services and helps users 

find information on the NCI Web site. Provides NCI printed materials.

Toll-free: 1-800-4-CANCER (1-800-422-6237)

Visit: www.cancer.gov/cis 

Chat online: Click on “LiveHelp.” 

n Administration on Aging 

Provides information, assistance, individual counseling, organization of support groups, 

caregiver training, respite care, and supplemental services.

Phone: 1-202-619-0724

Visit: www.aoa.gov 

n Centers for Medicare and Medicaid Services 

Provides information for consumers about patient rights, prescription drugs, and health 

insurance issues, including Medicare and Medicaid.

Toll-free: 1-800-MEDICARE (1-800-633-4227)

Visit: www.medicare.gov (for Medicare information) or 

www.cms.hhs.gov (other information)

n Equal Employment Opportunity Commission 

Provides fact sheets about job discrimination, protections under the Americans 

With Disabilities Act, and employer responsibilities. Coordinates investigations of 

employment discrimination.

Toll-free: 1-800-669-4000

TTY: 1-800-669-6820

Visit: www.eeoc.gov

For more resources:

See National Organizations 

That Offer Cancer-Related 

Services at www.cancer.gov. 

In the search box, type in the 

words “national organizations.” 

Or call 1-800-4-CANCER 

(1-800-422-6237) to seek 

more help.
38

n U.S. Department of Labor Office of Disability Employment Policy 

Provides fact sheets on a variety of disability issues, including discrimination, workplace 

accommodation, and legal rights.

Phone: 1-866-633-7365

TTY: 1-877-889-5627

Visit: www.dol.gov/odep/ 

Private/NonProfit Organizations

n American Cancer Society

National Cancer Information Center

Available to answer questions 24 hours a day, 7 days a week.

Toll-free: 1-800-ACS-2345 (1-800-227-2345)

Visit: www.cancer.org

n CancerCare 

Offers free support, information, financial assistance, and practical help to people with 

cancer and their loved ones.

Toll-free: 1-800-813-HOPE (1-800-813-4673)

Visit: www.cancercare.org

n Cancer Support Community

Cancer Support Community is a national organization that provides support groups, 

stress reduction and cancer education workshops, nutrition guidance, exercise sessions, 

and social events.

Phone: 1-888-793-WELL (1-888-793-9355) 

Visit: www.cancersupportcommunity.org

n Kids Konnected 

Offers education and support for children who have a parent with cancer or who have lost a 

parent to cancer. 

Toll-free: 1-800-899-2866 

Visit: www.kidskonnected.org 
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n Lance Armstrong Foundation

The Lance Armstrong Foundation seeks to inspire and empower people living with, 

through, and beyond cancer to live strong. It provides education, advocacy, and public 

health and research programs.

Phone: 1-512-236-8820 (general number)

1-866-235-7205 (LIVESTRONG SurvivorCare program)

Web site: www.livestrong.org

n National Coalition for Cancer Survivorship 

Provides information on cancer support, employment, financial and legal issues, advocacy, 

and related issues.

Phone: 1-877-NCCS YES (1-877-622-7937)

Visit: www.canceradvocacy.org

n National Employment Lawyers Association 

Can help find a lawyer experienced in job discrimination cases.

Phone: 1-415-296-7629

Visit: www.nela.org

n NeedyMeds—Indigent Patient Programs

Lists medicine assistance programs available from drug companies. 

NOTE: Usually patients cannot apply directly to these programs. Ask your doctor, 

nurse, or social worker to contact them.

Visit: www.needymeds.com

n Patient Advocate Foundation 

Offers education, legal counseling, and referrals concerning managed care, insurance, 

financial issues, job discrimination, and debt crisis matters.

Toll-free: 1-800-532-5274

Visit: www.patientadvocate.org
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Notes

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NIH Publication No. 11-2709

Printed September 2011